Summary Stage 2018: Vulva
Summary Stage 2018
Notes
**Vulva**
8000-8040, 8042-8180, 8191-8246, 8248-8700, 9020, 9071
C510-C512, C518-C519
C510 Labium majus
C511 Labium minus
C512 Clitoris
C518 Overlapping lesion of vulva
C519 Vulva, 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 50 *Vulva*, 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
* 8041, 8190, 8247: *Merkel Cell Skin*
* 88710-8714, 8800-8934, 8940-9016, 9030-9070, 9072-9137, 9141-9582: *Soft Tissue*
* 8720-8790: *Melanoma Skin*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
**Note 3:** Basal and squamous cell carcinomas of the skin of the vulva are coded to C519 and are reportable; basal and squamous carcinomas of the skin of the perineum would be coded to C445 and would not be reportable.
**Note 4:** 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
| SS2018 |
Description |
| 0 |
In situ: noninvasive, intraepithelial |
| 1 |
Localized only (localized, NOS)
- FIGO Stage IA, IB, I [NOS]
+ Invasive carcinoma WITH or WITHOUT stromal invasion confined to
* Musculature
* Submucosa
* Vulva including skin |
| 2 |
Regional by direct extension only
- FIGO Stage II
+ Adjacent perineal structures
+ Anus
+ Bladder wall or bladder, NOS excluding mucosa
+ Perianal skin
+ Rectal wall or rectum, NOS excluding mucosa
+ Urethra, NOS
* Lower/distal third of urethra
+ Vagina, NOS
+ Vulva and perineum involved WITH or WITHOUT stromal invasion |
| 3 |
Regional lymph node(s) involved only
- FIGO Stage IIIA, IIIB, IIIC, III [NOS]
+ Deep inguinal, NOS
+ Femoral
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal (femoral)
+ Regional lymph node(s), NOS
* Lymph node(s), NOS
- FIGO Stage IVA based on regional lymph node involvement |
| 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 IVA, IVB, IV [NOS]
* Bladder mucosa
* Fixed to pubic bone (pelvic bone)
* Perineal body
* Rectal mucosa
* Urethra: upper/proximal two-thirds
- Distant lymph node(s), NOS
+ Common iliac
+ External iliac
+ Internal iliac (hypogastric)
+ Obturator
+ Pelvic, NOS
- 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) Gibb, R.K., Olawaiye, A.B., Mutch, D.G., et al. **Vulva**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 633-640
