Summary Stage 2018: Ovary and Primary Peritoneal Carcinoma

Summary Stage 2018

Notes

Ovary and Primary Peritoneal Carcinoma C481 Specified parts of peritoneum (female only) C482 Peritoneum (female only) C488 Overlapping lesion of retroperitoneum and peritoneum (female only) C569 Ovary **Note 1:** 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 55 *Ovary, Fallopian Tube, and Primary Peritoneal Carcinoma*, 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. **Note 2:** Ascites, NOS is considered negative. **Note 3:** Peritoneal implants outside the pelvis must be microscopically confirmed. Peritoneal implants may also be called seeding, salting, talcum powder appearance, or studding. **Note 4:** If implants are mentioned, determine whether they are in the pelvis or in the abdomen and code appropriately to regional by direct extension or to distant. If not stated, code to distant.

NAACCR Item

NAACCR #764
SS2018 Description
0 In situ: noninvasive, intraepithelial - Limited to tubal mucosa - Preinvasive
1 Localized only (localized, NOS) - FIGO Stage IA + Limited to one ovary (capsule intact) - FIGO Stage IB + Limited to both ovaries (capsule intact) - FIGO Stage IC1 + Limited to both ovaries WITH surgical spill - FIGO Stage I, IC (does not include IC2, IC3) + Limited to one or both ovary(ies), NOS - Localized primary peritoneal cancer + (Primary sites C481, C482, C488)
2 Regional by direct extension only - FIGO Stage IC2 + Limited to one or both ovaries * WITH capsule ruptured before surgery * OR tumor on ovarian surface - FIGO Stage IC3 + Malignant cells in ascites or peritoneal washings * WITH or WITHOUT capsule rupture - FIGO Stage IIA + Extension to or implants on * Adnexa * Fallopian tube * Uterus, NOS - FIGO Stage IIB + Extension to or implants on * Adjacent peritoneum * Bladder * Bladder serosa * Cul de sac (rectouterine pouch) * Ligament(s): (broad, ovarian, round, suspensory) * Mesovarium * Parametrium * Rectosigmoid * Rectum * Sigmoid colon (including sigmoid mesentery) * Ureter (pelvic portion) - FIGO Stage II [NOS] + Confined to pelvis + Tumor involves one or both ovaries * WITH pelvic extension, NOS (below pelvic brim) - FIGO Stage IIIA + Microscopic peritoneal implants beyond pelvis * Includes peritoneal surface/capsule of liver
3 Regional lymph node(s) involved only - Aortic, NOS + Lateral (lumbar) + Para-aortic + Periaortic - Iliac, NOS + Common + External + Internal (hypogastric, obturator, NOS) - Intra-abdominal - Lateral sacral (laterosacral) - Pelvic, NOS - Retroperitoneal, NOS - Subdiaphragmatic (primary peritoneal carcinoma) - 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) + FIGO Stage IIIB * Macroscopic peritoneal implants beyond pelvis * Less than or equal to 2 cm in diameter * Includes peritoneal surface of liver + FIGO Stage IIIC * Macroscopic peritoneal implants beyond pelvis * Greater than 2 cm in diameter * Includes peritoneal surface of liver (liver capsule) * Includes tumor extension to liver and spleen WITHOUT parenchymal * Involvement of either organ + FIGO Stage III [NOS] * One or both ovaries involved * OR primary peritoneal cancer * WITH microscopic confirmed peritoneal metastasis outside of the pelvis * Peritoneal implants, NOS + FIGO Stage IVA * Pleural effusion with positive cytology + FIGO Stage IVB * Extra-abdominal organs * Liver parenchymal * Spleen parenchymal * Transmural involvement of intestine + FIGO Stage IV [NOS] - Distant lymph node(s), NOS + Inguinal - Distant metastasis, NOS + Carcinomatosis (involvement of multiple parenchymal organs * OR diffuse involvement of multiple non-abdominal organs) + Distant metastasis 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) **Introduction to Female Reproductive Organs**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 631 (6) Prat, J., Olawaiye, A.B., Mutch, D.G., et al. **Ovary, Fallopian Tube, and Primary Peritoneal Carcinoma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 681-690