Summary Stage 2018: Esophagus

Summary Stage 2018

Notes

**Esophagus** C150-C155, C158-C159 (8000-8700, 8720-8790) C160 and Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach: 2 (8000-8149, 8154, 8157, 8160-8231, 8243-8248, 8250-8682, 8690-8700, 8720-8790) C150-C155, C158-C160 C150 Cervical esophagus C151 Thoracic esophagus C152 Abdominal esophagus C153 Upper third of esophagus C154 Middle third of esophagus C155 Lower third of esophagus C158 Overlapping lesion of esophagus C159 Esophagus, NOS C160 Cardia, esophagogastric junction (EGJ) **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 16 *Esophagus and Esophagogastric Junction*, 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 (8150-8153, 8155-8156, 8158, 8240-8242, 8249, 8683): *NET Stomach* * 8710-8714, 8800-8934, 8940-9138, 9141-9582: *Soft Tissue* * 8935-8936: *GIST* * 9140: *Kaposi Sarcoma* * 9700-9701: *Mycosis Fungoides* **Note 3:** Cancers involving the EGJ that have their epicenter within the proximal 2 cm of the cardia (Siewert types I/II) are to be staged as esophageal cancers (see the Esophagus (excluding GIST) chapter). Cancers whose epicenter is more than 2 cm distal from the EGJ, even if the EGJ is involved, will be staged using the stomach cancer chapter. * The Schema Discriminator *EsophagusGEJunction (EGJ)/Stomach* is used to discriminate between EsophagusGEJunction and Stomach which are coded to ICD-O-3 code C160 **Note 4:** Non-invasive carcinomas in the esophagus formerly called in situ are now called high grade dysplasia. High grade dysplasia and severe dysplasia are generally not reportable in cancer registries. * Code 0 if your registry collects these tumors

