Sarcomatoid Features
Description
Sarcomatoid features: present or absent and percentage refers to the observation of sheets and fascicles of malignant spindle cells in a kidney tumor which can occur across all histologic subtypes. The percentage of sarcomatoid component has been shown to correlate with cancer-specific mortality.
The presence of sarcomatoid or spindle cell features in a kidney tumor is a strong adverse prognostic factor. There is a specific ICD-O morphology code for renal cell carcinoma, sarcomatoid or spindle cell (8318/3), but this data item documents any sarcomatoid or spindle cell features in any renal cell cancer.
* Note: This data item applies to carcinomas only; rare sarcomas of the kidney should not be coded in this field
* Code the percentage of sarcomatoid features documented anywhere in the pathology report
Rationale
Sarcomatoid features for Kidney is a Registry Data Collection Variable in AJCC. It was previously collected as Kidney, CS SSF #4.
Additional Info
**Source Documents:** Surgical pathology report
For further information, refer to the **Kidney** cancer protocol published by the College of American Pathologists for the AJCC Staging System *Kidney*
Notes
**Note 1:** **Physician Staging**
* Physician statement of Sarcomatoid Features (spindle cell features) can be used to code this data item when no other information is available.
**Note 2:** **Criteria for coding**
* Surgical resection of primary site must be done
* If no surgical resection of primary site, code unknown (code 9)
* Do not use imaging findings to code this data item.
**Note 3:** **Sarcomatoid morphology/features**
* Sarcomatoid morphology may be manifested by any renal cell carcinoma. The presence of sarcomatoid component in a renal cell carcinoma may be prognostically important.
* Sarcomatoid features is mostly seen with renal cell carcinoma (all variants); however, if it’s seen with other carcinoma histologies, it can be coded.
Coding Guidelines
**1)** Record whether sarcomatoid features are present or absent as documented in the surgical pathology report
* **a.** a. Surgical resection of primary site must be done
* **b.** Do not use imaging findings to code this data item.
**2)** **Code 000** when the surgical pathology report states that there are no sarcomatoid features
**3)** **Code 001-100** code exact percentage of sarcomatoid features appropriately [1% (001) to 100% (100)]
**4)** **Code R01-R05** when only range documented (specific percentage not available)
**5)** **Code XX5** when the only information available about Sarcomatoid features is from a metastatic site
**6)** **Code XX6** when sarcomatoid features present, percentage unknown
**7)** **Code XX7** when histology is not renal cell carcinoma (includes other carcinomas that are not renal cell and sarcomas)
**8)** **Code XX9** when
* **a.** There is no documentation in the medical record
* **b.** Clinical diagnosis only
* **c.** Evaluation of sarcomatoid features not done or unknown if done
* **d.** Surgical resection of the primary site is performed and there is no mention of sarcomatoid features
Default
XX8
Metadata
SSDI
| Code |
Description |
| 000 |
Sarcomatoid features not present/not identified |
| 001-100 |
Sarcomatoid features 1-100% |
| R01 |
Sarcomatoid features stated as less than 10% |
| R02 |
Sarcomatoid features stated as range 10%-30% present |
| R03 |
Sarcomatoid features stated as a range 31% to 50% present |
| R04 |
Sarcomatoid features stated as a range 51% to 80% present |
| R05 |
Sarcomatoid features stated as greater than 80% |
| XX5 |
Sarcomatoid features present from metastatic site only AND
Sarcomatoid features not present, or unknown if present, in primary site |
| XX6 |
Sarcomatoid features present, percentage unknown |
| XX7 |
Not applicable: Not a renal cell carcinoma morphology |
| XX8 |
Not applicable: Information not collected for this case
(If this information is required by your standard setter, use of code XX8 may result in an edit error.) |
| XX9 |
Not documented in medical record
Sarcomatoid features not assessed or unknown if assessed
No surgical resection of primary site is performed |
