Summary Stage 2018: Stomach
Summary Stage 2018
Notes
**Stomach**
C160 and Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach: 0, 3, 9 (8000-8149, 8154, 8157, 8160-8231, 8243-8248, 8250-8682, 8690-8700, 8720-8790, 9700-9701)
All Other sites: 8000-8149, 8154, 8157, 8160-8231, 8243-8248, 8250-8682, 8690-8700, 8720-8790, 9700-9701
All sites: 8150-8153, 8155-8156, 8158, 8240-8242, 8249, 8683
C160-C166, C168-C169
C160 Cardia of stomach
C161 Fundus of stomach
C162 Body of stomach
C163 Gastric antrum
C164 Pylorus
C165 Lesser curvature of stomach, NOS
C166 Greater curvature of stomach, NOS
C168 Overlapping lesion of stomach
C169 Stomach, NOS
**Note 1:** The following sources were used in the development of this chapter
* 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/ssm2000/)
* Collaborative Stage Data Collection System, version 02.05: https://cancerstaging.org/cstage/Pages/default.aspx
* Chapter 17 *Stomach*, 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.
* Chapter 29 *Neuroendocrine Tumors of the Stomach*, 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 following chapters for the listed histologies
* C160 and Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach: 2 (8000-8149, 8154, 8157, 8160-8231, 8243-8248, 8250-8682, 8690-8700, 8720-8790, 9700-9701): *Esophagus*
* 8710-8714, 8800-8934, 8940-9137, 9141-9582: *Soft Tissue*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
**Note 3:** If a tumor involves the esophagogastric junction (EGJ) and its epicenter is less than or equal to 2 cm into the proximal stomach (i.e. less than or equal to 2 cm distal to the EGJ), use the esophageal cancer chapter for summary stage (see the Esophagus (excluding GIST) chapter). Tumors involving the EGJ with their epicenter >2 cm into the proximal stomach (i.e., >2cm distal to the EGJ) are now classified using the stomach chapter. Cardia cancers that do not invade the EGJ should be classified based on the stomach cancer chapter for summary stage.
* Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach is used to discriminate between EsophagusGEjunction and Stomach which are coded to ICD-O-3 code C160.
| SS2018 |
Description |
| 0 |
In situ, intraepithelial, noninvasive
- (Adeno)carcinoma, noninvasive, in a polyp |
| 1 |
Localized only (localized, NOS)
- Confined to stomach, NOS
- Extension through wall, NOS
- Implants within stomach
- Intraluminal spread to esophagus or duodenum
- Invasion of
+ Intramucosa, NOS
+ Lamina propria
+ Mucosa, NOS
+ Muscularis mucosae
+ Muscularis, NOS
+ Muscularis propria
+ Submucosa (superficial, NOS)
- Linitis plastica (diffuse involvement of the entire stomach wall)
- Perimuscular tissue invaded
- Polyp (head, stalk, NOS)
- Subserosal tissue/(sub)serosal fat |
| 2 |
Regional by direct extension only
- Adjacent (connective) tissue, NOS
- Colon/mesocolon (including transverse and flexures)
- Diaphragm
- Duodenum (via serosa)
- Esophagus (via serosa)
- Gastric artery
- Ileum
- Jejunum
- Ligaments
+ Gastrocolic
+ Gastrohepatic
+ Gastrosplenic
- Liver
- Mesothelium
- Omentum (greater, lesser, NOS)
- Pancreas
- Perigastric fat
- Serosa
- Small intestine, NOS
- Spleen
- Tunica serosa
- Visceral peritoneum |
| 3 |
Regional lymph node(s) involved only
- Celiac artery
- Common hepatic artery
- Hepatic, NOS
- Left gastric (superior gastric), NOS
+ Cardial, NOS
+ Cardioesophageal
+ Gastric artery
+ Gastric, left
+ Gastrohepatic
+ Gastropancreatic, left
+ Lesser curvature
+ Lesser omentum
+ Paracardial
- Pancreaticosplenic (pancreaticolineal)
- Perigastric, NOS
- Peripancreatic
- Pyloric, NOS
+ Infrapyloric (subpyloric)
+ Suprapyloric
- Right gastric (inferior gastric, NOS)
+ Gastrocolic
+ Gastroduodenal
+ Gastroepiploic (gastro-omental), right or NOS
+ Gastrohepatic
+ Greater curvature
+ Greater omentum
+ Pancreaticoduodenal
- Splenic (lineal), NOS
+ Gastroepiploic (gastro-omental), left
+ Splenic hilar/hilum
- Nodule(s) in perigastric fat
- 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)
+ Abdominal wall
+ Adrenal (suprarenal) gland
+ Aorta
+ Celiac axis
+ Kidney
+ Retroperitoneum
- Distant lymph node(s), NOS
+ Hepatoduodenal (along the proper hepatic artery, including portal)
+ Intra-abdominal
+ Mesenteric (inferior, superior, NOS)
+ Middle colic
+ Pancreaticoduodenal (all subsites EXCEPT greater curvature)
+ Para-aortic
+ Porta hepatic (portal) (hilar) (in hilus of liver)
+ Retropancreatic
+ Retroperitoneal
- Distant metastasis, NOS
+ Carcinomatosis
+ Krukenberg tumor (metastasis to ovary(ies))
+ Malignant (positive) peritoneal cytology
+ 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) Ajani, J.A., In, H., Sano, T., Hofstetter, W.L., et al. **Stomach**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 203-220
(6) Woltering, E.A., Bergsland, E.K., et al. **Neuroendocrine Tumors of the Stomach**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 351-359
