Q: A patient presents with blood in their stool, underwent colonoscopy positive for cancer and was taken to the OR for sigmoidectomy as definitive treatment. There was not an impending bowel obstruction and the resection was definitive treatment. A week after surgery the patient had a PET scan and MRI which both demonstrated liver mets. The patient was started on chemotherapy. Since clinical stage stops at definitive treatment, can we stage as cM1?
A: Yes, you may code a cM1 as exceptions can be made to the timing rule to truly represent the patients stage, how they will be treated and provide correct prognostic information.
Cancer Forum reference: http://cancerbulletin.facs.org/forums/forum/ajcc-tnm-staging/breast-chapter-32/2751-ajcc-stage-clinical-finding-after-treatment?_=1439832359245