Role of Pathologist in OC

Question 1

What is role of pathologist prior, during and after tx?

Answer 1

Prior: establish/confirm dx and report prognostic feature

During: assess completeness of excision

Afer: completeness of excision, report factors affect further tx planning

Question 2

What is reported on in initial incisional biospy?

Answer 2

Depth invasion - superficial or into structures
Pattern of invasion
Degree differentiation

Question 3

What is done to samples prior reporting?

Answer 3

Sample area frozen

Can be snap frozen in nitrogen - useful mid surgery

Question 4

Adv and disadv w/ frozen section reporting during surgery?

Answer 4

Adv: determine if complete excision - can remove more

Disadv: prolong time op, expensive, may not increase pt prognosis

Question 5

What does pathologist report on aftet tx?

Answer 5

Extend, spread and completeness of excision

Extent of spread

Question 6

What depth of invasion in related to a poorer prognosis?

Answer 6

> 4mm

Question 7

What are different patterns of invasion?

Answer 7

Cohesive or non-cohesive

Question 8

What is reported in final report of primary tumour?

Answer 8

Diameter
Depth and pattern invasion
Grade of tumour
Clearance of margins
Invasions

Question 9

What is reported on if neck dissection is undertaken?

Answer 9

No nodes each level

No nodes w/ metastasis

Question 10

If have cancer lateral border of tongue what levels would expect to see lymph node involvement?

Answer 10

Level II, III

Question 11

What does pathologist do in MTD meetings?

Answer 11

Reports on completeness of excision and factors important in prognosis
Liase w/ others about appropriate tx