Colon - CS Extension

Note 1: Ignore intraluminal extension to adjacent segment(s) of colon/rectum or to the ileum from the cecum; code depth of invasion or extracolonic spread as indicated.
Note 2: Codes 600-800 are used for contiguous extension from the site of origin. Discontinuous involvement is coded in CS Mets at DX.
Note 3: 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, 458, 500, and 550 as appropriate to describe the microscopically confirmed depth of tumor invasion for these cases. Use codes 600, 655-800 to code invasion of underlying structures from the adherent tumor.
Note 4: High grade dysplasia and severe dysplasia are generally not reportable in cancer registries, but if a registry does collect these, codes 000 or 050 should be used.

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	Invades 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 the head or stalk of a 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	Localized, NOS Confined to colon, 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 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: All colon sites: Adjacent tissue(s), NOS Connective tissue Mesenteric fat Mesentery Mesocolon Pericolic fat Ascending and descending colon Retroperitoneal fat Transverse colon and flexures Gastrocolic ligament Greater omentum	T3	T3	RE	RE
458	Fat, NOS	T3	T3	RE	RE
460	OBSOLETE DATA RETAINED AND REVIEWED V0203 See Note 3, codes 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	RE	RE
500	Invasion of/through serosa (mesothelium) (visceral peritoneum) Tumor penetrates to surface of visceral peritoneum	T4a	T4	RE	RE
550	500 + (450 or 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	All colon sites: Small intestine Cecum: Greater omentum Ascending colon: Greater omentum Liver, right lobe Transverse colon and flexures: Gallbladder/bile ducts Kidney Liver Pancreas Spleen Stomach Descending colon: Greater omentum Pelvic wall Spleen Sigmoid colon: Greater omentum Pelvic wall	T4b	T4	RE	RE
650	OBSOLETE DATA RETAINED AND REVIEWED V0203 See codes 655 and 675 All colon sites: Abdominal wall Retroperitoneum (excluding fat)	T4b	T4	RE	RE
655	All colon sites: Abdominal wall All colon sites excluding sigmoid: Retroperitoneum (excluding fat)	T4b	T4	RE	RE
660	Ascending colon: Right kidney Right ureter Descending colon: Left kidney Left ureter	T4b	T4	RE	RE
675	Sigmoid colon: Retroperitoneum (excluding fat)	T4b	T4	D	RE
700	Cecum, ascending, descending and sigmoid colon: Fallopian tube Ovary Uterus	T4b	T4	D	D
750	All colon sites unless otherwise stated above: Adrenal (suprarenal) gland Bladder Diaphragm Fistula to skin Gallbladder Other segment(s) of colon via serosa	T4b	T4	D	D
800	Further contiguous extension: Cecum: Kidney Liver Ureter Transverse colon and flexures: Ovary Fallopian tube Uterus Ureter Sigmoid colon: Cul de sac (rectouterine pouch) Ureter	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