In order to plan the treatment strategies we need to know whether this patient has a metastatic disease or just a locally advanced one.
Are there any other lymph nodes involved ? Has the patient been fully staged with PET and also laparoscopy ?
Of course this would have been M1a on TNM 6 but this is no longer the categorisation. However this patient must have a very high risk of occult micrometatstatic disease given the distribution of the cancer
Thanks Andrew
No. There was not any other than celiac node in CTscan. The patient could not afford PET scan. Laparoscopy was not carried out.
PET is quite important you would think as somewhere between 10-30 % of these patients may have additional updtaging after PET in this scenario.
For upper SCC we normally treat with definitive CRT if local disease. Were you considering surgery as part of the treatment depending on the coeliac node staging ?
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