Tumor size and metastasis???

[carolhg]

Does anyone know if there is a relation between the size of a tumor and whether it metastasizes of not? Does a small tumor mean that it most likely has not spread and a larger tumor mean that it has spread? Or is there no relationship at all between the size of the tumor and whether it metastasizes or not. I have heard that pancoast tumors, though they tend to be larger do not metastasize like other tumors. I was curious about andeocarcinoma tumors.

[TracyD]

I don't know what the relationship is, if any. All I know is what my own tumor is doing. It has grown from 1.9 cm in february to 4.4 cm this past July with no mets. I'm not sure how large my tumor is by any scale, but I know that to me it's WAY too big.

Tracy

[Don Wood]

I don't believe tumor size correlates with metastasis. One could have a large tumor that has not escaped, or one could have a small tumor that cells have escaped from. My wife had just a trace of tumor on her lung, yet it was all over the body. I think metastasis has more to do with the aggreessiveness of the tumor. Don

[RandyW]

Tumor Size Linked to Metastasis in Early Lung Cancer

By Judith Groch, MedPage Today Staff Writer

Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.

February 14, 2006

MedPage Today Action Points

Be aware that the subdivisions in this analysis of tumor size and metastasis are not yet the standard staging protocol.

Additional Lung Cancer Coverage

Review

NEW YORK, Feb 14 - The likelihood of asymptomatic early lung cancer's spread to the lymph nodes may depend on only a few millimeters of tumor size, researchers here have found.

In investigations of tiny early tumors found by spiral CT screening, the traditional stage IA and IB system -- either above or below 30 mm in diameter -- proved far too gross for an accurate estimation of non-small-cell lung cancer's nodal spread, they reported in the Feb. 13 Archives of Internal Medicine.

This study suggested that tumor diameter also serves as a prognostic indicator for curability, perhaps even for micrometastases not detectable by our current techniques, said Claudia I. Henschke, M.D., Ph.D., and colleagues at Weill Cornell Medical Center here. Dr. Henschke is a strong believer in using spiral CT screening to find the smallest possible tumors in high-risk patients for resection.

She and colleagues in the International Early Lung Cancer Action Program subdivided the staging to tumors that were 15 mm or less in size, those from 16 to 25 mm, those from 25 to 35 mm, and those 36 mm or greater. Nodal status was determined by independent pathologists.

Her group said it had determined "direct evidence" of a strong predictive relationship between tumor size and metastasis of NSCLC. The relationship also held for the study's few cases of small-cell carcinoma.

Of 28,689 patients at 38 institutions worldwide, screened at baseline with spiral CT for lung cancer, and then later, 436 were diagnosed with asymptomatic NSCLC and 28 with SCLC.

Of the 436 patients with NSCLC, the percentage with no metastases was 91% for tumors 15 mm or less in size, 83% for tumors 16 to 25 mm, 68% for tumors 25 to 35 mm, and 55% for tumors 36 mm or greater, Dr. Henschke's team reported.

The gradients in the successive percentages of no-metastases patients were significantly different, except in the last two categories (p= 0.02, 1-sided), the researchers added.

Analysis of the tumors by consistency found the association strongest for solid tumors, suggestive for part-solid tumors, and not suggestive for non-solid ones.

For small cell solid lung cancers, the relationship of no spread to tumor size was particularly significant, the researchers said. Of 28 SCLC tumors, the no-metastases percentages were 67% (10 of 15) for tumors 25 mm or less, compared with 23% (three of 13) for tumors greater than 25 mm (P =0.01, 1-sided).

Although the stage/size relationship determined from registry cases has been used as a prognostic indicator in early lung cancer, the researchers wrote that the size-based results of this study provide direct evidence of the relationship.

The percentages of non-metastasized cancer in CT screen-diagnosed lung cancers are much higher than previously reported in the Surveillance, Epidemiology, and End Results Registry (SEER), the investigators said.

