Appendix - CS Extension

Note 1: Ignore intraluminal extension to adjacent segment(s) of colon; code depth of invasion or extracolonic spread as indicated.
Note 2: Mucinous tumors are identified by morphology codes 8480, 8481, and 8490.
Note 3: One or more malignant satellite peritumoral nodules or tumor deposits (TD) in the periappendiceal adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule may represent discontinuous spread, venous invasion with extravascular spread, or a totally replaced lymph node. Replaced nodes are counted as positive nodes and coded in CS Lymph Nodes. TD representing discontinuous spread or venous invasion are coded in CS Extension, code 450, and the number of TD representing discontinuous spread or venous invasion is coded in CS Site-Specific Factor 4.
Note 4: Tumor that is adherent to other organs or structures, macroscopically, is classified cT4b. If tumor is present in adhesion(s) upon microscopic examination, the tumor is classified as pT4b. Use code 565 for macroscopic adhesions if no pathologic confirmation, and for pathologically confirmed tumor in adhesions. However, if no tumor is present in adhesion(s) upon microscopic examination, the classification is based upon extent of tumor invasion into or through the wall; use codes 000-160, 200, 400, 450, 500-550 as appropriate to describe the microscopically confirmed depth of tumor invasion for these cases. Use codes 600-650, 665, 700-810 to code invasion of underlying structures from the adherent tumor.
Note 5: Codes 600-650 and 700-750are used for contiguous extension from the site of origin. Except for intraperitoneal metastases limited to the right lower quadrant (RLQ) of the abdomen for mucinous tumors, discontinuous involvement is coded in CS Mets at DX.
Note 6: High-grade dysplasia is not always collected by cancer registries but, if collected, it should be coded 000 or 050.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepithelial, noninvasive	Tis	Tis	IS	IS
050	(Adeno)carcinoma, noninvasive, in a polyp or adenoma	Tis	Tis	IS	IS
100	Invasive tumor confined to mucosa, NOS (including intramucosal, NOS)	Tis	Tis	L	L
110	Invasive tumor confined to the lamina propria, including lamina propria in the stalk of a polyp	Tis	Tis	L	L
120	Confined to and not through the muscularis mucosae, including muscularis mucosae in the stalk of a polyp.	Tis	Tis	L	L
130	Confined to head of polyp, NOS	T1	T1	L	L
140	Confined to stalk of polyp, NOS	T1	T1	L	L
150	Invasive tumor in polyp, NOS	T1	T1	L	L
160	Invades submucosa (superficial invasion), including submucosa in stalk of polyp	T1	T1	L	L
170	Stated as T1 with no other information on extension	T1	T1	L	L
200	Muscularis propria invaded Stated as T2 with no other information on extension	T2	T2	L	L
300	Confined to appendix, NOS Localized, NOS	T1	T1	L	L
400	Extension through wall, NOS Invasion through muscularis propria or muscularis, NOS Non-peritonealized pericolic tissues invaded Perimuscular tissue invaded Subserosal tissue/(sub)serosal fat invaded Transmural, NOS Wall, NOS	T3	T3	L	L
410	OBSOLETE DATA CONVERTED V0203 See code 470 Stated as T3[NOS] with no other information on extension	ERROR	ERROR	ERROR	ERROR
420	OBSOLETE DATA CONVERTED V0203 See code 458 Fat, NOS	ERROR	ERROR	ERROR	ERROR
450	Extension to: Adjacent tissue(s), NOS Connective tissue Mesenteric fat Mesentery Mesoappendix Pericolic fat	T3	T3	RE	RE
458	Fat, NOS	T3	T3	RE	RE
460	OBSOLETE DATA RETAINED AND REVIEWED V0203 See Note 4, coded 565 and 570 Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)	T3	T3	RE	RE
470	Stated as T3 with no other information on extension	T3	T3	L	L
500	Invasion of/through serosa (mesothelium) (visceral peritoneum) Tumor penetrates to surface of visceral peritoneum	T4a	T4	RE	RE
510	For mucinous tumors only: Peritoneal involvement confined within right lower quadrant ONLY	T4a	TX	D	D
511	510 + any of (130-160 or 300) For mucinous tumors only: Peritoneal involvement confined within right lower quadrant plus local extension equivalent to T1	T4a	T1	D	D
512	510 + 200 For mucinous tumors only: Peritoneal involvement confined within right lower quadrant plus local extension equivalent to T2	T4a	T2	D	D
513	510 + (400, 450, 458) For mucinous tumors only: Peritoneal involvement confined within right lower quadrant plus regional extension equivalent to T3	T4a	T3	D	D
514	510 + 500 For mucinous tumors only: Peritoneal involvement confined within right lower quadrant plus regional extension equivalent to T4	T4a	T4	D	D
550	500 + (450, 458)	T4a	T4	RE	RE
560	Stated as T4a with no other information on extension	T4a	T4	RE	RE
565	Adherent to other organs or structures clinically with no microscopic examination Tumor found in adhesion(s) if microscopic examination performed	T4b	T4	RE	RE
570	Adherent to other organs or structures, NOS	T4b	T4	RE	RE
600	Greater omentum Small intestine	T4b	T4	RE	RE
650	Abdominal wall Retroperitoneum (excluding fat)	T4b	T4	RE	RE
660	OBSOLETE DATA RETAINED V0200 Ascending colon: Right kidney Right ureter Descending colon: Left kidney Left ureter	ERROR	T4	RE	RE
665	Any of (550, 565 - 650) + any of (510 - 514)	T4b	T4	D	D
670	OBSOLETE DATA CONVERTED V0203 See code 665 (570-650) + 510	ERROR	ERROR	ERROR	ERROR
675	OBSOLETE DATA CONVERTED V0203 See code 665 (570-650) + 511	ERROR	ERROR	ERROR	ERROR
680	OBSOLETE DATA CONVERTED V0203 See code 665 (570-650) + 512	ERROR	ERROR	ERROR	ERROR
690	OBSOLETE DATA CONVERTED V0203 See code 665 (570-650) + 513	ERROR	ERROR	ERROR	ERROR
700	Fallopian tube Ovary Uterus	T4b	T4	D	D
750	Adrenal (suprarenal) gland Bladder Diaphragm Fistula to skin Gallbladder Other segment(s) of colon/rectum via serosa	T4b	T4	D	D
800	Kidney Liver Ureter Other contiguous extension	T4b	T4	D	D
810	Any of (565-800) + 510 For mucinous tumors only: Regional extension characterized as T4b plus peritoneal involvement confined within right lower quadrant	T4b	T4	D	D
850	Stated as T4b with no other information on extension	T4b	T4	RE	RE
900	Stated as T4 [NOS] with no other information on extension	T4NOS	T4	RE	RE
950	No evidence of primary tumor	T0	T0	U	U
999	Unknown; extension not stated Primary tumor cannot be assessed Not documented in patient record	TX	TX	U	U