Summary Stage 2018: Pleural Mesothelioma

Summary Stage 2018


**Pleural Mesothelioma** 9050-9053 C340-C343, C348-C349, C384 C340 Main bronchus C341 Upper lobe, lung C342 Middle lobe, lung C343 Lower lobe, lung C348 Overlapping lesion of lung C349 Lung, NOS C384 Pleura **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) ( * SEER Summary Staging Manual-2000: Codes and Coding Instructions ( * Collaborative Stage Data Collection System, version 02.05: * Chapter 37 *Malignant Pleural Mesothelioma*, 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:** Most pleural effusions are due to tumor. When the cytopathological examinations of pleural fluid are negative for tumor, the effusion should be excluded as a staging element and the tumor should not be classified as metastasis. * The physician statement of pleural effusion can be used to code this data item * If the physician feels the pleural effusion is due to tumor, despite negative cytology, the physician's assessment can be used. * If pleural fluid cytology is described as suspicious/suspicious for mesothelioma, code 7


SS2018 Description
0 In situ, intraepithelial, noninvasive
1 Localized only (localized, NOS) - Confined to pleura, NOS - Invasive tumor (mesothelioma) confined to pleura, NOS - Ipsilateral parietal pleura WITH or WITHOUT involvement of + Diaphragmatic pleural + Mediastinal pleura + Parietal pleura + Visceral pleura
2 Regional by direct extension only - Adjacent (connective) tissue, NOS - Chest wall - Confluent visceral pleural tumor (including any involvement of interlobar fissure) - Diaphragmatic muscle - Endothoracic fascia - Ipsilateral pleural surfaces all involved + Diaphragmatic, parietal, mediastinal, and visceral - Lung parenchyma, or lung involvement, NOS - Mediastinal fat (mediastinal tissues) - Mediastinal organs (direct extension) - Nodule(s) beneath visceral pleural surface (ipsilateral pleura) - Pericardium (extension through the internal surface) (non-transmural, NOS) WITHOUT pericardial effusion - Pulmonary parenchyma (visceral pleural extension) - Rib
3 Regional lymph node(s) involved only - Aortic (above diaphragm), NOS + Ascending aorta (phrenic) + Peri/para-aortic + Subaortic (aortico-pulmonary window) - Carinal (tracheobronchial) (tracheal bifurcation) - Hilar (ipsilateral) + Bronchopulmonary + Proximal lobar + Pulmonary root - Intercostal - Internal mammary (parasternal) - Intrapulmonary + Interlobar + Lobar + Segmental + Subsegmental - Mediastinal, NOS (ipsilateral) + Anterior + Posterior (tracheoesophageal) - Pericardial - Peri/parabronchial - Peri/paraesophageal (below carina) - Peri/paratracheal (lower [azygos], upper, NOS) - Pretracheal and retrotracheal (precarinal), NOS - Prevascular - Pulmonary ligament - Subcardial - Subcarinal - 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) + Brachial plexus + Cervical (neck) tissues + Contralateral lung + Contralateral pleura (direct contiguous extension) + Contralateral pleura/chest wall (discontinuous involvement) + Heart muscle + Intra-abdominal organs + Mediastinal organs (discontinuous involvement) + Mesothelioma WITH malignant pleural fluid + Pericardial effusion, malignant + Pericardium WITH pericardial effusion + Peritoneum (direct transdiaphragmatic extension of tumor) + Peritoneum (discontinuous extension of tumor) + Pleural effusion (see Note 3) + Spine - Distant lymph node(s), NOS + Hilar (contralateral, bilateral) * Bronchopulmonary * Proximal lobar * Pulmonary root + Mediastinal (contralateral, bilateral) * Anterior * Posterior (tracheoesophageal) + Peridiaphragmatic (ipsilateral, contralateral) * Mediastinal + Scalene (ipsilateral, contralateral) * Inferior deep cervical + Supraclavicular (ipsilateral or contralateral) * Transverse cervical - 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) Rusch, V.W., et al. **Malignant Plural Mesothelioma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017