EOD Primary Tumor


**Note 1:** Gerota’s fascia is a fibrous tissue sheath surrounding the kidney and suprarenal or adrenal gland. The perirenal fat, renal capsule, and renal parenchyma lie below the fascia. **Note 2:** The most common site for renal parenchymal cancer to develop is in the proximal convoluted tubule. Tumor extension from one of these structures into another is coded 100 and is dependent on size in the absence of further involvement.
Code Description SS2018 T
000 In situ, intraepithelial, noninvasive IS
100 Any size tumor - Invasion of renal capsule - Invasive cancer confined to kidney cortex and/or medulla - Pelvicalyceal system - Renal pelvis or calyces involved - Separate focus of tumor in renal pelvis/calyx Confined (limited) to the kidney, NOS Localized, NOS L
200 Blood vessel(s) (major) - Extrarenal portion of renal vein or segmental (muscle containing branches) - Hilar blood vessel - Perirenal vein - Renal artery - Renal vein, NOS - Tumor thrombus in a renal vein, NOS Invasion of perirenal and/or renal sinus fat but not beyond Gerota’s fascia Perinephric tissue invasion WITHOUT extension beyond the Gerota’s fascia RE
300 Inferior vena cava (IVC) below diaphragm RE
400 IVC above diaphragm or invades wall of IVC RE
500 Tumor extends into major veins (excluding ipsilateral adrenal gland) Not beyond Gerota’s fascia (see code 600) IVC, NOS RE
600 Extension beyond Gerota's fascia to - Adrenal gland (ipsilateral) (contiguous metastasis) - Ascending colon from right kidney - Beyond Gerota’s fascia, NOS - Descending colon from left kidney - Diaphragm - Duodenum from right kidney - Peritoneum - Psoas muscle - Quadratus lumborum muscle - Retroperitoneal soft tissue - Tail of pancreas - Ureter (ipsilateral), including implant(s) RE
700 Aorta Liver from right kidney Ribs Spleen from left kidney Stomach 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) Rini, B.I., McKiernan, J.M., Stadler, W.M., et al. **Kidney**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 739-748