Collaborative Stage

Note 1: This field and Site-Specific Factor 3, CS Extension - Pathologic Extension, must both be coded, whether or not a prostatectomy was performed. Information from prostatectomy and autopsy is EXCLUDED from this field and coded only in Site-Specific Factor 3.
Note 2:
        A. A clinically inapparent tumor is one that is neither palpable nor reliably visible by imaging. A clinically apparent tumor/nodule/mass is palpable or visible by imaging.
            Do not infer inapparent or apparent tumor based on the registrar's interpretation of other terms in the DRE or imaging reports. A physician assignment of cT1 or cT2 is a clear statement of inapparent or apparent respectively. Code to 300 (which maps to T2 NOS) in the absence of a clear physician's statement of inapparent or apparent.
        B. CODES 100 to 150 are used only for clinically inapparent tumor not palpable or visible by imaging and/or incidentally found microscopic carcinoma (latent, occult) in one or both lobes. Within this range, give priority to codes 130-150 over code 100. Use codes 100-140 when a TURP is done, not for a biopsy only. Do not use code 150 when a TURP is done. When tumor is found in one lobe, both lobes or in prostatic apex by needle biopsy but is not palpable or visible by imaging, use code 150.
        C. CODES 200 to 240 are used only for clinically/radiographically apparent tumor/nodule/mass which is palpable or visible by imaging. To decide among codes 200-240, use only physical exam or imaging information, and NOT biopsy information. Biopsy information is coded in Site-Specific Factor 14. Codes 210 and 220 have precedence over code 200. Code 200 has precedence over code 240. Use code 240 if the physician assigns cT2 without a subcategory of a, b, or c.
        D. CODE 300 is used for localized cancer when it is unknown if clinically or radiographically apparent. An example would be when a diagnosis is made prior to admission for a prostatectomy with no details provided on clinical findings prior to admission.
        E. CODES 310, 330 and 340 have been made OBSOLETE, CODES NO LONGER USED. Information about prostate apex involvement has been moved to Site-Specific Factor 4, Prostate Apex Involvement. AJCC does not use prostate apex involvement in the "T" classification.
        F. CODES 410 to 700 are used for extension beyond the prostate. Biopsy of extraprostatic tissue coded in the range 410-700 can be used if it proves extension.
Note 3: Involvement of the prostatic urethra does not alter the extension code.
Note 4: "Frozen pelvis" is a clinical term which means tumor extends to pelvic sidewall(s). In the absence of a more detailed statement of involvement, assign this to code 600.
Note 5: AUA stage. Some of the American Urological Association (AUA) stages A-D are provided as guidelines for coding in the absence of more specific information in the medical record. If physician-assigned AUA stage D1-D2 is based on involvement of lymph nodes only, code under CS Lymph Nodes or CS Mets at DX, not CS Extension.
Note 6: This schema includes evaluation of other pathologic tissue such as a biopsy of the rectum.
Note 7: For the extension fields for this site, the mapping values for TNM, SS77, and SS2000 and the associated c, p, yp, or a indicator (staging basis) are assigned based on the values in CS Extension, CS Tumor Size/Ext Eval, and Site-Specific Factor 3. The calculation is performed differently depending on whether clinical information or pathological information takes precedence in a specific case. Note that for prostate, AJCC pathologic staging usually requires a prostatectomy. Pathologic staging information from a prostatectomy takes precedence EXCEPT when neoadjuvant treatment has been given and the clinical staging information is either AS extensive or MORE extensive than the pathologic information. The Collaborative Staging algorithm implements this logic as shown in the special calculation extra tables. Some combinations of codes may be errors. The CS algorithm will still calculate stage outputs if possible, and another edit program will need to identify the errors for correction.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ: noninvasive; intraepithelial	TX	TX	IS	IS
