Dear OncoLink "Ask The Experts,"
Would you advise or think it necessary for any treatment following a colorectal resection for the following: adenocarcinoma, arising within a tubulovillous adenoma with high grade dysplasia, proximal and distal margins free of tumor, radial margin free of tumor, and 0 (zero) number of lymph nodes with metastatic carcinoma.
James M. Metz, MD, Editor-in-Chief of OncoLink and Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:
There are a number of factors that are considered when deciding if postoperative therapy is needed with either chemotherapy or radiation therapy. This includes the location of the tumor within the rectum or colon, the type of surgery performed, and the total number of lymph nodes removed, even if they are all negative. Typically tumors that are found incidentally in a tubulovillous adenoma are of an early stage, but each of the factors listed above still has a bearing on whether postoperative treatment is recommended. You should have this discussion with your physicians to weigh the pros and cons of postoperative treatment.