Summary Stage 2018: Pancreas

Summary Stage 2018

Notes

Pancreas

8000-8700, 8720-8790, 8971

C250-C254, C257-C259
C250 Head of pancreas
C251 Body of pancreas
C252 Tail of pancreas
C253 Pancreatic duct
C254 Islets of Langerhans
C257 Other specified parts of pancreas
C258 Overlapping lesion of pancreas
C259 Pancreas, 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 28 Exocrine Pancreas, 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 34 Neuroendocrine Tumors of the Pancreas, 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.
Neuroendocrine Tumors of the Pancreas, from the AJCC Cancer Staging System Version 9 (2023). 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, 8940-8970, 8972-9138, 9141-9582: Soft Tissue
8935-8936: GIST
9140: Kaposi Sarcoma
9700-9701: Mycosis Fungoides

Note 3: For tumors of the islet cells, determine which subsite of the pancreas is involved and use that primary site code. If the subsite cannot be determined, use the general code for Islets of Langerhans, C254.

Note 4: The terms "abutment," "abut(s)," "encases," or "encasement" of the major blood vessels can be interpreted as involvement of these structures.

NAACCR Item

NAACCR #764

SS2018	Description
0	In situ, intraepithelial, noninvasive High-grade pancreatic intraepithelial neoplasia (PanIn-3) Intraductal papillary mucinous neoplasm with high grade dysplasia Intraductal tubulopapillary neoplasm with high grade neoplasm Mucinous cystic neoplasm with high-grade dysplasia
1	Localized only (localized, NOS) Confined to pancreas
2	Regional by direct extension only All sites Ampulla of Vater Blood vessel(s) (major) Aortic artery Celiac artery Common hepatic artery Further contiguous extension to other major arteries Portal vein Superior mesenteric artery/vein Duodenum Extrahepatic bile duct(s) Fixation to adjacent structure(s), NOS Peripancreatic tissue, NOS Stomach Pancreas Head (C250) Adjacent stomach Blood vessel(s) (major) Gastroduodenal artery Transverse colon, including hepatic flexure Pancreas Body Tail (C251, C252) Spleen Splenic artery/vein Splenic flexure
3	Regional lymph node(s) involved only All sites Anterior, NOS Common hepatic artery Hepatic, NOS Inferior to head and body of pancreas Lateral aortic (lumbar) Pancreaticoduodenal (anterior, posterior) Peripancreatic, NOS Posterior, NOS Proximal mesentery (anterior, posterior) Retroperitoneal Superior mesenteric Superior to head and body of pancreas Regional lymph node(s), NOS Lymph node(s), NOS Pancreas Head (C250) Common bile duct (pericholedochal) Lateral wall (right) Portal vein Pyloric (infrapyloric, retropyloric, subpyloric, suprapyloric) Pyloric, NOS Pancreas Body Tail (C251, C252) Gastroepiploic (gastro-omental, left) Pancreaticosplenic (pancreaticolineal) Splenic (artery, hilum, lineal) Suprapancreatic Pancreas Other (C253-C254, C257-C259) Celiac Common bile duct (pericholedochal) Gastroepiploic (gastro-omental) Lateral wall right Pancreaticosplenic (pancreaticolienal) Portal vein Pyloric (infrapyloric, retropyloric, subpyloric, suprapyloric, NOS) Splenic (artery, hilum, lineal) Suprapancreatic
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 to other organs) All sites Adrenal gland/suprarenal gland Gallbladder Kidney Liver, including porta hepatis Mesenteric fat Mesentery Mesocolon Peritoneum Retroperitoneum Small intestine (excluding duodenum) Ureter Pancreas Head (C250) Colon (other than transverse colon including hepatic flexure) Omentum Spleen Pancreas Body Tail (C251, C252) Colon (other than splenic flexure) Diaphragm Distant lymph node(s), NOS Pancreas Head (C250) Celiac Gastroepiploic (gastro-omental), left Pancreaticosplenic (pancreaticolienal) Splenic (artery, hilum, lineal) Suprapancreatic Pancreas Body Tail (C251, C252) Celiac Common bile duct (pericholedochal) Lateral wall (right) Porta hepatic Portal vein Pyloric (infrapyloric, retropyloric, subpyloric, suprapyloric, NOS) Distant metastasis, NOS Carcinomatosis Distant metastasis except distant lymph node(s) Seeding of peritoneum, even if limited to the lesser sac region Positive peritoneal cytology
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) Kakar, S., Pawlik, T.M., Vauthey, J.N., et al. Exocrine Pancreas. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017

(6) Bergsland, E.K., Woltering, E.A., Klimstra, D.S., et al. Neuroendocrine Tumors of the Pancreas. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017

(7) Neuroendocrine Tumors of the Pancreas, from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois.