]> C22.0 Liver C22.1 Intrahepatic bile duct Note 1: For C22.0, the BileDuctsIntraHepat schema includes only M-8160, 8161, 8180. For other histologies, see the Liver schema. Note 2: For C22.1, the BileDuctsIntraHepat schema only includes M-8000-8162, 8180-9136, 9141-9582, and 9700-9701. For hepatocellular carcinoma, M-8170-8175, see the Liver schema. Note 3: AJCC TNM 7 staging will be derived for cases with primary site code of C22.1 and histology code of 8160, 8161, and 8180 only. Note 4: Staging for intrahepatic bile ducts was included in the Liver chapter in the AJCC 6th Edition. Intrahepatic Bile Ducts is a separate chapter in the AJCC 7th Edition. &commonsizebiliary; CS Extension Note 1: "Multiple (satellite) nodules/tumors" include satellitosis, multifocal tumors, and intrahepatic metastases. Note 2: Major vascular invasion is defined as invasion of the branches of the main portal vein (right or left portal vein, not including sectoral or segmental branches) or as invasion of one or more of the three hepatic veins (right, middle, or left). Invasion of the hepatic artery or vena cava is coded to 660. Note 3: Extension to gallbladder is not considered in AJCC staging for intrahepatic bile ducts but does affect Summary Stage. Use appropriate combination codes when gallbladder is involved. Note 4: All tumors with a periductal infiltrating growth pattern, a diffuse longitudinal growth pattern along the bile duct, are considered T4 by AJCC. For tumors with periductal infiltrating growth pattern, code the most specific information available about the extent of the tumor in CS Extension, and code periductal infiltrating growth pattern in CS Site-Specific Factor 10. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 Tis TX IS IS 100 ^ T1 L L 120 ^ T1 RE RE 140 ^ T1 RE RE 160 ^ T1 RE RE 170 ^ T1 L L 200 ^ T2 L L 220 ^ T2 RE RE 240 ^ T2 RE RE 250 ^ T3 RE RE 260 ^ T3 RE RE 270 Stated as T2a with no other information on extension ^ T2 L L 300 ^ * L L 400 ^ * L L 420 ^ * RE RE 450 ^ T3 RE RE 455 ^ T3 RE RE 460 ^ * D RE 465 ^ * D RE 470 ^ T3 D RE 475 ^ T2 L L 480 ^ T2 L L 500 ^ T1 L L 510 ^ T1 RE RE 520 ^ T2 RE RE 530 ERROR ERROR ERROR ERROR 540 ERROR ERROR ERROR ERROR 545 ERROR ERROR ERROR ERROR 550 ERROR ERROR ERROR ERROR 560 ERROR ERROR ERROR ERROR 570 ERROR ERROR ERROR ERROR 580 Extrahepatic bile ducts ^ T4 RE RE 590 ERROR ERROR ERROR ERROR 620 ^ T4 D RE 630 ERROR T3 RE RE 631 ^ T3 RE RE 632 ^ T3 RE RE 640 Direct extension/perforation of visceral peritoneum ^ T4 RE RE 643 640 + (460, 465, 470) ^ T4 D D 645 Multiple (satellite) nodules on surface of liver parenchyma ^ T4 D D 650 ^ * D RE 655 ERROR ERROR ERROR ERROR 660 Extension to hepatic artery or vena cava ^ T4 RE RE 665 660 + (460, 465, 470) ^ T4 D RE 670 ERROR T3 D RE 675 ^ T3 D RE 700 Diaphragm ^ T4 RE RE 750 ^ T4 RE RE 755 Lesser omentum Ligament(s): Coronary Falciform Hepatoduodenal Hepatogastric Round (of liver) Triangular Parietal peritoneum ^ T4 RE RE 760 ERROR T4 D RE 765 ^ T4 D RE 770 (700 or 750) + (460, 465, 470) ^ T4 D RE 780 Stated as T3 with no other information on extension ^ T3 RE RE 800 ^ T4 D D 850 ERROR ERROR ERROR ERROR 855 Stated as T4 with no other information on extension T4 T1 L L 950 No evidence of primary tumor T0 T0 U U 999 ^ TX U U ^ For CS Extension codes 100-520, 580, 620, 631-650, 660-665, 675-755, 765-800, and 999 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 10, as shown in the Extension Periductal Invasion AJCC 7 Table for this schema. * For CS Extension codes 300, 400, 420, 460, 465, 