California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures
Listed below are special conditions that may occur and must be taken into account when coding Summary Stage.
IMPORTANT NOTE: The SEER Summary Staging Manual and Online Versions DO NOT include:
CODE 8 - Benign & Borderline Brain and/or CNS tumors
Code added in 2003
Use code 8 for all benign and borderline brain and CNS tumors
Microinvasive: This is a term used by pathologists to describe the earliest invasive stage, and has a precise meaning for cancer of certain sites.
A statement of microinvasion indicates the tumor is no longer insitu and is at least localized.
Example: “final diagnosis of carcinoma in situ with focus of microinvasion on the lateral margin”.
Multicentric tumors/Multifocal disease: If same cell type, “metastases within the organ of origin or multifocal disease (meaning tumors with more than one focus, or starting point) are considered localized unless there is extension beyond the primary site, however a tumor that has developed a satellite nodule, that is a lesion secondary to the primary one, might not be localized.
Example: Pathology reports states “Right breast with widespread multifocal metastases throughout breast parenchyma”. Provided disease is confined to the breast (see list of tissue involved in Summary Stage Manual) this tumor description would be coded as “Localized”.
Blood vessel invasion, perineural invasion, or vascular invasion within the primary site only indicates “potential for spread”, and is still considered localized disease, unless there is evidence of invasion outside of the organ of origin.
Satellite nodule: A tumor that has developed a satellite nodule, that is, a lesion secondary to the primary one, might not be localized.
Example: Melanoma of right forearm with satellite nodule 1.2 cm lateral to primary lesion; this description would be Summary stage Code 2 Regional by direct extension, provided there is no lymph node involvement.
Lymph Node Involvement Assessment
It is important to refer to the Summary Stage Manual (page 7) to review the “regional lymph node involvement” terms, definitions and directions.
Pediatric Staging:
While Summary Stage does not contain pediatric specific staging scheme, pediatric cancers can be staged using Summary Stage. Stage pediatric cancers in Summary Stage as you would an adult.