Summary Stage 2018: Ovary and Primary Peritoneal Carcinoma
Summary Stage 2018
Notes
**Ovary and Primary Peritoneal Carcinoma**
8000-8700, 8720-8790, 8806, 8822, 8930-8931, 8933, 8950, 8960, 8980, 9000, 9050, 9052, 9060, 9070-9071, 9073, 9080, 9085, 9090-9091, 9100, 9110
C569: 8810, 8815, 8825, 8890, 8935-8936
C481-C482, C488, C569
C481 Specified parts of peritoneum (female only)
C482 Peritoneum (female only)
C488 Overlapping lesion of retroperitoneum and peritoneum (female only)
C569 Ovary
**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 55 *Ovary, Fallopian Tube, and Primary Peritoneal Carcinoma*, 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
* C481-C482, C488 and Sex: 1, 3, 5, 9 (8000-8700, 8720-8790, 8822, 8933, 8950, 8960, 8980, 9000, 9050, 9052, 9060, 9070-9071, 9073, 9080, 9085, 9090-9091, 9100, 9110-9111): *Retroperitoneum*
* C481-C482, C488 and Sex: 1, 3, 5, 9 (8806, 8930-8931) and C481-C482, C488 (8804-8805, 8991, 9020, 9044, 9231, 9581): *Soft Tissue*
* C481-C482, C488 (8710-8714, 8800-8803, 8810-8821, 8823-8921, 8932, 8934, 8940-8941, 8951-8959, 8963-8976, 8981-8990, 9010-9016, 9030-9043, 9045, 9051, 9053-9055, 9061-9065, 9072, 9081-9084, 9086, 9101-9105, 9120-9138, 9141-9230, 9240-9580, 9582): *Retroperitoneum*
* C481-C482, C488 (8935-8936): *GIST*
* C569 (8710-8714, 8800-8805, 8811-8814, 8816-8818, 8820-8821, 8823-8824, 8826-8881, 8891-8905, 8910-8921, 8932, 8934, 8940-8941, 8951-8959, 8963-8976, 8981-8992, 9010-9016, 9020, 9030-9045, 9051, 9053-9055, 9061-9065, 9072, 9081-9084, 9086, 9101-9105, 9120-9133, 9135-9138, 9141-9175, 9180-9222, 9230-9231, 9240-9368, 9370-9582): *Soft Tissue*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
**Note 3:** Ascites, NOS should be excluded as a staging element.
**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
**Note 5:** Peritoneal implants outside the pelvis must be microscopically confirmed. Peritoneal implants may also be called seeding, salting, talcum powder appearance, or studding.
**Note 6:** If implants are mentioned, determine whether they are in the pelvis or in the abdomen and code appropriately to regional by direct extension or to distant. If not stated, code to distant.
| SS2018 |
Description |
| 0 |
In situ: noninvasive, intraepithelial
- Limited to ovarian mucosa
- Preinvasive
- Serous tubal intraepithelial carcinoma (STIC) (8441/2) |
| 1 |
Localized only (localized, NOS)
Limited to one or both ovaries WITH capsule intact
Limited to one or both ovaries WITH or WITHOUT surgical spill
Limited to one or both ovaries WITHOUT or UNKNOWN
* Tumor on ovarian surface
* Malignant cells in ascites or peritoneal washings
Confined to ovary, NOS
Localized, NOS
Localized primary peritoneal cancer
+ (Primary sites C481, C482, C488)
FIGO Stage I (IA, IB, IC1, I NOS) |
| 2 |
Regional by direct extension only
Limited to one or both ovaries WITH
* Tumor on ovarian surface
* Malignant cells in ascites or peritoneal washings
* Pelvic extension, NOS (below pelvic brim)
Extension to and/or discontinuous metastasis to any of the following
* Adnexa
* Adjacent (pelvic) peritoneum
* Bladder
* Bladder serosa
* Corpus uteri
* Cul de sac (rectouterine pouch)
* Fallopian tube(s)
* Ligament(s) (broad, ovarian, round, suspensory)
* Mesosalpinx (Mesovarium)
* Parametrium
* Pelvic wall
* Rectosigmoid
* Rectum
* Sigmoid colon (including sigmoid mesentery)
* Ureter (pelvic portion)
* Uterus, NOS
FIGO Stage IC2, IC3
FIGO Stage II (IIA, IIB, II NOS) |
| 3 |
Regional lymph node(s) involved only
- Intrabdominal
- Para-aortic, NOS
+ Aortic
+ Lateral aortic/lateral lumbar
+ Periaortic
- Pelvic, NOS
+ Iliac, NOS
+ Common
+ External
+ Internal (hypogastric) (obturator)
+ Paracervical
+ Parametrial
+ Sacral, NOS
+ Lateral (laterosacral)
+ Middle (promontorial) (Gerota's node)
+ Presacral
+ Uterosacral
- Retroperitoneal, NOS
- Subdiaphragmatic (primary peritoneal carcinoma)
- Regional lymph node(s), NOS
+ Lymph node(s), NOS
FIGO Stage IIIA1 (IIA1i, IIIA1ii, IIIA1 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)
* Abdominal mesentery
* Diaphragm
* Gallbladder
* Intestine, large (except rectum, rectosigmoid and sigmoid colon, see code 2)
* Kidneys
* Liver (capsular or parenchymal involvement)
* Omentum (infracolic, NOS)
* Pancreas
* Pericolic gutter
* Peritoneum, NOS
* Peritoneal implants beyond pelvis
* Pleural effusion with positive cytology
* Small intestine
* Spleen (capsular or parenchymal involvement)
* Stomach
* Ureters (outside pelvis)
- Distant lymph node(s), NOS
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal (femoral)
- Distant metastasis, NOS
* Carcinomatosis (involvement of multiple parenchymal organs)
+ WITH or WITHOUT distant lymph node(s) OR pleural effusion
* Distant metastasis WITH or WITHOUT distant lymph node(s)
FIGO Stage III (IIIA, IIIA2, IIIB, IIIC, III NOS)
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) Prat, J., Olawaiye, A.B., Mutch, D.G., et al. **Ovary, Fallopian Tube, and Primary Peritoneal Carcinoma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