560, and 650 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size AJCC 6 Table for this schema. &commoncstsextevalliver; CS Lymph Nodes Note 1: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in CS Mets at DX. Note 2: Inferior phrenic nodes are classified as regional nodes for AJCC 7 staging. They are now coded in CS Lymph Nodes. Note 3: Periduodenal and peripancreatic nodes are regional for tumors in the right liver, and gastrohepatic nodes are regional for tumors in the left liver, for AJCC 7 staging. Use codes 120 and 130 only for regional nodes specific to the involved lobe of liver. Use code 140 if both lobes of liver are involved and periduodenal/peripancreatic and gastrohepatic nodes are involved. Note 4: Caval nodes are classified as distant nodes and coded in CS Mets at DX. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 * NONE NONE 100 N1 * RN RN 110 N1 * RN RN 120 N1 * D D 130 N1 * D D 140 N1 * D D 200 N1 * D D 300 N1 * D D 310 N1 * D D 500 N1 * RN RN 800 N1 * RN RN 999 NX * U U * For CS Lymph Nodes codes 000-999, the N and M categories for AJCC 6 staging are assigned based on the coding of CS Lymph Nodes and CS Mets at DX as shown in the Lymph Nodes Mets at DX AJCC 6 Table for this schema. &generalregnodeseval; &generalreglnpos; &generalreglnexam; CS Mets at DX Note 1: Inferior phrenic nodes are classified as regional nodes for AJCC 7 staging and coded in CS Lymph Nodes. Note 2: Periduodenal and peripancreatic nodes are distant for tumors in the left liver, and gastrohepatic nodes are distant for tumors in the right liver. If both lobes of liver are involved, code involvement of periduodenal/peripancreatic and gastrohepatic nodes in CS Lymph Nodes. Note 3: Caval nodes are classified as distant for AJCC 7 staging. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 00 No distant metastasis M0 * NONE NONE 07 M1 * RN RN 10 Distant lymph node(s), NOS M1 * D D 11 M1 * RN D 12 M1 * RN D 13 M1 * D D 14 M1 * RN D 15 ERROR * D D 16 M1 * D D 17 M1 * D D 18 M1 * D D 20 M1 * D D 40 M1 * D D 50 ERROR * D D 51 M1 * D D 52 M1 * D D 55 M1 * D D 58 M1 * D D 60 M1 * RN RN 99 M0 * U U * For CS Mets at DX codes 00-99, the N and M categories for AJCC 6 staging are assigned based on the coding of CS Lymph Nodes and CS Mets at DX as shown in the Lymph Nodes Mets at DX AJCC 6 Table for this schema. &generalmetseval; &commonssf1liver; &commonssf2liver; &commonssf3liver; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; CS Site-Specific Factor 10 Tumor Growth Pattern Note 1: Cholangiocarcinoma may be classified by growth pattern. The tumor growth patterns of intrahepatic cholangiocarcinoma include the mass forming type, the periductal infiltrating type, and a mixed type. The periductal infiltrating type of cholangiocarcinoma demonstrates a diffuse longitudinal growth pattern along the bile duct. Limited analyses suggest that the diffuse periductal infiltrating type is associated with a poor prognosis. Note 2: Record the presence or absence of an infiltrating periductal component. Note 3: If periductal component is not mentioned, record 000 as absence of periductal component. If the pathology report is not available, record 999 for unknown. Note 4: All tumors with a periductal infiltrating growth pattern are considered T4 by AJCC. For tumors with periductal infiltrating growth pattern, code the most specific information available about the extent of the tumor in CS Extension, and code periductal infiltrating growth pattern here. The algorithm will adjust the T category