Summary Stage 2018: Anus

Summary Stage 2018

Notes

**Anus and Anal Canal** C210 Anus, NOS (excluding skin of anus and perianal skin C445) C211 Anal canal C212 Cloacogenic zone C218 Overlapping lesion of rectum, anus and anal canal **Note:** The following sources were used in the development of this schema * SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998) (https://seer.cancer.gov/archive/manuals/EOD10Dig.3rd.pdf) * SEER Summary Staging Manual-2000: Codes and Coding Instructions (https://seer.cancer.gov/tools/ssm/) * Collaborative Stage Data Collection System, version 02.05: https://cancerstaging.org/cstage/Pages/default.aspx * Chapter 21 *Anus*, in the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. Used with permission of the American College of Surgeons, Chicago, Illinois.

NAACCR Item

NAACCR #764
SS2018 Description
0 In situ, intraepithelial, noninvasive - Anal intraepithelial neoplasia III - Bowen disease
1 Localized only (localized, NOS) - Confined to anus, NOS - Incidental finding of malignancy in hemorrhoid, NOS - Intramucosa - Lamina propria - Mucosa, NOS - Muscularis mucosae - Muscularis propria (internal sphincter) - Submucosa (superficial invasion)
2 Regional by direct extension only - Ischiorectal fat/tissue - Perianal skin - Perineum - Perirectal skin - Rectal mucosa or submucosa - Rectal wall - Skeletal muscle(s) + Anal sphincter (external) + Levator ani - Subcutaneous perianal tissue - Vulva
3 Regional lymph node(s) involved only - Anorectal - External iliac - Inferior hemorrhoidal - Inguinal (femoral) (deep, superficial) - Internal iliac (hypogastric) - Lateral sacral (laterosacral) - Mesorectal - Obturator - Perirectal - Superior rectal (hemorrhoidal) (femoral) - Regional lymph node(s), NOS + Lymph node(s), NOS
4 Regional by BOTH direct extension AND regional lymph node(s) involved - Codes (2) + (3)
7 Distant site(s)/lymph node(s) involved - Distant site(s) (including further contiguous extension) + Bladder + Broad ligament(s) + Cervix uteri + Corpus uteri + Pelvic peritoneum + Prostate + Urethra + Vagina - Distant lymph node(s), NOS - Distant metastasis, NOS + Carcinomatosis + Distant metastases WITH or WITHOUT distant lymph node(s)
9 Unknown if extension or metastasis
(1) Fritz AG, Ries LAG (eds). **SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998)**, National Cancer Institute, NIH Pub. No. 98-2313, Bethesda, MD, 1998 (2) Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds.). **SEER Summary Staging Manual-2000: Codes and Coding Instructions**, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001. (3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05.** American Joint Committee on Cancer (Chicago, IL) (4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging.** In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 3-30 (5) Welton, M.L., Jessup, J.M., et al. **Anus**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 275-284