EOD Primary Tumor


**Note 1:** The wall of the esophagus has five layers: mucosal (code 100), submucosal (code 200), muscular (code 250), subserosal (code 300) and serosal (code 400). * The three layers of the mucosa (epithelium, lamina propria, and muscularis mucosae) may be called the m1, m2, and m3 layers. The submucosa may be described as having inner, middle, and outer thirds called sm1, sm2, and sm3. **Note 2:** Non-invasive carcinomas in the esophagus formerly called in situ are now called high grade dysplasia. High grade dysplasia and severe dysplasia are generally not reportable in cancer registries. * Code 000 if your registry collects these tumors **Note 3:** Ignore intraluminal extension to adjacent segment(s) of esophagus or to cardia of stomach and code depth of invasion or extra-esophageal spread as indicated. **Note 4:** If the tumor's extension is only described by a phrase like "through the muscularis propria", this could mean that the cancer has penetrated the outermost muscle cells but not beyond (code 250); but usually "through the muscularis" or “through the esophageal wall” is used to indicate that the cancer extends beyond the muscle and into adjacent tissue (code 300).
Code Description SS2018 T
000 In situ, intraepithelial, non-invasive, high-grade dysplasia (Adeno)carcinoma, noninvasive, in a polyp IS
100 Intramucosal, NOS Lamina propria Mucosa, NOS Muscularis mucosae L
150 Submucosa (superficial invasion) L
200 Confined to esophagus, NOS Localized, NOS L
250 Muscularis propria L
300 Extension through wall, NOS Invasion through muscularis propria or muscularis, NOS Perimuscular tissue invaded Subserosal tissue/(sub)serosal fat invaded L
350 Adventitia and/or soft tissue invaded Esophagus is described as "FIXED" Extension to adjacent (connective) tissue WITHOUT perforation of visceral peritoneum covering these structures Gastric artery Ligaments - Gastrocolic - Gastrohepatic - Gastrosplenic - Omentum (greater, lesser, NOS) Perigastric fat RE
400 All subsites - Azygos vein - Diaphragm (excluding abdominal/lower esophagus, see code 500) - Mesothelium - Pericardium (excluding thoracic/middle esophagus, see code 500) - Peritoneum, NOS - Pleura (excluding cervical/upper esophagus, see code 500) - Serosa (invasion of/or through) - Tunica serosa - Visceral peritoneum (including perforation) Cervical esophagus - Hypopharynx - Jugular vein - Larynx - Thyroid gland Intrathoracic esophagus, lower portion (abdominal) - Blood vessel(s), major + Gastric artery/vein - Stomach, cardia (via serosa) RE
500 Abdominal/lower esophagus - Diaphragm fixed Cervical/upper esophagus - Pleura Thoracic/middle esophagus - Pericardium Esophagus GE Junction - Abdominal wall - Adrenal (suprarenal) gland - Kidney - Retroperitoneum D
600 All subsites - Adjacent structure(s), NOS - Aorta Cervical esophagus - Blood vessel(s) + Carotid artery + Subclavian artery - Carina - Cervical vertebra(e) - Trachea Intrathoracic, upper or mid-portion, esophagus - Blood vessel(s), major + Pulmonary artery/vein + Vena cava - Carina - Trachea Intrathoracic, lower portion (abdominal), esophagus - Blood vessel(s) + Vena cava Intrathoracic esophagus (all portions) - Adjacent rib(s) - Lung via bronchus - Mediastinal structure(s), NOS - Thoracic vertebra(e) Esophagus GE Junction - Liver - Pancreas - Small intestine (duodenum [via serosa], ileum, jejunum) - Spleen - Transverse colon (including flexures) RE
700 All subsites - Airway - Vertebral body Cervical/upper esophagus - Lung - Mainstem bronchus Esophagus GE Junction - Trachea Stated as unresectable, NOS Further contiguous extension D
800 No evidence of primary tumor U
999 Unknown; extension not stated Primary tumor cannot be assessed Not documented in patient record Death Certificate Only U
(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: 3-30 (5) Rice, T.W., Kelsen, D., Hofstetter, W.L., et al. **Esophagus and Esophagogastric Junction**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 185-202