]> M-8935-8936 C19.9 Rectosigmoid junction C20.9 Rectum, NOS Note: The histologies included in this schema were not staged with AJCC 6th Edition. Therefore, the algorithm will not derive an AJCC 6th TNM or stage group. &commontumorsizegistappcolonrectum; CS Extension Note 1: AJCC does not include a Tis category for gastrointestinal stromal tumors (GIST). Any case with a CS Extension code of 000 is mapped to TX for AJCC 7 stage and in situ Summary Stage. Note 2: For rectosigmoid, ignore intraluminal extension to adjacent segment(s) of colon and rectum; code depth of invasion or extra-rectosigmoidal spread as indicated. Note 3: The assignment of T categories for GISTs is based on tumor size. A physician's statement of the T category may be used to code CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently: for example the record may document size but not extension, other than the physician's statement of the T category. Use codes 170, 210, 250, and 270 as appropriate to code CS Extension based on a statement of T when no other extension information is available. Note 4: Use code 150 only if GIST is described as arising in a polyp. Do not use this code for GIST described as arising in the wall of the rectum and extending into the lumen with a polypoid appearance. Note 5: Use code 300 for localized cases only if no information is available to assign a more specific code Note 6: Use code 570 for tumor with macroscopic adhesions to other organs or structures and for pathologically confirmed tumor in adhesions. However, if no tumor is present in adhesion(s) upon microscopic examination, use lower codes to describe the microscopically confirmed depth of tumor invasion for these cases (excluding adherence to liver, see Note 7). Note 7: Adherence to the liver capsule is not considered distant metastasis. Use code 570 for any adherence to the liver capsule. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 In situ, intraepithelial, noninvasive TX NA IS IS 050 TX NA IS IS 100 ^ NA L L 110 ^ NA L L 120 ^ NA L L 130 ^ NA L L 140 ^ NA L L 150 Invasive tumor in polyp, NOS ^ NA L L 155 Tumor confined to muscular wall ^ NA L L 160 ^ NA L L 165 ^ NA L L 170 Stated as T1 with no other information on extension ^ NA L L 200 ^ NA L L 210 Stated as T2 with no other information on extension ^ NA L L 250 Stated as T3 with no other information on extension ^ NA L L 270 Stated as T4 with no other information on extension ^ NA L L 300 ^ NA L L 400 ^ NA L L 410 ERROR ERROR ERROR ERROR 420 ERROR ERROR ERROR ERROR 440 ^ NA RE L 450 ^ NA RE RE 455 ^ NA RE RE 458 ^ NA RE RE 460 ^ NA RE RE 490 ERROR ERROR ERROR ERROR 500 ^ NA RE RE 550 ^ NA RE RE 555 500 + (440, 455 or 458) ^ NA RE RE 560 Invasion of/through serosa with invasion of/through mucosa ^ NA RE RE 570 ^ NA RE RE 600 ERROR ERROR ERROR ERROR 610 ^ NA RE RE 700 ^ NA D D 800 ^ NA D D 950 No evidence of primary tumor T0 NA U U 999 TX NA U U ^ For CS Extension codes 100-800 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size AJCC 7 Table for this schema. &commonexteval76NA; 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: For rectosigmoid primaries, middle and superior rectal nodes are coded 200, and inferior rectal nodes are coded in CS Mets at DX; for rectum primaries, the inferior, middle, and superior rectal nodes are coded 200. Rectal nodes, NOS are coded 100 for both rectosigmoid and rectum primaries. Note 3: For rectum primaries, obturator nodes and internal iliac (hypogastric) nodes, NOS are coded 200; for rectosigmoid primaries, these are coded in CS Mets at DX. Note 4: For rectosigmoid primaries, left colic nodes and colic nodes, NOS are coded 200; for rectum primaries, these are coded in CS Mets at DX. Note 5: Nodal metastasis is very rare in gastrointestinal stromal tumors and surgeons generally agree that nodal dissection is not indicated. In the absence of information on regional lymph node status, N0 is appropriate; code 999 is mapped to N0 accordingly. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 NA NONE NONE 050 Nodule(s) or foci in perirectal fat N1 NA RN RN 100 N1 NA RN RN 110 N1 NA RN RN 200 N1 NA RN RN 300 N1 NA RN RN 400 Stated as N1 with no other information on regional lymph nodes N1 NA RN RN 450 ERROR NA RN RN 800 Lymph nodes, NOS N1 NA RN RN 999 N0 NA U U &commonnodeseval76NA; &generalreglnpos; &generalreglnexam; CS Mets at DX Note 1: Liver metastasis implies the presence of tumor inside the liver parenchyma as one or more nodules. Adherence to the liver capsule, even if extensive, should not be considered liver metastasis . Code direct adherence to the liver in CS Extension code 570. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 00 No distant metastasis M0 NA NONE NONE 08 M1 NA D RN 10 ERROR ERROR ERROR ERROR 11 ERROR ERROR ERROR ERROR 12 M1 NA D D 15 Distant lymph nodes, NOS M1 NA D D 40 M1 NA D D 50 M1 NA D D 60 M1 NA D D 99 M0 NA U U &commonmetseval76NA; &commonssf1gistappendix; &commonssf2gist; ¬appssfactor3; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; ¬appnewssf10; &commonssf11gistcolorectal; &commonssf12gistcolorectal; &commonssf13gistcolorectal; &commonssf14gistcolorectal; &commonssf15gistcolorectal; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusiongist; ¬appajcchistologies; &commonstagegistintestinetnm7; ¬appcsstage; &commonsummarystage; Extension Size AJCC 7 Table Note: For CS Extension codes 100-800 only, the T category for AJCC 7 staging is assigned based on the value of Tumor Size from this table. CS Extension CS Tumor Size 000-000 0 CS Tumor Size 001-020 1 20 CS Tumor Size 021-050 21 50 CS Tumor Size 051-100 51 100 CS Tumor Size 101-989 101 989 CS Tumor Size 990-991 990 991 CS Tumor Size 992 992 CS Tumor Size 993 993 CS Tumor Size 994-995 994 995 CS Tumor Size 996 996 CS Tumor Size 997 997 CS Tumor Size 998 998 CS Tumor Size 999 999 100 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 110 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 120 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 130 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 140 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 150 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 155 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 160 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 165 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 170 ERROR T1 T2 T3 T4 T1 T1 T2 T1 T1 T1 ERROR T1 200 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 210 ERROR T1 T2 T3 T4 T1 T2 T2 T2 T2 T2 ERROR T2 250 ERROR T1 T2 T3 T4 T1 T3 T2 T3 T3 T3 ERROR T3 270 ERROR T1 T2 T3 T4 T1 T4 T2 T4 T4 T4 ERROR T4 300 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 400 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 440 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 450 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 455 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 458 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 460 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 500 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 550 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 555 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 560 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 570 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 610 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 700 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX 800 ERROR T1 T2 T3 T4 T1 T1 T2 T2 T3 T4 ERROR TX &commonmitoticrategist;