[blaze100]

Hi Carol, Did you have a large tumor too?

Well I read the stats that say the larger the tumor the worse the prognosis back when I was dx'd. Now this scared me since my tumor was 10 cm. One article I read even said "imminent death" for large tumors like mine.

So I asked my onc and his answer was great. He said if my tumor was going to spread, then it would have happened long ago. The fact that my tumor was so large and still stayed confined to one lung was actually a good sign that it would never ever spread.

Not sure if that's true, but it made sense at the time. It's been almost 6 years now and so far, so good.

Hope this helps. Barb

[carolhg]

My tumor was 2.7 cm on one ct scan and 3.4 on a later one. My concern was that I had two lymph nodes that lit up in the center of my chest. I had chemo and radiation before surgery. 20 nodes were removed during surgery. I was just trying to figure out if the nodes were cancerous and the chemo and radiation cleaned them up or if they were never cancerous to begin with. I did not have them checked until I was on the table for surgery, by then they were clean or they may have been clean all of the time. I was told it does not matter because all turned out well, but I just cannot help but to be curious.

[Andrea]

My mom's was over 5 cm at diagnosis. She was IIIA,so it was just in lymphs

[Littlegirl]

Barb - so glad to hear of your success! My mom also had a whopper. The doc said NSLC is typically a slower growing one. With a 10cm tumor that most likely has been around for awhile we expected to find mets, but (knock on wood) have not.

Carol - my mom also had a questionable lymph node that they said later was not cancerous. I thought I read an explanation somewhere about the way the lymph node works and lung not functioning properly that causes it to enlarge, etc. I don't remember exaclty what I read but it made sense at the time.

Karen

[Connie B]

My tumor was 4.3 cm's and mine had spread to 2 or 3 lymph nodes. I was told size doesn't mean anything as far as spreading goes. That's part of the mystery of this disease, size doesn't matter.

[joanie55]

My tumor was only 1.1 cm., but unfortunately had metastised. I was told size had nothing to do with whether or not it would or could spread.

On my fist visit to the onc, I met a women, about my age, with a 10 cm. tumor that had not spread.

????

If only we knew.

Joan

[TamHol]

I don't think anything is predictable or regular about this.

My Dad started with a mass 3.2cm that grew to be 3.8cm from Feb-June /06 with (presumed to be cancer'ed) lymphnoid on both lungs. To date no spread anywhere using dye, bone and brian scans.

My neighbour started with a 2.3cm mass in Feb /06, after getting all the tatoos and tests for radiation he was changed to terminal. He passed away in July after it steadily spread to the brian. The mass never did grow with the radiation given for pain management etc.

Bottom line both men were in the same general health but the cancer acted completely differently in each of them within the same time frame.

I look at each of the postings comments and found not one of are simular outside of medications used.

I came here to find out the same thing and maybe prepredict what this will do ........ I haven't gotten past Go on this one.

Tammy

[blaze100]

Hi Carol, Oh now I can understand why you are wondering - that darn guy staged you based on just a Pet of those nodes without biopsying them.

Pet spots can come and go. You know, if they staged folks based on pet spots, then I've been to stage III and back a couple times.

So if it were me sitting in your shoes and doing so well, I'd tend to believe they most likely over staged me.

I hope this helps Carol.

Barb

[Welthy]

I agree with Tammy -- no one can predict how cancer will spread in each body. Tony had a 3 x 5 cm primary tumor and the cancer spread with hundreds (they said way too many to count) of tumors in both lungs, in between, etc., yet NOT one tumor ever went outside of the chest area. Why not brain, liver, or bone mets -- who knows? (And knocking on wood that he doesn't have any either!) I still can't get a handle on the lack of logic this disease has.

Welthy

[chrissy63078]

My mom has only (1) 1.7 com mass on her upper left lobe and (1) metasis on her left Axillary Lymph node in her armpit. The axillary lymph node is considered distant cancer.

Chrissy