]> C24.0 Extrahepatic bile duct Note: Extrahepatic Bile Duct was a single chapter in the AJCC 6th Edition. It has been divided into two chapters in the AJCC 7th Edition: Perihilar Bile Ducts and Distal Bile Duct. &generalsize; CS Extension Note 1: Perihilar bile duct tumors arise at the confluence of the right and left hepatic ducts in the hilar area of the liver. Note 2: The biliary radicals are the ducts or tubes that drain bile into the intestine as part of the digestive process. The second-order biliary radicals are the next largest branches or ducts of the biliary system which join to form or empty into the main hepatic bile duct. Note 3: For AJCC 7 staging, T3 and T4 are defined strictly in terms of invasion into specific large blood vessels and the biliary radicals within the liver. Give priority to coding invasion into blood vessels and biliary radicals over the named structures in . codes 605, 651, 700, 760, and 800. Use combination codes 665, 720, and 815 when information is available regarding extension to the specified vessels and/or the biliary radicals within the liver plus involvement of other named organs. Note 4: Involvement within the porta hepatis is coded according to the structures involved: portal vein, common hepatic artery, and common hepatic duct. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 In situ, intraepithelial, noninvasive Tis Tis IS IS 100 T1 T1 L L 200 Muscularis propria T1 T1 L L 300 Localized, NOS T1 T1 L L 350 Stated as T1 with no other information on extension T1 T1 L L 400 T2a T2 RE RE 450 Stated as T2a with no other information on extension T2a T2 RE RE 500 Adjacent hepatic parenchyma T2b T3 RE RE 510 T2b T3 RE RE 550 Stated as T2b with no other information on extension T2b T2 RE RE 555 T2NOS T2 RE RE 560 T2b T3 RE RE 600 ERROR T3 RE RE 605 TX T3 RE RE 610 T3 T3 RE RE 612 T3 T3 RE RE 615 Stated as T3 with no other information on extension T3 T3 RE RE 650 ERROR T4 RE RE 651 TX T4 RE RE 660 ERROR T4 RE RE 661 T4 T4 RE RE 665 661 + (605 and/or 651) T4 T4 RE RE 670 T4 T4 RE RE 700 TX T4 D RE 720 TX T4 D RE 750 ERROR T4 D D 760 Abdominal wall TX T4 D D 800 Further contiguous extension TX T4 D D 810 800 + (700 or 760) TX T4 D D 815 T4 T4 D D 820 Stated as T4 with no other information on extension T4 T4 RE RE 950 No evidence of primary tumor T0 T0 U U 999 TX TX U U &generalcstsexteval; 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: Para-aortic and pericaval lymph nodes are classified as regional nodes for AJCC 7 staging. They are now coded in CS Lymph Nodes. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 N0 NONE NONE 150 N1 N1 RN RN 200 Stated as N1 with no other information on lymph nodes N1 N1 RN RN 350 N2 N1 D D 400 N2 N0 D D 450 N2 N1 D D 750 Stated as N2 with no other information on lymph nodes N2 N1 D D 800 Lymph nodes, NOS N1 N1 RN RN 999 NX NX U U &generalregnodeseval; &generalreglnpos; &generalreglnexam; CS Mets at DX Note 1: Para-aortic and pericaval lymph nodesare classified as regional nodes for AJCC 7 staging and are coded in CS Lymph Nodes. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 00 No distant metastasis M0 * NONE NONE 10 ERROR M1 D D 15 M1 M1 D D 40 M1 M1 D D 50 ERROR M1 D D 51 M1 M1 D D 60 M1 M1 D D 99 M0 * U U * For CS Mets at DX codes 00 and 99, the M category for AJCC 6 staging is assigned based on the value of CS Lymph Nodes as shown in the Lymph Nodes Mets at DX AJCC 6 Table for this schema. &generalmetseval; ¬appssfactor1; ¬appssfactor2; ¬appssfactor3; ¬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. Code Description 000 Absence of periductal component 010 Presence of periductal component 988 999 &commonssf11bileducts; &commonssf12bileducts; &commonssf13bileducts; &commonssf14bileducts; ¬appnewssf15; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; &commonssf25bileductsdistalperihilar; &commonhistinclusioncarcinomanonnet; &commonhistologyexclusions1; AJCC TNM 7 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 UNK T0 N2 M0 IVB T0 NX M0 UNK Tis N0 M0 0 Tis N1 M0 ERROR Tis N2 M0 ERROR Tis NX M0 0 T1 N0 M0 I T1 N1 M0 IIIB T1 N2 M0 IVB T1 NX M0 UNK T2a N0 M0 II T2a N1 M0 IIIB T2a N2 M0 IVB T2a NX M0 UNK T2b N0 M0 II T2b N1 M0 IIIB T2b N2 M0 IVB T2b NX M0 UNK T2NOS N0 M0 II T2NOS N1 M0 IIIB T2NOS N2 M0 IVB T2NOS NX M0 UNK T3 N0 M0 IIIA T3 N1 M0 IIIB T3 N2 M0 IVB T3 NX M0 UNK T4 N0 M0 IVA T4 N1 M0 IVA T4 N2 M0 IVB T4 NX M0 IVNOS TX N0 M0 UNK TX N1 M0 UNK TX N2 M0 IVB TX NX M0 UNK T0 N0 M1 IVB T0 N1 M1 IVB T0 N2 M1 IVB T0 NX M1 IVB Tis N0 M1 ERROR Tis N1 M1 ERROR Tis N2 M1 ERROR Tis NX M1 ERROR T1 N0 M1 IVB T1 N1 M1 IVB T1 N2 M1 IVB T1 NX M1 IVB T2a N0 M1 IVB T2a N1 M1 IVB T2a N2 M1 IVB T2a NX M1 IVB T2b N0 M1 IVB T2b N1 M1 IVB T2b N2 M1 IVB T2b NX M1 IVB T2NOS N0 M1 IVB T2NOS N1 M1 IVB T2NOS N2 M1 IVB T2NOS NX M1 IVB T3 N0 M1 IVB T3 N1 M1 IVB T3 N2 M1 IVB T3 NX M1 IVB T4 N0 M1 IVB T4 N1 M1 IVB T4 N2 M1 IVB T4 NX M1 IVB TX N0 M1 IVB TX N1 M1 IVB TX N2 M1 IVB TX NX M1 IVB &commonstagebileductsdistalperihilar; &commonsummarystage; Lymph Nodes Mets at DX AJCC 6 Table Note: For CS Mets at DX codes 00 and 99, the M category for AJCC 6 staging is determined by the code in CS Lymph Nodes as shown in this table. CS Lymph Nodes CS Mets at DX 00 0 CS Mets at DX 99 99 000 M0 MX 150 M0 MX 200 M0 MX 350 M0 MX 400 M1 M1 450 M1 M1 750 M0 MX 800 M0 MX 999 M0 MX