100	Incidental histologic finding on TURP, number of foci or percent involved tissue not specified (clinically inapparent) Stated as cT1 [NOS] with no other information on clinical extension Stage A, NOS (see also Note 2B)	T1NOS	T1NOS	L	L
130	Incidental histologic finding on TURP in 5% or less of tissue resected (clinically inapparent) Stated as cT1a with no other information on clinical extension (see also Note 2B)	T1a	T1a	L	L
140	Incidental histologic finding on TURP more than 5% of tissue resected (clinically inapparent) Stated as cT1b with no other information on clinical extension (see also Note 2B)	T1b	T1b	L	L
150	Tumor identified by needle biopsy (clinically inapparent) Example - for elevated PSA Stated as cT1c with no other information on clinical extension (see also Note 2B)	T1c	T1c	L	L
200	Involvement in one lobe/side, NOS (clinically apparent on physical exam or imaging, DO NOT use information from biopsy; see also Note 2C)	T2NOS	T2NOS	L	L
210	Involves one half of one lobe/side or less (clinically apparent on physical exam or imaging, DO NOT use information from biopsy; see also Note 2C) Stated as cT2a with no other information on clinical extension	T2a	T2a	L	L
220	Involves more than one half of one lobe/side, but not both lobes/sides (clinically apparent on physical exam or imaging, DO NOT use information from biopsy; see also Note 2C) Stated as cT2b with no other information on clinical extension	T2b	T2b	L	L
230	Involves both lobes/sides (clinically apparent on physical exam or imaging, DO NOT use information from biopsy; see also Note 2C) Stated as cT2c with no other information on clinical extension	T2c	T2c	L	L
240	Clinically apparent tumor confined to prostate, NOS Stated as cT2 [NOS] without subcategory a, b, or c and no other information on clinical extension Stage B, NOS	T2NOS	T2NOS	L	L
300	Localized, NOS Confined to prostate, NOS Intracapsular involvement only Not stated if Stage A or B, T1 or T2, clinically apparent or inapparent	T2NOS	T2NOS	L	L
310	OBSOLETE DATA REVIEWED AND CHANGED V0102 Into prostatic apex/arising in prostatic apex, NOS (See Note 2E and Site-Specific Factor 4)	ERROR	ERROR	ERROR	ERROR
330	OBSOLETE DATA REVIEWED AND CHANGED V0102 Arising in prostatic apex (See Note 2E and Site-Specific Factor 4)	ERROR	ERROR	ERROR	ERROR
340	OBSOLETE DATA REVIEWED AND CHANGED V0102 Extending into prostatic apex (See Note 2E and Site-Specific Factor 4)	ERROR	ERROR	ERROR	ERROR
410	Extension to periprostatic tissue Extracapsular extension (beyond prostatic capsule), NOS Through capsule, NOS Stage C1, NOS	T3NOS	T3NOS	RE	RE
420	Unilateral extracapsular extension	T3a	T3a	RE	RE
430	Bilateral extracapsular extension	T3a	T3a	RE	RE
440	Microscopic bladder neck involvement	T3a	T4	RE	RE
445	Stated as T3a with no other information on extension	T3a	T3a	RE	RE
450	Extension to seminal vesicle(s) Stated as T3b with no other information on extension Stage C2, NOS	T3b	T3b	RE	RE
470	450 + 440 Extension to seminal vesicle(s) plus microscopic bladder neck involvement	T3b	T4	RE	RE
490	Periprostatic extension, NOS (Unknown if seminal vesicle(s) involved) Stated as T3 [NOS] with no other information on extension Stage C, NOS	T3NOS	T3NOS	RE	RE
500	Extension to or fixation to adjacent structures other than seminal vesicles: Bladder neck except microscopic bladder neck involvement (see code 440) Bladder, NOS Fixation, NOS Rectovesical (Denonvillier's) fascia Rectum; external sphincter	T4	T4	RE	RE
520	Levator muscles Skeletal muscle, NOS Ureter(s)	T4	T4	D	RE
600	Extension to or fixation to pelvic wall or pelvic bone "Frozen pelvis", NOS (See Note 4)	T4	T4	D	D
700	Further contiguous extension including: Bone Other organs Penis Sigmoid colon Soft Tissue other than periprostatic Stage D2, NOS	T4	T4	D	D
750	Stated as T4 with no other information on extension	T4	T4	RE	RE
950	No evidence of primary tumor	T0	T0	U	U
999	Extension unknown Primary tumor cannot be assessed Not documented in patient record	TX	TX	U	U

Prostate

CS Extension - Clinical Extension