CS Extension

Notes

**Note 1**: AJCC does not include a Tis category for gastrointestinal stromal tumors (GIST). Any case with a CS Extension code of 000 is mapped to TX for AJCC 7 stage and in situ Summary Stage. **Note 2**: Ignore intraluminal extension to adjacent segment(s) of colon/rectum or to the ileum from the cecum; code depth of invasion or extracolonic spread as indicated. **Note 3**: The assignment of T categories for GISTs is based on tumor size. A physician's statement of the T category may be used to code CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently: for example the record may document size but not extension, other than the physician's statement of the T category. Use codes 170, 210, 250, and 270 as appropriate to code CS Extension based on a statement of T when no other extension information is available. **Note 4**: Use code 150 only if GIST is described as arising in a polyp. Do not use this code for GIST described as arising in the wall of the colon and extending into the lumen with a polypoid appearance. **Note 5**: Use code 300 for localized cases only if no information is available to assign a more specific code. **Note 6**: Use code 570 for tumor with macroscopic adhesions to other organs or structures and for pathologically confirmed tumor in adhesions. However, if no tumor is present in adhesion(s) upon microscopic examination, use lower codes to describe the microscopically confirmed depth of tumor invasion for these cases (excluding adherence to liver, see Note 7). **Note 7**: Adherence to the liver capsule is not considered distant metastasis. Use code 570 for any adherence to the liver capsule. **Note 8**: Codes 600-800 are used for contiguous extension from the site of origin. Discontinuous involvement is coded in CS Mets at DX.Code
Code Description AJCC 7 T AJCC 6 T Summary Stage 1977 T Summary Stage 2000 T
000 In situ, intraepithelial, noninvasive TX NA IS IS
050 OBSOLETE DATA RETAINED AND REVIEWED V0203
See code 000

(Adeno)carcinoma in a polyp or adenoma noninvasive
TX NA IS IS
100 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Invasive tumor confined to mucosa, NOS (includes intramucosal, NOS)
Extension Size AJCC7 NA L L
110 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Lamina propria
Extension Size AJCC7 NA L L
120 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Confined to and not through the muscularis mucosae
Extension Size AJCC7 NA L L
130 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Confined to head of polyp, NOS
Extension Size AJCC7 NA L L
140 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Confined to stalk of polyp, NOS
Extension Size AJCC7 NA L L
150 Invasive tumor in polyp, NOS Extension Size AJCC7 NA L L
155 Tumor confined to muscular wall Extension Size AJCC7 NA L L
160 OBSOLETE DATA RETAINED AND REVIEWED V0203
See codes 155 and 165

Invades submucosa (superficial invasion)
Extension Size AJCC7 NA L L
165 Tumor invades through submucosa and muscularis mucosae to involve mucosa Extension Size AJCC7 NA L L
170 Stated as T1 with no other information on extension Extension Size AJCC7 NA L L
200 OBSOLETE DATA RETAINED AND REVIEWED V0203
See code 155 and 165

Muscularis propria invaded
Extension Size AJCC7 NA L L
210 Stated as T2 with no other information on extension Extension Size AJCC7 NA L L
250 Stated as T3 with no other information on extension Extension Size AJCC7 NA L L
270 Stated as T4 with no other information on extension Extension Size AJCC7 NA L L
300 Confined to colon, NOS
Localized, NOS
Extension Size AJCC7 NA L L
400 Extension through wall, NOS
Invasion through muscularis propria or muscularis, NOS
Non-peritonealized pericolic tissues invaded
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded
Transmural, NOS
Wall, NOS
Extension Size AJCC7 NA L L
410 OBSOLETE DATA CONVERTED V0203
See code 250

Stated as T3, NOS
ERROR: ERROR: ERROR: ERROR:
420 OBSOLETE DATA CONVERTED V0203
See code 458

Fat, NOS
ERROR: ERROR: ERROR: ERROR:
450 For all colon sites:
Adjacent tissue(s), NOS
Connective tissue
Mesenteric fat
Mesentery
Mesocolon
Pericolic fat
For ascending and descending colon :
Retroperitoneal fat
For transverse colon and flexures :
Gastrocolic ligament
Greater omentum
Extension Size AJCC7 NA RE RE
458 Fat, NOS Extension Size AJCC7 NA RE RE
460 OBSOLETE DATA RETAINED AND REVIEWED V0203
See Note 6 and code 570

Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)
Extension Size AJCC7 NA RE RE
490 OBSOLETE DATA CONVERTED V0203
See code 270

Stated as T4, NOS
ERROR: ERROR: ERROR: ERROR:
500 Invasion of/through serosa (mesothelium) (visceral peritoneum) Extension Size AJCC7 NA RE RE
550 500 + (420 or 450) Extension Size AJCC7 NA RE RE
560 Invasion of/through serosa with invasion of/through mucosa Extension Size AJCC7 NA RE RE
570 Adherent to liver capsule
Adherent to other organs or structures, NOS
Extension Size AJCC7 NA RE RE
600 For all colon sites:
Small intestine
For cecum:
Greater omentum
For ascending colon:
Greater omentum
Liver, right lobe
For transverse colon and flexures:
Bile ducts
Gallbladder
Kidney
Liver
Pancreas
Spleen
Stomach
For descending colon:
Greater omentum
Pelvic wall
Spleen
For sigmoid colon:
Greater omentum
Pelvic wall
Extension Size AJCC7 NA RE RE
650 Abdominal wall
Retroperitoneum (excluding fat)
Extension Size AJCC7 NA RE RE
660 For ascending colon:
Kidney, right
Ureter, right
For descending colon:
Kidney, left
Ureter, left
Extension Size AJCC7 NA RE RE
700 For cecum, ascending colon, descending colon , and sigmoid colon:
Fallopian tube
Ovary
Uterus
Extension Size AJCC7 NA D D
750 For all colon sites unless otherwise listed above:
Adrenal (suprarenal) gland
Bladder
Diaphragm
Fistula to skin
Gallbladder
Other segment(s) of colon via serosa
Extension Size AJCC7 NA D D
800 Further contiguous extension including:
For cecum:
Kidney, right
Liver
Ureter, right
For transverse colon and flexures:
Ureter
For sigmoid colon:
Cul de sac (rectouterine pouch)
Ureter
Extension Size AJCC7 NA D D
950 No evidence of primary tumor T0 NA U U
999 Unknown; extension not stated
Primary tumor cannot be assessed
Not documented in patient record
TX NA U U
- For CS Extension codes 100-800 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size AJCC 7 Table for this schema.