Summary Stage 2018: Brain

Summary Stage 2018

Notes

**Brain** **Malignant histologies (/3):** * 8000-8803, 8810-8858, 8860-8900, 8902-8905, 8921, 8932-8934, 8940-8990, 8992, 9000-9016, 9030-9043, 9045-9221, 9230, 9240-9365, 9370-9580, 9582 * ***Note:** For 2023+, the following histologies are collected in the Medulloblastoma Summary Stage chapter: 9362, 9470-9478, 9501-9504, 9508* **Benign/Borderline histologies (/0, /1):** * 8000-9582 C700, C710-C719 C700: Cerebral meninges C710: Cerebrum C711: Frontal lobe C712: Temporal lobe C713: Parietal lobe C714: Occipital lobe C715: Ventricle, NOS C716: Cerebellum, NOS C717: Brain stem C718: Overlapping lesion of brain C719: Brain, NOS **Note 1:** **Sources 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 72 *Brain and Spinal Cord*, 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. * Brain and Spinal Cord, from the AJCC Cancer Staging System Version 9 (2022). Used with permission of the American College of Surgeons, Chicago, Illinois. **Note 2:** **Medulloblastoma** * For diagnoses January 1, 2023, and forward, the following histologies will be collected in the Medulloblastoma Summary Stage chapter * 9362, 9470-9478, 9501-9504, 9508 **Note 3:** **Other Summary Stage Chapters with Brain sites (/3 only)** * **GIST**: 8935-8936 * **Soft Tissue**: 8804-8806, 8859, 8901, 8910-8920, 8930-8931, 8991, 9020, 9044, 9222, 9231, 9366-9368, 9581 **Note 4:** **Only staging system** * Summary Stage is the only applicable staging system for this site/histology/schema. **Note 5:** **Benign/Borderline tumors** * Benign (/0) or Borderline (/1) tumors **are always coded to 8** regardless of size, extension to adjacent sites, or multiple tumors **Note 6:** **Not applicable codes** * Codes 0, 3, and 4 are not applicable for this chapter. **Note 7:** **Infratentorial and Supratentorial** * The tentorium cerebelli is an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes. * The location of the tumor above or below the tentorium can help in determining the type of tumor; also, most adult brain tumors are supratentorial, and most pediatric brain tumors are infratentorial. * In the following list, note that ICD-O-3 codes C710 and C719 include both supratentorial and infratentorial subsites. - The following subsites are **Infratentorial** * All subsites for codes C716-C717 * Hypothalamus (C710) * Pallium (C710) * Posterior cranial fossa (C719) * Thalamus (C710) - The following subsites are **Supratentorial** * All subsites for codes C711-C715 * Primary site C710 (excluding hypothalamus, pallium, thalamus) * Anterior cranial fossa (C719) * Corpus callosum (C718) * Middle cranial fossa (C719) * Tapetum (C718) * Suprasellar (C719) **Note 8:** **Midline shift** * A midline shift is not the same thing as crossing the midline (code 2). * Documentation must state “crossing/crosses the midline”

NAACCR Item

NAACCR #764

Metadata

None
SS2018 Description
1 **Localized only (localized, NOS)** * Confined to brain, NOS * Confined to meninges, NOS * Confined to ventricles - Tumor invades or encroaches upon ventricular system * Infratentorial tumor confined to - Brain stem or meninges of brain stem (one side) + Medulla oblongata + Midbrain (mesencephalon) + Pons - Cerebellum or meninges of cerebellum (one side or midline) + Lateral lobes + Median lobe of cerebellum + Vermis - Hypothalamus - Thalamus * Infratentorial tumor - Both cerebellum and brain stem involved with tumor on one side * Supratentorial tumor confined to - Cerebral hemisphere (cerebrum) or meninges of cerebral hemisphere (one side) + Frontal lobe + Occipital lobe + Parietal lobe + Temporal lobe
2 **Regional by direct extension only** Tumor crosses the midline * All sites - Bone (skull) - Contralateral hemisphere - Corpus callosum (including splenium) - Major blood vessel(s) - Meninges (e.g., dura) - Nerves (cranial, NOS) - Spinal cord/canal * Supratentorial tumor extends/invades infratentorially to involve - Brain stem - Cerebellum - Hypothalamus - Pallium - Posterior cranial fossa - Thalamus * Infratentorial tumor extends/invades supratentorially to involve - Anterior cranial fossa - Cerebrum (cerebral hemisphere) (excluding hypothalamus, pallium, thalamus) - Corpus callosum - Middle cranial fossa - Suprasellar brain - Tapetum
7 **Distant site(s)/lymph node(s) involved** * Distant site(s) (including further contiguous extension) - Circulating cells in cerebral spinal fluid (CSF) - Nasal cavity - Nasopharynx - Other direct extension outside CNS - Posterior pharynx * Distant lymph node(s), NOS * Distant metastasis, NOS - Carcinomatosis - Distant metastasis WITH or WITHOUT distant lymph node(s) - Metastasis within CNS and CSF pathways + "Drop" metastasis + Extra-neural metastasis + Metastasis outside the CNS
8 **Benign or borderline brain** * Behavior is /0 or /1
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) Laws, E.R., Curran, W.J., et al. **Brain and Spinal Cord**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017 (5) **Brain and Spinal Cord**, from the AJCC Cancer Staging System Version 9 (2022). Used with permission of the American College of Surgeons, Chicago, Illinois.