Summary Stage 2018: Stomach

Summary Stage 2018

Notes

**Stomach** **C160 and Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach: 0, 3, 9**: 8000-8149, 8154, 8160-8231, 8243-8248, 8250-8682, 8690-8700, 8720-8790, 8940-8960, 8965-8983, 9000, 9050-9111, 9270, 9300-9312, 9340-9363, 9380-9539, 9541 **C160**: 8150-8153, 8155-8156, 8158, 8240-8242, 8249, 8683 **C161-C169**: 8000-8700, 8720-8790, 8940-8960, 8965-8983, 9000, 9050-9111, 9270, 9300-9312, 9340-9363, 9380-9539, 9541 C160-C166, C168-C169 C160: Cardia of stomach C161: Fundus of stomach C162: Body of stomach C163: Gastric antrum C164: Pylorus C165: Lesser curvature of stomach, NOS C166: Greater curvature of stomach, NOS C168: Overlapping lesion of stomach C169: Stomach, NOS **Note 1:** **Sources used in the development of this schema** * 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 17 *Stomach*, 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 29 *Neuroendocrine Tumors of the Stomach*, 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 Stomach*, from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois. **Note 2:** **Other EOD Schemas with Stomach sites** * **Esophagus**: C160 and Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach: 2 8000-8015, 8021-8046, 8060, 8071-8073, 8075-8076, 8078-8082, 8084-8149, 8154, 8160-8231, 8243-8248, 8250-8552, 8561-8682, 8690-8700, 8720-8790, 8940-8960, 8965-8983, 9000, 9050-9111, 9270, 9300-9312, 9340-9363, 9380-9539, 9541 * **GIST**: 8935-8936 * **Kaposi Sarcoma**: 9140 * **Mycosis Fungoides**: 9700-9701 * **Soft Tissue**: 8710-8714, 8800-8934, 8963-8964, 8990-8992, 9010-9045, 9120-9138, 9141-9262, 9271-9290, 9320-9330, 9364-9373, 9540, 9542-9582 **Note 3:** **Esophagogastric junction** * If a tumor involves the esophagogastric junction (EGJ) and its epicenter is less than or equal to 2 cm into the proximal stomach (i.e. less than or equal to 2 cm distal to the EGJ * Use the *Esophagus (excluding GIST)* chapter for summary stage * Tumors involving the EGJ with their epicenter >2 cm into the proximal stomach (i.e., >2cm distal to the EGJ) are now classified using the *Stomach* chapter. * Use the *Stomach* chapter for Summary Stage * Includes cardia cancers that do not invade the EGJ . * **Schema Discriminator** * Schema Discriminator 1: EsophagusGEJunction (EGJ)/Stomach is used to discriminate between EsophagusGEjunction and Stomach which are coded to ICD-O-3 code C160.

NAACCR Item

NAACCR #764

SS2018	Description
0	In situ, intraepithelial, noninvasive * (Adeno)carcinoma, noninvasive, in a polyp
1	Localized only (localized, NOS) * Confined to stomach, NOS * Extension through wall, NOS * Implants within stomach * Intraluminal spread to esophagus or duodenum * Invasion of - Intramucosa, NOS - Lamina propria - Mucosa, NOS - Muscularis mucosae - Muscularis, NOS - Muscularis propria - Submucosa (superficial, NOS) * Linitis plastica (diffuse involvement of the entire stomach wall) * Perimuscular tissue invaded * Polyp (head, stalk, NOS) * Subserosal tissue/(sub)serosal fat
2	Regional by direct extension only * Adjacent (connective) tissue, NOS * Colon/mesocolon (including transverse and flexures) * Diaphragm * Duodenum (via serosa) * Esophagus (via serosa) * Gastric artery * Ileum * Jejunum * Ligaments - Gastrocolic - Gastrohepatic - Gastrosplenic * Liver * Mesothelium * Omentum (greater, lesser, NOS) * Pancreas * Perigastric fat * Serosa * Small intestine, NOS * Spleen * Tunica serosa * Visceral peritoneum
3	Regional lymph node(s) involved only * Celiac artery * Common hepatic artery * Hepatic, NOS * Left gastric (superior gastric), NOS - Cardial, NOS - Cardioesophageal - Gastric artery - Gastric, left - Gastrohepatic - Gastropancreatic, left - Lesser curvature - Lesser omentum - Paracardial * Pancreaticosplenic (pancreaticolineal) * Perigastric, NOS * Peripancreatic * Pyloric, NOS - Infrapyloric (subpyloric) - Suprapyloric * Right gastric (inferior gastric, NOS) - Gastrocolic - Gastroduodenal - Gastroepiploic (gastro-omental), right or NOS - Gastrohepatic - Greater curvature - Greater omentum - Pancreaticoduodenal * Splenic (lineal), NOS - Gastroepiploic (gastro-omental), left - Splenic hilar/hilum * Nodule(s) in perigastric fat * 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) - Abdominal wall - Adrenal (suprarenal) gland - Aorta - Celiac axis - Kidney - Retroperitoneum * Distant lymph node(s), NOS - Hepatoduodenal (along the proper hepatic artery, including portal) - Intra-abdominal - Mesenteric (inferior, superior, NOS) - Middle colic - Pancreaticoduodenal (all subsites EXCEPT greater curvature) - Para-aortic - Porta hepatic (portal) (hilar) (in hilus of liver) - Retropancreatic - Retroperitoneal * Distant metastasis, NOS - Carcinomatosis - Krukenberg tumor (metastasis to ovary(ies)) - Malignant (positive) peritoneal cytology - 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) Ajani, J.A., In, H., Sano, T., Hofstetter, W.L., et al. **Stomach**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017 (6) Woltering, E.A., Bergsland, E.K., et al. **Neuroendocrine Tumors of the Stomach**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017 (7) **Neuroendocrine Tumors of the Stomach,** from the AJCC Cancer Staging System Version 9 (2023). Used with permission of the American College of Surgeons, Chicago, Illinois.

