Summary Stage 2018: Vagina
Summary Stage 2018
Notes
**Vagina**
8000-8700, 8720-8790, 8933, 8980, 9071, 9110
C529
C529 Vagina, 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 51 *Vagina*, 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
* 8710-8714, 8800-8932, 8934, 8940-8975, 8981-9070, 9072-9105, 9120-9138, 9141-9582: *Soft Tissue*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
**Note 3:** 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
| SS2018 |
Description |
| 0 |
In situ: noninvasive, intraepithelial |
| 1 |
Localized only (localized, NOS)
* Confined to vagina
* Musculature involved
* Submucosa (stroma) (vagina)
FIGO Stage I |
| 2 |
Regional by direct extension only
+ Bladder wall or bladder, NOS (excluding mucosa)
+ Cervix
+ Cul de sac (rectouterine pouch)
+ Extension to lower third of the vagina (from proximal vagina)
+ "Frozen pelvis" (clinically diagnosed)
+ Hydronephrosis or nonfunctioning kidney
+ Parametrium
+ Paravaginal soft tissue
+ Pelvic wall
* Fascia
* Muscle
* Neurovascular structures
* Skeletal portions of bony pelvis
+ Rectal wall or rectum, NOS excluding mucosa
+ Rectovaginal septum
+ Vesicovaginal septum
+ Vulva
FIGO Stage II
FIGO Stage III WITHOUT lymph node involvement |
| 3 |
Regional lymph node(s) involved only
- Lower third of vagina (ipsilateral and bilateral)
+ Femoral
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal
- Upper two thirds of vagina
+ Pelvic, NOS
+ Iliac, NOS
+ Common
+ External
+ Internal (hypogastric) (obturator)
+ Paracervical
+ Parametrial
+ Sacral, NOS
+ Lateral (laterosacral)
+ Middle (promontorial) (Gerota's node)
+ Presacral
+ Uterosacral
- Regional lymph node(s), NOS
+ Lymph node(s), NOS
FIGO Stage III
* 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)
* Bladder mucosa (excluding bullous edema)
* Extension beyond true pelvis
* Rectal mucosa
* Urethra
- Distant lymph node(s), NOS
+ All sites
+ Mediastinal
+ Para-aortic, NOS
+ Aortic
+ Lateral aortic/lateral lumbar
+ Periaortic
+ Retroperitoneal, NOS
+ Scalene
+ Lower third of vagina (ipsilateral and bilateral)
+ Pelvic, NOS
+ Iliac, NOS
+ Common
+ External
+ Internal (hypogastric) (obturator)
+ Paracervical
+ Parametrial
+ Sacral, NOS
+ Lateral (laterosacral)
+ Middle (promontorial) (Gerota's node)
+ Presacral
+ Uterosacral
+ Upper two thirds of vagina
+ Femoral
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal
- Distant metastasis, NOS
+ Carcinomatosis
+ Distant metastasis WITH or WITHOUT distant lymph node(s)
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) Gibb, R.K., Olawaiye, A.B., Mutch, D.G., et al. **Vagina**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
