Collaborative Stage for TNM 7 - Revised 10/23/2010 [ Schema ]
CS Site-Specific Factor 6
Circumferential Resection Margin (CRM)
- Note 1: Tumor involvement of the circumferential resection margin (CRM) appears to be a strong prognostic factor for local or systemic recurrences and survival after surgery.
- Note 2: The CRM may also be referred to as the circumferential radial margin or mesenteric margin.
- Note 3: According to AJCC 7th Edition Cancer Staging Manual, "The CRM is the surgically dissected nonperitonealized surface of the specimen. It corresponds to any aspect of the colorectum that is not covered by a serosal layer of mesothelial cells and must be dissected from the retroperitoneum or subperitoneum in order to remove the viscus. In contradistinction, serosalized surfaces of the colorectum are not dissected; they are naturally occurring anatomic structures and are not pathologic surgical margins. The circumferential surface of surgical resection specimens of ascending colon, descending colon, or upper rectum is only partially peritonealized, and the demarcation between the peritonealized surface and the nonperitonealized surface (corresponding to the CRM) of such specimens is not always easily appreciated on pathologic examination."
- Note 4: Record to the nearest tenthin millimeters (mm) the distance between the leading edge of the tumor and the nearest edge of surgically dissected margin as recorded in the pathology report. For example, if the CRM is 2 mm, code 020. If the margin is involved (positive), use code 000. If the margin is described as less than 1 mm with no more specific measurement, use code 000; margins of 0-1 mm are recorded by the pathologist as involved.
- Note 5: Codes 001-980 record exact measurements. Codes 992-996 are used for margin descriptions lacking specific measurements.
- Note 6: Use code 999 (CRM not mentioned) if the pathology report describes only distal and proximal margins, or margins, NOS. Only specific statements about the CRM are collected in this data item.
|000||Margin IS involved with tumor|
Circumferential resection margin (CRM) positive
Described as "less than 1 millimeter (mm)"
|001-980||0.1- 98.0 millimeter (mm)|
(Exact size to nearest tenth of millimeter)
|981||98.1 mm or greater|
|988||Not applicable: Information not collected for this case|
(May include cases converted from code 888 used in CSv1 for "Not applicable" or when the item was not collected. If this item is required to derive T, N, M, or any stage, use of code 988 may result in an error.)
|990||No residual tumor identified on specimen|
|991||Margins clear, distance from tumor not stated|
CRM negative, NOS
|992||Described as "less than 2 mm," or "greater than 1 mm," or "between 1 mm and 2 mm"|
|993||Described as "less than 3 mm," or "greater than 2 mm," or "between 2 mm and 3 mm"|
|994||Described as "less than 4 mm," or "greater than 3 mm," or "between 3 mm and 4 mm"|
|995||Described as "less than 5 mm," or "greater than 4 mm," or "between 4 mm and 5 mm"|
|996||Described as "greater than 5 mm"|
|998||No resection of primary site|
|999||Unknown or no information|
CRM not mentioned
Not documented in patient record