Summary Stage 2018: Extrahepatic Bile Ducts
Summary Stage 2018
Notes
**Extrahepatic Bile Ducts**
8000-8700, 8720-8790
C240
C240 Cystic duct
C240 Distal bile ducts
C240 Perihilar bile ducts
**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 24 *Gallbladder*, 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 25 *Perihilar Bile Ducts*, 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 26 *Distal Bile Duct*, 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, 8800-8934, 8940-9138, 9141-9582: *Soft Tissue*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
| SS2018 |
Description |
| 0 |
In situ, intraepithelial, noninvasive
High-grade biliary intraepithelial neoplasia (BilIn-3) |
| 1 |
Localized only (localized, NOS)
- Confined to
+ Cystic duct, NOS
+ Distal bile duct(s), NOS
+ Extrahepatic bile duct(s), NOS
+ Perihilar bile duct(s), NOS
- Lamina propria
- Mucosa, NOS
- Muscle layer of fibrous tissue (bile ducts perihilar only)
- Muscularis propria
- Subepithelial connective tissue (tunica mucosa) (bile ducts perihilar only)
- Submucosa (superficial invasion) |
| 2 |
Regional by direct extension only
- All sites
+ Adipose tissue
+ Adjacent (connective) tissue, NOS
+ Colon
+ Duodenum
+ Gallbladder
+ Hepatic artery (common, NOS)
+ Liver
+ Main portal vein or its branches bilaterally
+ Omentum (greater, lesser, NOS)
+ Pancreas
+ Periductal/fibromuscular connective tissue
+ Portal vein, NOS
+ Stomach
- Cystic duct
+ Ampulla of Vater
+ Beyond wall of cystic duct
+ Perimuscular connective tissue
+ Perimuscular tissue, NOS
+ Serosa (visceral peritoneum)
+ Small intestine
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left)
- Distal bile duct(s)
+ Adjacent hepatic parenchyma
+ Beyond wall of bile duct
+ Porta hepatis
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left)
- Perihilar bile duct(s)
+ Beyond wall of bile duct
+ Second-order biliary radicals bilaterally
* Unilateral second-order biliary radicals
* WITH contralateral portal vein or hepatic artery involvement
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left) |
| 3 |
Regional lymph node(s) involved only
- Choledochal (bile ducts perihilar only)
- Cystic duct (node of the neck of the gallbladder) (Calot's node)
- Hepatic/hepatic artery nodes (common, NOS)
- Hilar (porta hepatic) (portal) (in hilus of liver)
- Node of the foramen of Winslow (omental) (epiploic)
- Pancreaticoduodenal (anterior, posterior) (bile ducts distal only)
- Pancreaticoduodenal, NOS (cystic duct only)
- Pericholedochal (node along common bile duct)
- Periduodenal
- Peripancreatic (near head of pancreas only)
- Periportal
- Portal vein
- 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
+ Celiac axis (bile ducts distal only)
+ Superior mesenteric artery (bile ducts distal only)
- Distant lymph node(s), NOS
+ Celiac (axis) artery
+ Para-aortic
+ Periaortic (cystic duct only)
+ Pericaval
+ Peripancreatic (along body and tail of pancreas only)
+ Superior mesenteric artery
+ Superior mesenteric vein
- 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
(5) Zhu, A.X., Pawlik, T.M., Vauthey, J.N., et al. **Gallbladder**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(6) Nagorney, D.M., Pawlik, T.M., Vauthey, J.N., et al. **Perihilar Bile Ducts**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(7) Krasinskas, A., Pawlik, T.M., Vauthey, J.N., et al. **Distal Bile Duct**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
