Presentation on theme: "Statistics and Medicine – Friends or Foes? Monika Krzyzanowska MD MPH Medical Oncologist, Princess Margaret Cancer Centre Associate Professor of Medicine,"— Presentation transcript:
Statistics and Medicine – Friends or Foes? Monika Krzyzanowska MD MPH Medical Oncologist, Princess Margaret Cancer Centre Associate Professor of Medicine, University of Toronto
Case 61 year old male tailor Presented with iron deficiency anemia Colonoscopy: tumour in colon Sent to general surgeon who removed the primary cancer from the colon The surgeon has referred the patient to you (medical oncologist) for an opinion regarding what to do next?
What do you need to know to advise the patient on next steps? How serious is the cancer? What are the “treatment” options? What are the benefits of treatment? What are the risks?
TNM Staging System T: depth of invasion into bowel wall – T1Invasion of submucosa – T2Invasion into muscularis propria – T3Invasion through muscularis into serosa – T4Invasion of other organs +/- perforation N: regional nodes – N0No nodal mets – N1Mets to 1-3 lymph nodes – N2Mets in 4 nodes M: distant metastases
TNM Staging System TNM ClassificationDukes’Survival (no tx) Stage IT1N0M0 T2N0M0 A> 90% Stage IIIIA IIB T3N0M0 T4N0M0 B60-85% Stage IIIIIIA IIIB IIIC T1-2N1M0 T3-4N1M0 anyTN2M0 C25-65% Stage IVanyTanyNM1D5%
Case Revisited CT scans – no spread of disease Pathology – Adenocarcinoma – invading through the muscularis into serosa – 7/15 LN involved with tumour Stage: pT3N2M0 (Stage 3)