for tumors with periductal growth pattern. Code Description 000 Absence of periductal component 010 Presence of periductal component 988 999 &commonssf11bileducts; &commonssf12bileducts; ¬appnewssf13; ¬appnewssf14; ¬appnewssf15; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusioncholangiocarcinoma; &commonhistologyexclusions1; AJCC TNM 7 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 IVA T0 NX M0 UNK Tis N0 M0 0 Tis N1 M0 ERROR Tis NX M0 0 T1 N0 M0 I T1 N1 M0 IVA T1 NX M0 UNK T2a N0 M0 II T2a N1 M0 IVA T2a NX M0 UNK T2b N0 M0 II T2b N1 M0 IVA T2b NX M0 UNK T2NOS N0 M0 II T2NOS N1 M0 IVA T2NOS NX M0 UNK T3 N0 M0 III T3 N1 M0 IVA T3 NX M0 UNK T4 N0 M0 IVA T4 N1 M0 IVA T4 NX M0 IVA TX N0 M0 UNK TX N1 M0 IVA TX NX M0 UNK T0 N0 M1 IVB T0 N1 M1 IVB T0 NX M1 IVB Tis N0 M1 ERROR Tis N1 M1 ERROR Tis NX M1 ERROR T1 N0 M1 IVB T1 N1 M1 IVB T1 NX M1 IVB T2a N0 M1 IVB T2a N1 M1 IVB T2a NX M1 IVB T2b N0 M1 IVB T2b N1 M1 IVB T2b NX M1 IVB T2NOS N0 M1 IVB T2NOS N1 M1 IVB T2NOS NX M1 IVB T3 N0 M1 IVB T3 N1 M1 IVB T3 NX M1 IVB T4 N0 M1 IVB T4 N1 M1 IVB T4 NX M1 IVB TX N0 M1 IVB TX N1 M1 IVB TX NX M1 IVB AJCC TNM 6 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 IIIC T0 NX M0 UNK T0 N0 M1 IV T0 N1 M1 IV T0 NX M1 IV T0 N0 MX UNK T0 N1 MX UNK T0 NX MX UNK T1 N0 M0 I T1 N1 M0 IIIC T1 NX M0 UNK T1 N0 M1 IV T1 N1 M1 IV T1 NX M1 IV T1 N0 MX UNK T1 N1 MX UNK T1 NX MX UNK T2 N0 M0 II T2 N1 M0 IIIC T2 NX M0 UNK T2 N0 M1 IV T2 N1 M1 IV T2 NX M1 IV T2 N0 MX UNK T2 N1 MX UNK T2 NX MX UNK T3 N0 M0 IIIA T3 N1 M0 IIIC T3 NX M0 IIINOS T3 N0 M1 IV T3 N1 M1 IV T3 NX M1 IV T3 N0 MX UNK T3 N1 MX UNK T3 NX MX UNK T4 N0 M0 IIIB T4 N1 M0 IIIC T4 NX M0 IIINOS T4 N0 M1 IV T4 N1 M1 IV T4 NX M1 IV T4 N0 MX UNK T4 N1 MX UNK T4 NX MX UNK TX N0 M0 UNK TX N1 M0 IIIC TX NX M0 UNK TX N0 M1 IV TX N1 M1 IV TX NX M1 IV TX N0 MX UNK TX N1 MX UNK TX NX MX UNK &commonsummarystage; Extension Size AJCC 6 Table Note: For CS Extension codes 300, 400, 420, 460, 465, 560, and 650 ONLY, the T category is assigned based on the value of CS Tumor Size, as shown in this table. CS Extension CS Tumor Size 000 0 CS Tumor Size 001-050 1 50 CS Tumor Size 051-989 51 989 CS Tumor Size 990-995 990 995 CS Tumor Size 996 996 CS Tumor Size 997-998 997 998 CS Tumor Size 999 999 300 ERROR T2 T3 T2 T3 ERROR TX 400 ERROR T2 T3 T2 T3 ERROR TX 420 ERROR T2 T3 T2 T3 ERROR TX 460 ERROR T2 T3 T2 T3 ERROR TX 465 ERROR T2 T3 T2 T3 ERROR TX 650 ERROR T2 T3 T2 T3 ERROR TX Extension Periductal Invasion AJCC 7 Table Note: For CS Extension codes 100-520, 580, 620, 631-650, 660-665, 675-755, 765-800 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 10, as shown in this table. CS Extension CS SSF 10 000 0 CS SSF 10 010 10 CS SSF 10 988, 999 988 999 100-170, 500-510 T1 T4 T1 200-270, 520, 631 T2a T4 T2a 300-475, 632, 650, 675 T2b T4 T2b 480 T2NOS T4 T2NOS 580, 620, 640-645, 660-665, 700-755, 765-800 T3 T4 T3 999 TX T4 TX Lymph Nodes Mets at DX AJCC 6 Table Note: For CS Lymph Nodes codes 000-999, and CS Mets at DX codes 00-99, the N and M categories for AJCC 6 staging are assigned as shown in this table. CS Mets at DX CS Lymph Nodes 000 0 CS Lymph Nodes 100-110 100 110 CS Lymph Nodes 120-200 120 200 CS Lymph Nodes 300-310 300 310 CS Lymph Nodes 500-800 500 800 CS Lymph Nodes 999 999 00 N0 M0 N1 M0 N0 M1 N1 M1 N1 M0 NX MX 07 N1 M0 N1 M0 N1 M1 N1 M1 N1 M0 NX MX 10-13, 16-18, 40, 51-52, 58-60 N0 M1 N1 M1 N0 M1 N1 M1 N1 M1 NX M1 15, 50 N0 M1 N0 M1 N0 M1 N0 M1 N0 M1 N0 M1 14, 20, 55 N1 M1 N1 M1 N1 M1 N1 M1 N1 M1 N1 M1 99 NX MX N1 MX N0 M1 N1 M1 N1 MX NX MX