Summary Stage 2018: Small Intestine
Summary Stage 2018
Notes
**Small Intestine**
8000-8700, 8720-8790
C170-C173, C178-C179
C170 Duodenum
C171 Jejunum
C172 Ileum (excluding ileocecal valve C18.0)
C173 Meckel diverticulum (site of neoplasm)
C178 Overlapping lesion of small intestine
C179 Small intestine, 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 18 *Small Intestine*, 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 30 *Neuroendocrine Tumors of the Duodenum and Ampulla of Vater*, 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 31 *Neuroendocrine Tumors of the Jejunum and Ileum*, 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 Duodenum and Ampulla of Vater,* from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois.
* *Neuroendocrine Tumors of the Jejunum and Ileum,* 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, 8940-9138, 9141-9582: *Soft Tissue*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
| SS2018 |
Description |
| 0 |
In situ, intraepithelial, noninvasive
- (Adeno)carcinoma, noninvasive, in a polyp or adenoma |
| 1 |
Localized only (localized, NOS)
- Confined to small intestine, NOS
- Extension through wall, NOS
- Intraluminal spread to other segments of small intestine or cecum
- Invasion of
+ Intramucosa, NOS
+ Lamina propria
+ Mucosa, NOS
+ Muscularis mucosae
+ Muscularis, NOS
+ Muscularis propria
+ Submucosa (superficial invasion)
- Polyp (head, stalk, NOS)
- Subserosal tissue/(sub)serosal fat invaded
- Transmural, NOS
- Wall, NOS |
| 2 |
Regional by direct extension only
- All sites
+ Abdominal wall (via serosa)
+ Adjacent organ(s)/structure(s)
+ Adjacent tissue(s) (connective), NOS
+ Fat, NOS
+ Mesenteric fat
+ Mesentery (adjacent loops of bowel)
+ Mesothelium
+ Nonperitonealized perimuscular tissue
+ Other loops of small intestine
+ Other segments of small intestine (via serosa)
+ Retroperitoneum
+ Serosa
+ Tunica serosa
+ Visceral peritoneum
- Duodenum (C170)
+ Ampulla of Vater
+ Blood vessel(s), major
* Aorta
* Gastroduodenal artery
* Portal vein
* Renal vein
* Superior mesenteric artery or vein
* Vena cava
+ Diaphragm
+ Extrahepatic bile duct(s)
+ Gallbladder
+ Hepatic flexure
+ Kidney (right or NOS)
+ Liver (quadrate lobe, right lobe or NOS)
+ Omentum
+ Pancreas (pancreatic duct)
+ Stomach
+ Transverse colon
+ Ureter, right
- Jejunum and Ileum (C171, C172)
+ Colon including appendix |
| 3 |
Regional lymph node(s) involved only
- All sites
+ Regional lymph node(s), NOS
* Lymph node(s), NOS
- Duodenum (C170)
+ Duodenal
+ Gastroduodenal
+ Hepatic
+ Pancreaticoduodenal (inferior)
+ Pericholodochal (common bile duct)
+ Pyloric (infrapyloric, subpyloric, NOS)
+ Retropancreatic
+ Superior mesenteric
- Jejunum and ileum (C171, C172)
+ Cecal (anterior, posterior, retrocecal) (terminal ileum only)
+ Ileocecal (ileocolic) (terminal ileum only)
+ Mesenteric, NOS
+ Superior mesenteric |
| 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)
+ Jejunum and Ileum (C171, C172)
* Bladder
* Fallopian tube(s)
* Ovary(ies)
* Uterus
- Distant lymph node(s), NOS
+ Celiac
+ Pericholedochal (jejunum and ileum only)
- 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) Coit, D.G., Kelsen, D., Hofstetter, W.L., et al. **Small Intestine**. 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 Duodenum and Ampulla of Vater**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(7) Woltering, E.A., Bergsland, E.K., et al. **Neuroendocrine Tumors of the Jejunum and Ileum**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
(8) **Neuroendocrine Tumors of the Duodenum and Ampulla of Vater,** from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois.
(9) **Neuroendocrine Tumors of the Jejunum and Ileum**, from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois.
