I am currently receiving adjuvant chemotherapy (16 weeks of cisplatin/vinorelbine) after a LUL lobectomy removing a 1.9cm peripheral adenocarcinoma that invaded the visceral pleura (PL1). The main tumour had a 'relatively predominant lepidic pattern on the periphery' with an invasive component that was acinar. The report doesn't state the relative proportions numerically.
The pathologist also found two other areas in the completion lobectomy. One was a 2mm area of aah and the other was a 2mm area of 'carcinoma in situ' that was labelled a satellite nodule although the report is negative for 'intrapulmonary metastases' it states that this additional area 'had a lepidic pattern that is suggestive of endobronchial spread'.
No cancer was found in lymph nodes. I also had a mediastinoscopy, ct and pet scans prior to surgery with no mets or lymph nodes found positive. However the ct scan found several tiny 2mm nodules that suggested to follow in other parts of my lung.
I have read a couple of papers that suggest that lepidic type cancers can present multifocal and carcinoma in situ should not be used to upstage cancers. However my report was staged at T3 because of the satellite nodule and therefore stage 2.
Do you think I should be T2 (because of vpi) and stage 1 instead?
There also was no LVI or necrosis or anything else of concern in the report.
I am wondering if I am wasting my time, health and energy getting chemo and would really appreciate another opinion. I can say that I live in Canada and my pathology report was reviewed and signed off on by 2 pathologists.