Ovary - CS Extension

Note 1. AJCC considers "in situ carcinoma of ovary" an impossible diagnosis. Any case so coded will be mapped to an unknown AJCC stage and an in situ Summary Stage.
Note 2: AJCC TNM values correspond to the stages accepted by the Federation Internationale de Gynecologie et d'Obstetrique (FIGO), and FIGO stages are included for coding where no more specific information is available in the record. When both FIGO stage and extension detail are available, record the code with extension detail in preference to a statement of FIGO stage. Note that FIGO uses a single stage value which corresponds to different groupings of T, N, and M values. FIGO Stage IIIC is assigned based on tumor extension and/or regional lymph node involvement. Code CS Extension based on a physician's statement of FIGO Stage IIIC only if it is known that the stage value is assigned because of tumor extension. If FIGO Stage IIIC is specified but it is unknown whether it is based on extension or lymph nodes, code to CS Lymoh Nodes
Note 3: T1 and T2 tumors with malignant ascites are categorized as T1c and T2c (FIGO Stages IC and IIC), respectively. Ascites, NOS is considered negative.
Note 4: Both extension to and discontinuous metastasis to any of the following pelvic organs are included in the T2 category (FIGO Stage II) and coded in the range 500-650: adnexa, NOS; bladder and bladder serosa; broad ligament (mesovarium); cul de sac; fallopian tubes; parametrium; pelvic peritoneum; pelvic wall; rectosigmoid; rectum; sigmoid colon; sigmoid mesentery; pelvic ureter; uterus and uterine serosa.
Note 5: Peritoneal implants outside the pelvis (codes 700-730) must be microscopically confirmed. Peritoneal implants may also be called seeding, salting, talcum powder appearance, or studding.
Note 6: If implants are mentioned, determine whether they are in the pelvis or in the abdomen and code appropriately (600-650) or (700-730). If the location is not specified, use code 750.
Note 7: Both extension to and discontinuous metastasis to any of the following abdominal organs by way of peritoneal seeding or implants are included in the T3 category (FIGO Stage III) and coded in the range 700-750: abdominal mesentery; diaphragm; gallbladder; infracolic omentum; kidneys; large intestine except rectum, rectosigmoid, and sigmoid colon; liver (peritoneal surface); omentum; pancreas; pericolic gutter; peritoneum, NOS; small intestine; spleen; stomach; and ureters outside pelvis. Residual tumor in any of these organs would be considered FIGO III and coded in the 700-750 range below and in CS Site-Specific Factors 3 and 4. (Hematogenous metastases are included in M1 (FIGO Stage IV) disease.)
Note 8: Parenchymal liver nodules are coded in CS Mets at DX.
Note 9: Since "cancer cells in ascites or in peritoneal washings" was not specifically categorized in the 1977 Summary Staging Guide, it is unclear to which stage previous cases may have been coded.
Note 10: In some registries benign/borderline ovarian tumors are reportable by agreement. If the tumor being reported is benign or borderline, code CS Extension to 999.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepithelial, noninvasive, preinvasive	TX	TX	IS	IS
100	Tumor limited to one ovary, capsule intact, no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings	T1a	T1a	L	L
150	FIGO Stage IA	T1a	T1a	L	L
200	Tumor limited to both ovaries, capsule(s) intact, no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings	T1b	T1b	L	L
250	FIGO Stage IB	T1b	T1b	L	L
300	OBSOLETE DATA RETAINED V0204 See codes 310 and 460 Tumor limited to ovaries, unknown if capsule(s) ruptured or if one or both ovaries involved Localized, NOS FIGO Stage I, NOS	T1NOS	T1NOS	L	L
