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Ask Internist Your Own Question
Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 1066
Experience:  MBBS,MD (USA)Diplomate American Board of Internal Medicine
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What is a aortocaval node ?

Customer Question

What is a aortocaval node ?
Submitted: 2 years ago.
Category: Medical
Expert:  Internist replied 2 years ago.
Hi
Aortocaval Node is one of the lymph node groups located around aorta,
Nodes around the aorta are divided into groups Pre aortc,retro-aortic, and Right and left lateral aortic nodes.
The purpose of the lymph nodes is to drain lymph,and relatively big particles which are not drained by capillaries and blood vessels.
I hope the info helps
Customer: replied 2 years ago.

I see . i ask as my dad had colon cancer surgery in march where colon tumor was removed . There was no distant spread . But a pet scan in sept showed a met in the aortocaval node at 10 mm and a met in the liver at 1.6cm.

I was worried re the node .what would be best treatment and

is this serious issue ?

Expert:  Internist replied 2 years ago.
Thanks for your prompt response,
I am sorry to hear about your father's illness
Unfortunately it is a problem, and if that node is lighting up on PET CT , it needs investigation ,mets in the liver and nodes make it metastatic disease.
The lighting up intensity is reported as SUVs, so your oncologist will look at that number reported in PET CT..
I would suggest to get back to oncologist and gastroenterologist so that diagnostic testing like liver biopsy or node biopsy can be done.
The doctor may do blood tests for tumor markers e.g CEA and Alpha fetoprotein first..
Early initiation of chemotherapy would be required if the disease is proven to metastatic.
Hope it helps
Customer: replied 2 years ago.

1 liver met was SUV uptake of 5.2

and the node lit up. cea last

was 8.

what can the chemo

actually do?

would ablation / removal not be better ?

Expert:  Internist replied 2 years ago.
Thanks for your reply and details,
SUV is high enough to sugges that these are metastasis and the recommended treatment would be chemotherapy
Chemotherapy can regress the size of tumor mets and prolong survival
With multiple site mets including lymph node and liver lesion there is no role of surgical resection or ablation.

I hope that helps
Customer: replied 2 years ago.

y would there be no role in ablation removal with 1 node and 1 met?plus they are both small

what is survival like ?

Expert:  Internist replied 2 years ago.
Hi
Well there is trend for surgical resection of isolated liver mets, some people even resect two lesions in liver as well as long as it is less than 5 % involvement.

Now regarding nodal disease, there is very limited data and it usually happens in less than 2% of the patients that they can have solitary nodal involvement which might be a surgical candidate,

Combined liver and nodal mets make risks of surgery outweight the benefits
But again as i mentioned he needs to see oncologist at the earliest...

five years survival with stage IV disease if widely metastatic is 10-15%
but with limited and treatbale disease is better that which is probably his case and is around 35-50% if remained controlled
Customer: replied 2 years ago.

Short survival

is more for lots of mets right and large ones ?

well they have started folfiri recently and will

scan in january .

but with folfiri can he get more spread while on it?

Expert:  Internist replied 2 years ago.
Thanks for the additional info

I am glad you mentioned that they already started him on.
Survival is related to the number and extent of tumor burden and metastasis

While being on treatment, chances of getting more spread is very less likely..

I hope i have answered your question, please click ACCEPT if you are satisfied with the answer, you can always ask any follow up questions if you have,in this way i get credit for the time ...
Thanks
Internist and 4 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

so what you think with 1 node n 1 liver met at present ?

i am worried that scan in jan will show more ?

hjs cea is 8. Should it not be more higher ?

Expert:  Internist replied 2 years ago.
I understand your concern and what your are going through,
Unfortunately there is no way to predict that scan in Jan is going to show more, most likely and hopefully with the therapy it should not show more.....

CEA Levels of 8 is high, more than 5 is considered abnormal.
Its value in patients who have alreadu undergone surgery for primarty tumor is of significant importance and serial 2-3 months surveillance for about 2 years is recommended to see any evidence of recurrence, so i would not ignore it for sure and it is abnormal..

Lets hope the therapy works and his repeat Scan shows regression and improvement...

I hope that helps
Customer: replied 2 years ago.

Can further mets appear still on folfiri. ?


 


Also , does this mean initially xeloda did not work , ? but he did start them 12 weeks post surgery ( late ) as he was not sure he wanted pills and it was stopped 4 th cycle as scans were being carried out .


 


That's y I think may be folfiri may not work

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