Esophagus - CS Extension

Note 1: Ignore intraluminal extension to adjacent segment(s) of esophagus or to cardia of stomach and code depth of invasion or extra-esophageal spread as indicated.
Note 2: The three layers of the mucosa (epithelium, lamina propria, and muscularis mucosae) may be called the m1, m2, and m3 layers. The submucosa may be described as having inner, middle, and outer thirds called sm1, sm2, and sm3.
Note 3: For this schema, AJCC defines Tis as high-grade dysplasia, in which they include "all non-invasive neoplastic epithelium that was formerly called carcinoma in situ". Cancers stated to be noninvasive or in situ are classified as Tis. High grade dysplasia is generally not reportable in cancer registries; but if a registry does collect high grade dysplasia, code 000 should be used.
Note 4: If the tumor's extension is only described by a phrase like "through the muscularis propria", this could mean that the cancer has penetrated the outermost muscle cells but not beyond (T2); but usually "through the muscularis" is used to indicate that the cancer extends beyond the muscle and into adjacent tissue, consistent with a T3 tumor. When the most specific description is a phrase like "through the muscularis" or "through the esophageal wall", then use code 400 unless a T3 is contraindicated by other information.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepithelial, noninvasive; high grade dysplasia	Tis	Tis	IS	IS
100	Invasive tumor confined to mucosa, NOS (including intramucosal, NOS)	T1a	T1	L	L
110	Invades lamina propria	T1a	T1	L	L
120	Invades muscularis mucosae	T1a	T1	L	L
130	Stated as T1a with no other information on extension	T1a	T1	L	L
160	Invades submucosa	T1b	T1	L	L
165	Stated as T1b with no other information on extension	T1b	T1	L	L
170	Invades lamina propria, muscularis mucosae, or submucosa, with the exact layer not specified Stated as T1 [NOS] with no other information on extension	T1NOS	T1	L	L
200	Muscularis propria invaded	T2	T2	L	L
210	Stated as T2 with no other information on extension	T2	T2	L	L
300	Localized, NOS	T1NOS	T1	L	L
400	Adventitia and/or soft tissue invaded Esophagus is described as "FIXED"	T3	T3	RE	RE
450	Stated as T3 with no other information on extension	T3	T3	RE	RE
600	OBSOLETE DATA RETAINED V0200 T4 subclassified in AJCC 7th Edition; See Codes 610-730 Tumor invades adjacent structures Cervical esophagus: Blood vessel(s): Carotid artery Jugular vein Subclavian artery Thyroid gland Intrathoracic, upper or mid-portion, esophagus: Blood vessel(s), major: Aorta Azygos vein Pulmonary artery/vein Vena cava Carina Diaphragm Main stem bronchus Trachea Intrathoracic, lower portion (abdominal), esophagus: Blood vessel(s): Aorta Gastric artery/vein Vena cava Diaphragm, not fixed, or NOS Stomach, cardia (via serosa)	ERROR	T4	RE	RE
610	OBSOLETE DATA REVIEWED AND CHANGED V0203 See codes 615, 720, 725 Tumor invades adjacent structures Cervical esophagus: Hypopharynx Jugular vein Larynx Thyroid gland Intrathoracic, upper or mid-portion, esophagus: Blood vessel(s), major: Azygos vein Diaphragm Intrathoracic, lower portion (abdominal), esophagus: Blood vessel(s): Gastric artery/vein Diaphragm, not fixed, or NOS Stomach, cardia (via serosa) Intrathoracic esophagus: Pleura	ERROR	ERROR	ERROR	ERROR
615	Tumor invades adjacent structures: For cervical esophagus: Hypopharynx Jugular vein Larynx Thyroid gland For intrathoracic esophagus, upper or middle portion: Diaphragm For intrathoracic esophagus, lower portion (abdominal): Blood vessel(s), major: Gastric artery/vein Diaphragm, not fixed; diaphragm, NOS Stomach, cardia (via serosa) For intrathoracic esophagus: Pleura	T4a	T4	RE	RE
650	OBSOLETE DATA RETAINED V0200 T4 subclassified in AJCC 7th Edition; See Codes 610-730 Cervical esophagus: Carina Cervical vertebra(e) Hypopharynx Larynx Trachea Intrathoracic esophagus: Lung via bronchus Mediastinal structure(s), NOS Pleura Rib(s) Thoracic vertebra(e)	ERROR	T4	RE	RE
660	Thoracic/middle esophagus: Pericardium	T4a	T4	RE	D
680	Cervical/upper esophagus: Pleura Abdominal/lower esophagus: Diaphragm fixed	T4a	T4	D	D
700	OBSOLETE DATA CONVERTED V0203 See code 815 Stated as T4 [NOS]	ERROR	ERROR	ERROR	ERROR
710	Stated as T4a with no other information on extension	T4a	T4	RE	RE
720	Tumor invades adjacent structures: For intrathoracic esophagus, upper or middle: Azygos vein	T4b	T4	RE	RE
725	720 + 615	T4b	T4	RE	RE
728	720 + 660	T4b	T4	RE	D
730	Tumor invades adjacent structures Cervical esophagus: Blood vessel(s): Carotid artery Subclavian artery Carina Cervical vertebra(e) Trachea Intrathoracic, upper or mid-portion, esophagus: Blood vessel(s), major: Aorta Pulmonary artery/vein Vena cava Carina Trachea Intrathoracic, lower portion (abdominal), esophagus: Blood vessel(s): Aorta Vena cava Intrathoracic esophagus (all portions): Adjacent Rib(s) Lung via bronchus Mediastinal structure(s), NOS Thoracic vertebra(e)	T4b	T4	RE	RE
740	730 + 660 Any structure in code 730 involving thoracic/middle esophagus plus pericardium	T4b	T4	D	D
745	730 + 680 Any structure in code 730 involving cervical/upper esophagus plus pleura OR Any structure in code 730 involving abdominal/lower esophagus plus fixation of diaphragm	T4b	T4	D	D
750	Cervical/upper esophagus: Lung Main stem bronchus	T4b	T4	D	D
780	OBSOLETE DATA RETAINED V0200 T4 subclassified in AJCC 7th Edition; See Code 660 Thoracic/middle esophagus: Pericardium	ERROR	T4	RE	D
800	OBSOLETE DATA RETAINED V0200 T4 subclassified in AJCC 7th Edition; See Codes 730 and 750 Further contiguous extension: Cervical/upper esophagus: Lung Main stem bronchus Pleura Abdominal/lower esophagus: Diaphragm fixed	ERROR	T4	D	D
810	Further contiguous extension Stated as T4b with no other information on extension	T4b	T4	D	D
815	Invades adjacent structures, NOS Stated as T4 [NOS] with no other information on extension	T4NOS	T4	RE	RE
820	Tumor invades adjacent structures listed in codes 615, 660, 680, or 720, stated as unresectable	T4b	T4	D	D
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