NAACCR Item

NAACCR #764
SS2018 Description
0 In situ, intraepithelial, non-invasive; high-grade dysplasia - (Adeno)carcinoma, noninvasive, in a polyp
1 Localized only (localized, NOS) - Confined to esophagus, NOS - Extension through wall, NOS - Invasion of + Intramucosa, NOS + Lamina propria + Mucosa, NOS + Muscularis mucosae + Muscularis, NOS + Muscularis propria + Submucosa (superficial invasion) - Perimuscular tissue invaded - Subserosal tissue/(sub)serosal fat invaded
2 Regional by direct extension only - All sites + Adjacent structure(s), NOS + Adventitia and/or soft tissue invaded + Aorta + Azygos vein + Diaphragm (excluding abdominal/lower esophagus, see code 7) + Esophagus is described as "FIXED" + Extension to adjacent (connective) tissue WITHOUT perforation of visceral peritoneum covering these structures + Gastric artery + Ligaments * Gastrocolic * Gastrohepatic * Gastrosplenic * Omentum (greater, lesser, NOS) + Mesothelium + Pericardium (excluding thoracic/middle esophagus, see code 7) + Perigastric fat + Peritoneum, NOS + Pleura (excluding cervical/upper esophagus, see code 7) + Serosa (invasion of/or through) + Tunica serosa + Vertebral body + Visceral peritoneum (including perforation) - Cervical esophagus + Blood vessel(s) * Carotid artery * Subclavian artery + Carina + Cervical vertebra(e) + Hypopharynx + Jugular vein + Larynx + Thyroid + Trachea - Intrathoracic, upper or mid-portion, esophagus + Blood vessel(s), major * Gastric artery/vein * Pulmonary artery/vein * Vena cava + Carina + Stomach, cardia (via serosa) + Trachea - Intrathoracic, lower portion (abdominal), esophagus + Blood vessel(s) * Vena cava - Intrathoracic esophagus (all portions) + Adjacent rib(s) + Lung via bronchus + Mediastinal structure(s), NOS + Thoracic vertebra(e) - Esophagus GE Junction + Liver + Pancreas + Small intestine (duodenum [via serosa], ileum, jejunum) + Spleen + Transverse colon (including flexures)
3 Regional lymph node(s) involved only - All subsites + Nodule(s) in perigastric fat + Peri-/paraesophageal (8L, 8M) (excluding GE junction) + Regional lymph node(s), NOS * Lymph node(s), NOS - Cervical esophagus only + Cervical, NOS * Anterior deep cervical (laterotracheal) (recurrent laryngeal) * Deep cervical, NOS * Internal jugular, NOS - Jugulodigastric (subdigastric) - Upper, NOS + Scalene (inferior deep cervical) (1) + Supraclavicular (transverse cervical) (1) - Intrathoracic esophagus, upper or middle, only + Internal jugular, NOS * Deep cervical, NOS - Jugulodigastric (subdigastric) - Jugulo-omohyoid (supraomohyoid) - Lower, NOS - Middle - Upper cervical, NOS + Intrabronchial * Carinal (tracheobronchial) (10R, 10L) (tracheal bifurcation) * Hilar (bronchopulmonary) (proximal lobar) (pulmonary root) * Left gastric (superior gastric) (17) - Cardiac (cardial) - Lesser curvature - Perigastric, NOS * Peritracheal + Posterior mediastinal (tracheoesophageal) + Superior mediastinal - Intrathoracic esophagus, lower (abdominal) only + Left gastric (superior gastric) (17) * Cardiac (cardial) * Lesser curvature * Perigastric, NOS + Posterior mediastinal (3P) (tracheoesophageal) - Esophagus GE Junction + Celiac (20) + Hepatic (excluding gastrohepatic and hepatoduodenal) + Left gastric (superior gastric), NOS * Cardiac * Cardioesophageal * Gastric, left (17) * Gastropancreatic, left * Lesser curvature * Lesser omental * Pericardial (16) + Pancreaticosplenic (pancreaticolineal) + Pancreatoduodenal + Perigastric, NOS + Peripancreatic + Right gastric (inferior gastric), NOS * Gastrocolic * Gastroduodenal * Gastroepiploic (gastro-omental), right or NOS * Gastrohepatic * Greater curvature * Greater omental * Pyloric, NOS - Infrapyloric (subpyloric) - Suprapyloric + Splenic (lienal), NOS * Gastroepiploic (gastro-omental), left * Splenic hilar
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) + All subsites * Airway * Stated as unresectable, NOS * Vertebral body + Abdomen/lower esophagus * Diaphragm fixed + Cervical/upper esophagus * Lung * Pleura * Mainstem bronchus + Thoracic/middle esophagus * Pericardium + Esophagus GE Junction * Abdominal wall * Adrenal (suprarenal) gland * Kidney * Pulmonary ligament (9) * Retroperitoneum * Trachea - Distant lymph node(s), NOS + All subsites * Anterior mediastinal (6) * Common hepatic (18) * Diaphragmatic (15) * Mediastinal, NOS * Splenic (19) * Subcarinal (tracheal carina) (7) + Cervical esophagus * Aortopulmonary (5) * Para-aortic (ascending aorta or phrenic) - Subaortic * Paratracheal (2R, 2L, 4R, 4L) * Posterior mediastinal (3P) * Superior mediastinal + Intrathoracic esophagus, upper or middle, only * Aortopulmonary (5) - Para-aortic (ascending aorta or phrenic) * Cervical + Lower thoracic (abdominal) esophagus * Aortopulmonary (5) - Para-aortic (ascending aorta or phrenic) - Subaortic * Celiac (20) * Paratracheal (2R, 2L, 4R, 4L) * Superior mediastinal + Esophagus GE Junction * Hepatoduodenal * Mesenteric, NOS - Inferior mesenteric - Superior mesenteric * Para-aortic * Paraesophageal, NOS * Periesophageal, NOS - Anterior mediastinal (6) - Aortopulmonary (5) - Paraesophageal, lower (8l) - Paraesophageal, middle (8m) - Paratracheal, lower (4L, 4R) - Paratracheal, upper (2L, 2R) - Posterior mediastinal (3p) - Supraclavicular (1) - Tracheobronchial (hilar) (10L, 10R) * Porta hepatis (portal) (hilar) (in hilus of liver) * Retropancreatic * Retroperitoneal - 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) Rice, T.W., Kelsen, D., Hofstetter, W.L., et al. **Esophagus and Esophagogastric Junction**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017 Manual. 8th Ed. New York: Springer; 2017