310	Tumor limited to ovaries, unknown if capsule(s) ruptured or if one or both ovaries involved Localized, NOS	T1NOS	T1NOS	L	L
350	Tumor limited to ovary(ies), capsule(s) ruptured	T1c	T1c	L	RE
360	Tumor on ovarian surface	T1c	T1c	D	RE
410	Tumor limited to ovary(ies) WITH malignant cells in ascites or peritoneal washings	T1c	T1c	RE	RE
430	410 + 350 Tumor limited to ovary(ies) WITH malignant cells in ascites or peritoneal washings plus capsule(s) ruptured	T1c	T1c	RE	RE
440	(360) + any of (350 or 410) Tumor on ovarian surface plus capsul(es) ruptured or WITH malignant cells in ascites or peritoneal washings	T1c	T1c	D	RE
450	FIGO Stage IC	T1c	T1c	RE	RE
460	FIGO Stage I, NOS	T1NOS	T1NOS	L	L
500	Extension to or implants on (but no malignant cells in ascites or peritoneal washings): Adnexa, ipsilateral or NOS Fallopian tube(s), ipsilateral or NOS	T2a	T2a	RE	RE
510	500 + 360 Extension to structures in 500 (but no malignant cells in ascites or peritoneal washings) plus tumor on ovarian surface	T2a	T2a	RE	RE
520	Extension to or implants on (but no malignant cells in ascites or peritoneal washings): Adnexa, contralateral Fallopian tube(s), contralateral Uterus	T2a	T2a	D	RE
550	FIGO Stage IIA	T2a	T2a	RE	RE
600	Extension to or implants on other pelvic structures (but no malignant cells in ascites or peritoneal washings): Pelvic tissue: Adjacent peritoneum Ligament(s): Broad, ipsilateral, NOS Ovarian Round Suspensory Mesovarium, ipsilateral, NOS Pelvic wall	T2b	T2b	RE	RE
605	600 + 360 Extension to structures in 600 (but no malignant cells in ascites or peritoneal washings) plus tumor on ovarian surface	T2b	T2b	D	RE
610	Extension to or implants on other pelvic structures (but no malignant cells in ascites or peritoneal washings): Broad ligament(s), contralateral Mesovarium, contralateral Bladder , Bladder serosa Cul de sac Parametrium Rectosigmoid, Rectum Sigmoid colon Sigmoid mesentery Ureter (pelvic portion)	T2b	T2b	D	RE
615	FIGO Stage IIB	T2b	T2b	RE	RE
620	Any structure in 500 and /or 600 WITH malignant cells in ascites or peritoneal washings	T2c	T2c	RE	RE
625	620 + 360 Any structure in 500 and/or 600 WITH malignant cells in ascites or peritoneal washings plus tumor on ovarian surface	T2c	T2c	D	RE
630	OBSOLETE DATA REVIEWED AND CHANGED V0203 See codes 620, 625, 635 (520 and/or 600) WITH malignant cells in ascites or peritoneal washings	ERROR	ERROR	ERROR	ERROR
635	Any structure in 520 WITH malignant cells in ascites or peritoneal washings	T2c	T2c	D	RE
640	Any structure in 610 WITH malignant cells in ascites or peritoneal washings	T2c	T2c	D	RE
645	FIGO Stage IIC	T2c	T2c	D	RE
650	Tumor involves one or both ovaries with pelvic extension, NOS	T2NOS	T2NOS	RE	RE
660	FIGO Stage II [NOS]	T2NOS	T2NOS	RE	RE
700	Microscopic peritoneal implants beyond pelvis, including peritoneal surface/capsule of liver FIGO Stage IIIA (See Note 7)	T3a	T3a	D	D
710	Macroscopic peritoneal implants beyond pelvis, less than or equal to 2 cm in diameter, including peritoneal surface of liver FIGO Stage IIIB (See Note 7)	T3b	T3b	D	D
720	Peritoneal implants beyond pelvis, greater than 2 cm in diameter, including peritoneal surface of liver (liver capsule) FIGO Stage IIIC (based on tumor extension) (See Notes 2, 7)	T3c	T3c	D	D
730	Tumor involves one or both ovaries with microscopically confirmed peritoneal metastasis outside the pelvis, NOS (See Note 7)	T3NOS	T3NOS	D	D
750	Peritoneal implants, NOS (See Note 7)	T3NOS	T3NOS	D	D
780	FIGO Stage III [NOS]	T3NOS	T3NOS	D	D
800	Further contiguous extension	T3NOS	T3NOS	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