Posted by CLDing on May 13, 1999 at 12:03:54:
In Reply to: Re: Yet another RCC posted by Chit Sin on May 12, 1999 at 10:18:17:
Is there a previous postop CT to show that the left crus area was clear? 2x3 cm is not very big and unless it is discrete, what I wrote earlier about CT of adrenal gland will apply, and I will certainly go along with you to wait and rescan in 3 months. After all the chance of cure in such circumstances is only about 10% (adopting figures for so-called solitary recurrences, admittedly mainly colonic ca cases). Halstead's concept of cancer surgery still applies today. I am a pessimist in this area and would find a reason not to operate rather than to rush in, even if the CT is correct. I think informed consent is important in these difficult circumstances, especially warning patient that the whole operation may prove to be futile a few months after it is over. If I have to do it for this guy, it would be a left flank supra-12 approach.