Pathology NX MX

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Regular Member

Date Joined Feb 2011
Total Posts : 45
   Posted 5/18/2011 1:12 PM (GMT -6)   
Does this mean that all is well, or just that the lymph nodes were not removed, so the pathologist can't tell if there is not metastases?

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 5/18/2011 1:17 PM (GMT -6)   
Means cannot be assessed....thus they don't know...weren't sampled on the nodes and unknown on mets at that time.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 5/18/2011 1:22 PM (GMT -6)   

From Google:

"We pathologists only can make assessments based on tissue provided us.

The Mx indicates that the pathologist had no tissue to assess whether any distant spread had occurred. It is a subtle distinction. Similarly, if I am not provided any lymph nodes to examine, then the N would be reported as Nx."

Regular Member

Date Joined Feb 2011
Total Posts : 45
   Posted 5/18/2011 1:24 PM (GMT -6)   
Geez...........I wonder why not provided. Always something to worry about.....
Thank you .

Forum Moderator

Date Joined Jan 2010
Total Posts : 7084
   Posted 5/18/2011 1:31 PM (GMT -6)   
If Lymph nodes were provided to the pathologist, they would be listed in the summary of the tissue samples. Not all surgeons take them, and when they do, it seems that the number is all over the place.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -

Veteran Member

Date Joined May 2009
Total Posts : 739
   Posted 5/18/2011 3:40 PM (GMT -6)   
As others have said, this means they were not assessed. But it also means the surgeon didn't think it was necessary to take them out, which is a good sign, at least in the case of good surgeons. Can he have made a mistake and left in some positive ones? Sure, in fact I may be a case for that, although I doubt if they would have seen anything even if some had been removed.
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 and 19 month detectable .05.

Veteran Member

Date Joined Feb 2011
Total Posts : 4093
   Posted 5/18/2011 3:50 PM (GMT -6)   
The MX made me uncomfortable also until a friend explained that it can't be anything else because the surgery itself cannot produce such a determination.

Surgical skill, nerve sparing has also a lot to do with the margins. That's why my mother was happy my surgery took a little longer than usual, she said "it must mean he took a really good look inside".
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2218
   Posted 5/19/2011 12:22 AM (GMT -6)   
Mx is almost always the case after surgery as the surgeon does look for mets. In fact he can't really look for mets as they are not going to be in the area he is working in.

Nx is also common, as unless it has been agreed beforehand, then lymph nodes will not be removed and sent to the lab. (However, if a surgeon spots something "suspicious" then he might well remove a lymph node, but there may also be the issue here of whether or not he has received consent from the patient to do so! )

Age dx 48
Apr 09 PSA 8.6
DRE neg
Biop 2/12 pos
Gleason 3+3
Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
Nov 09 PSA 0.1
Mar 10 PSA 0.4 sent to RT
13 Apr CT
RT 66Gy ends 11 Jun 10
Tired + weird BMs
Sep 10 PSA <0.1
Jan 11 PSA <0.1
Apr 11 PSA <0.1
Erection OK
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