Summary Stage 2018: Cervix
Summary Stage 2018
Notes
**Cervix**
8000-8700, 8720-8790, 8805, 8933, 8980, 9110, 9581, 9700-9701
C530-C531, C538-C539
C530 Endocervix
C531 Exocervix
C538 Overlapping lesion of cervix
C539 Cervix uteri
**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 52 *Cervix Uteri*, 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
* 8710-8714, 8800-8804, 8806-8932, 8934, 8940-8975, 8981-9105, 9120-9137, 9141-9580, 9582: *Soft Tissue*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
**Note 3:** Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters not greater than 0.2 mm, usually detected by immunohistochemical (IHC) or molecular methods. ITCs do not usually show evidence of malignant activity (e.g., proliferation or stromal reaction).
* Lymph nodes with ITCs only are **not** counted as positive nodes for Summary Stage
**Note 4:** Para-aortic nodes are now regional instead of distant.
| SS2018 |
Description |
| 0 |
In situ, intraepithelial, noninvasive
- Cancer in situ WITH endocervical gland involvement
- Cervical intraepithelial neoplasia (CIN) Grade III
- Preinvasive |
| 1 |
Localized only (localized, NOS)
- FIGO Stage IA1
+ Measured stromal invasion 3.0 mm or less and 7.0 mm or less in horizontal spread
- FIGO Stage IA2
+ Measured stromal invasion 3.1 mm to 5.0 mm with a horizontal spread of 7.0 mm or less
- FIGO Stage IA [NOS]
+ Measured stromal invasion 5.0 mm or less measured from the base of the epithelium AND horizontal spread of 7.0 mm or less
- FIGO Stage IB
- FIGO Stage I [NOS]
+ Clinically visible lesion (macroscopic), including superficial invasion
+ Confined to cervix uteri or uterus, NOS, except corpus uteri, NOS
* (Not clinically visible or unknown if clinically visible) |
| 2 |
Regional by direct extension only
- FIGO Stage IIA, IIB, II [NOS]
+ Confined to corpus uteri, size, depth and horizontal spread unknown
+ Corpus uteri, NOS
+ Cul de sac (rectouterine pouch)
+ Invasion beyond uterus, NOS
+ Ligament(s) (broad, cardinal, uterosacral)
+ Parametrial (paracervical soft tissue) invasion
+ Upper two-thirds of vagina including fornices
+ Vagina, NOS
+ Vaginal wall, NOS
- FIGO Stage IIIA
+ Bladder wall
+ Bladder, NOS excluding mucosa
+ Bullous edema of bladder mucosa
+ Lower third of vagina
+ Rectal wall
+ Rectum, NOS excluding mucosa
+ Ureter, intra- and extramural
+ Vagina, lower third (not extending to pelvic wall)
+ Vulva
- FIGO Stage IIIB
+ Described clinically as frozen pelvis
+ Hydronephrosis or nonfunctioning kidney
+ Pelvic wall(s)
- FIGO Stage III [NOS]
+ Fallopian tube(s)
+ Ovary(ies)
+ Urethra |
| 3 |
Regional lymph node(s) involved only
- Aortic
+ Lateral aortic
+ Para-aortic
+ Periaortic
- Iliac, NOS
+ Common
+ External
+ Internal (hypogastric) (obturator), NOS
- Paracervical
- Parametrial
- Pelvic, NOS
- Sacral, NOS
+ Lateral (laterosacral)
+ Middle (promontorial) (Gerota's node)
+ Presacral
+ Uterosacral
- 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 mucosa
+ Rectal mucosa
+ Sigmoid colon
+ Small intestine
+ FIGO Stage IVA, IVB, IV [NOS]
- Distant lymph node(s), NOS
+ Inguinal
+ Mediastinal
+ Scalene
+ Supraclavicular
- Distant metastasis, NOS
+ Carcinomatosis
+ 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) Erickson, B.A., Olawaiye, A.B., Mutch, D.G., et al. **Cervix Uteri**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 649-659