SS2018	Description
0	In situ, intraepithelial, noninvasive * (Adeno)carcinoma, noninvasive, in a polyp
1	Localized only (localized, NOS) * Confined to stomach, NOS * Extension through wall, NOS * Implants within stomach * Intraluminal spread to esophagus or duodenum * Invasion of - Intramucosa, NOS - Lamina propria - Mucosa, NOS - Muscularis mucosae - Muscularis, NOS - Muscularis propria - Submucosa (superficial, NOS) * Linitis plastica (diffuse involvement of the entire stomach wall) * Perimuscular tissue invaded * Polyp (head, stalk, NOS) * Subserosal tissue/(sub)serosal fat
2	Regional by direct extension only * Adjacent (connective) tissue, NOS * Colon/mesocolon (including transverse and flexures) * Diaphragm * Duodenum (via serosa) * Esophagus (via serosa) * Gastric artery * Ileum * Jejunum * Ligaments - Gastrocolic - Gastrohepatic - Gastrosplenic * Liver * Mesothelium * Omentum (greater, lesser, NOS) * Pancreas * Perigastric fat * Serosa * Small intestine, NOS * Spleen * Tunica serosa * Visceral peritoneum
3	Regional lymph node(s) involved only * Celiac artery * Common hepatic artery * Hepatic, NOS * Left gastric (superior gastric), NOS - Cardial, NOS - Cardioesophageal - Gastric artery - Gastric, left - Gastrohepatic - Gastropancreatic, left - Lesser curvature - Lesser omentum - Paracardial * Pancreaticosplenic (pancreaticolineal) * Perigastric, NOS * Peripancreatic * Pyloric, NOS - Infrapyloric (subpyloric) - Suprapyloric * Right gastric (inferior gastric, NOS) - Gastrocolic - Gastroduodenal - Gastroepiploic (gastro-omental), right or NOS - Gastrohepatic - Greater curvature - Greater omentum - Pancreaticoduodenal * Splenic (lineal), NOS - Gastroepiploic (gastro-omental), left - Splenic hilar/hilum * Nodule(s) in perigastric fat * 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) - Abdominal wall - Adrenal (suprarenal) gland - Aorta - Celiac axis - Kidney - Retroperitoneum * Distant lymph node(s), NOS - Hepatoduodenal (along the proper hepatic artery, including portal) - Intra-abdominal - Mesenteric (inferior, superior, NOS) - Middle colic - Pancreaticoduodenal (all subsites EXCEPT greater curvature) - Para-aortic - Porta hepatic (portal) (hilar) (in hilus of liver) - Retropancreatic - Retroperitoneal * Distant metastasis, NOS - Carcinomatosis - Krukenberg tumor (metastasis to ovary(ies)) - Malignant (positive) peritoneal cytology - Distant metastasis WITH or WITHOUT distant lymph node(s)
9	Unknown if extension or metastasis