St. Jude/Murphy Staging System

Notes

**Note 1:** This SSDI is effective for diagnosis years 2023+ * For cases diagnosed 2018-2022, leave this SSDI blank **Note 2:** Registrar is required to assign St/Jude Murphy Stage based on the criteria provided in this data item. * If a physician documents the St/Jude Murphy Stage, document this in the text field, but don’t use that to code this data item **Note 3:** Extensive disease (Stage III) typically exhibits spread to para-aortic and retro-peritoneal areas by implants and plaques in mesentery or peritoneum, or by direct infiltration of structures adjacent to the primary tumor. Ascites may be present, and complete resection of all gross tumor is not possible.

NAACCR Item

NAACCR #9615

Metadata

SSDI

Code	Description
1	Involvement of a single tumor, mass or nodal area * EXCLUDING the abdomen and mediastinum
2	Single tumor (extranodal) with regional node involvement OR Two or more nodal areas on the SAME side (either above or below) the diaphragm OR Two or more single (extranodal) tumors * WITH or WITHOUT regional lymph node involvement * AND on SAME side (either above or below) the diaphragm OR Completely resectable primary gastrointestinal tract tumor * WITH or WITHOUT involvement of associated mesenteric nodes only
3	Tumor (extranodal) or nodal areas on BOTH side (above and below) of the diaphragm OR Any primary intrathoracic tumor (mediastinal, hilar, pulmonary, pleural or thymic) OR Extensive (unresectable) primary intraabdominal disease OR Any paraspinal or epidural tumors regardless of other tumor sites
4	Initial CNS involvement * Any CNS tumor mass (identified by imaging techniques [i.e., CT, MRI]) OR * Cranial nerve palsy that cannot be explained by extradural lesions, OR * Blasts morphologically identified in CSF - In the absence of a CSF tumor mass and cranial nerve palsy, a CSF report is required to confirm or exclude CNS involvement AND/OR Bone marrow involvement * Morphologic evidence of >= 5% blasts or lymphoma cells by bone marrow aspiration or biopsy
7	Not applicable: histologies 9731, 9732, 9734
8	Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error.)
9	Not documented in medical record St Jude Staging System not assessed
<BLANK>	N/A-Diagnosis year is prior to 2023

(1) Aitken JF, Youlden D, O’Neill L, Gupta S, Frazier AL, eds. Childhood cancer staging for population registries according to the Toronto Childhood Cancer Stage Guidelines – Version 2. Cancer Council Queensland and Cancer Australia: Brisbane, Australia; 2021.