Summary Stage 2018: Cervix
Summary Stage 2018
Notes
**Cervix**
8000-8700, 8710-8803, 8805, 8810-8814, 8816-8858, 8860-8900, 8902-8910, 8921-8941, 8951-8976, 8980-8990, 8992-9016, 9030-9043, 9045-9111, 9121-9132, 9135-9138, 9141-9175, 9181-9221, 9230, 9240-9365, 9370-9580, 9582
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.
* Cervix Uteri, from the AJCC Cancer Staging System Version 9 (2020). Used with permission of the American College of Surgeons, Chicago, Illinois
* Chapter 54 *Corpus Uteri-Sarcoma,* in the AJCC Cancer Staging Manual, Eight Edition (2017) published by Spring International Publishing. Used with permission of the American College of Surgeons, Chicago, Illinois
**Note 2:** See the following chapters for the listed histologies
* 8815, 8859, 8901, 8912, 8920, 8950, 9120, 9133, 9180, 9222, 9366-9368, 9581: *Soft Tissue*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
**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)
* Clinically visible lesion (macroscopic), including superficial invasion
* Confined to cervix uteri or uterus, NOS, except corpus uteri, NOS (see code 2 for corpus uteri)
+ Not clinically visible or unknown if clinically visible
* Measured stromal invasion less than 5 mm or less measured from the based of the epithelium AND horizontal spread of 7.0 mm or less
FIGO Stage I (IA1, IA2, IA NOS, IB1, IB2, IB3, IB NOS, I NOS) |
| 2 |
Regional by direct extension only
* Bladder wall
* Bladder, NOS excluding mucosa (see code 7 for bladder mucosa)
* Bullous edema of bladder mucosa
* Confined to corpus uteri, size, depth and horizontal spread unknown
* Corpus uteri, NOS
* Cul de sac (rectouterine pouch)
* Fallopian tube(s)
* "Frozen pelvis" (clinically described)
* Hydronephrosis or nonfunctioning kidney
* Invasion beyond uterus, NOS
* Ligament(s) (broad, cardinal, uterosacral)
* Ovary(ies)
* Parametrial (paracervical soft tissue) invasion
* Pelvic wall(s)
* Rectal wall
* Rectum, NOS excluding mucosa (see code 7 for rectal mucosa)
* Upper two-thirds of vagina including fornices
* Ureter (intra- and extramural)
* Urethra
* Vagina (lower third (not extending into pelvic wall), NOS)
* Vaginal wall, NOS
* Vulva
FIGO Stage II (IIA, IIB, II NOS)
FIGO Stage III (IIIA, IIIB, III NOS) |
| 3 |
Regional lymph node(s) involved only
- Para-aortic
+ Aortic
+ Lateral aortic/lateral lumbar
+ Periaortic
- Pelvic
+ Iliac, NOS
+ Common
+ External
+ Internal (hypogastric) (obturator)
+ Paracervical
+ Parametrial
+ Sacral, NOS
+ Lateral (laterosacral)
+ Middle (promontorial) (Gerota's node)
+ Presacral
+ Uterosacral
- Regional lymph node(s), NOS
+ Lymph node(s), NOS
FIGO Stage IIIC (IIIC1, IIIC2, IIIC NOS)
+ Localized tumor WITH 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)
+ Adnexa
+ Bladder mucosa
+ Peritoneal spread
+ Rectal mucosa
+ Sigmoid colon
+ Small intestine
+ Uterine serosa
- Distant lymph node(s), NOS
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal89654
+ Mediastinal
+ Scalene
+ Supraclavicular
- Distant metastasis, NOS
+ Carcinomatosis
+ Distant metastasis WITH or WITHOUT distant lymph node(s)
FIGO Stage IV (IVA, IVB, IV NOS) |
| 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
(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
(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
(7) Dizon, D.S., Olawaiye, A.B., Mutch, D.G., et al. **Corpus Uteri - Sarcoma.** In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(8) **Cervix Uteri**, from the AJCC Cancer Staging System Version 9 (2020). Used with permission of the American College of Surgeons, Chicago, Illinois.
