Summary Stage 2018: Prostate
Summary Stage 2018
Notes
**Prostate** C619 C619 Prostate gland **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 58 *Prostate*, 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:** See the *Urethra* schema, for transitional cell (urothelial) carcinoma of the prostatic urethra (C680). **Note 3:** Assign code 1 when there is only a TURP. **Note 4:** Imaging is not used to determine the clinical extension unless the physician clearly incorporates imaging findings into their evaluation. **Note 5:** If there is no information from the DRE, but the physician assigns a clinical extent of disease, the registrar can use that. * *Example:* DRE reveals prostate is “firm.” Physician stages the patient as a cT2a. The T2a (localized) can be used since the physician has documented this. **Note 6:** Involvement of prostatic urethra does not alter the Summary Stage code. **Note 7:** “Frozen pelvis” is a clinical term which means tumor extends to pelvic sidewall(s) (code 7). **Note 8:** When prostate cancer is an incidental finding during a prostatectomy for other reasons (for example, a cystoprostatectomy for bladder cancer), use the appropriate code for the extent of disease found.NAACCR Item
NAACCR #764| SS2018 | Description |
|---|---|
| 0 | In situ, intraepithelial, noninvasive |
| 1 | Localized only (localized, NOS) - Clinically apparent or inapparent tumor - Confined to prostate, NOS - Intracapsular involvement only - Invasion into (but not beyond) prostatic capsule - No extracapsular extension - One or more lobes involved |
| 2 | Regional by direct extension only - Bladder neck - Bladder, NOS - External sphincter - Extraprostatic/extracapsular extension (beyond prostate capsule), unilateral, bilateral, NOS - Extraprostatic urethra (membranous urethra) - Fixation, NOS - Levator muscles - Periprostatic tissue - Rectovesical (Denonvillier's) fascia - Rectum - Seminal vesicles - Skeletal muscle - Through capsule, NOS - Ureter(s) |
| 3 | Regional lymph node(s) involved only - Hypogastric - Iliac, NOS + External + Internal (hypogastric) (obturator), NOS - Pelvic, NOS - Periprostatic - Sacral, NOS + Lateral (laterosacral) + Middle (promontory) (Gerota’s node) + Presacral - 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) + Bone + Extension to or fixation to pelvic wall or pelvic bone + "Frozen pelvis", NOS + Other organs + Penis + Sigmoid colon + Soft tissue other than periprostatic - Distant lymph node(s), NOS + Aortic (lateral [lumbar], para-aortic, periaortic, NOS) + Cervical + Common iliac + Inguinal (deep, NOS) * Node of Cloquet or Rosenmuller (highest deep inguinal) * Superficial (femoral) + Retroperitoneal, NOS + Scalene (inferior deep cervical) + Supraclavicular (transverse cervical) - Distant metastasis, NOS + Carcinomatosis + Distant metastasis WITH or WITHOUT distant lymph node(s) |
| 9 | Unknown if extension or metastasis |