Transverse colon and flexures (C183, C184, C185) + Tumor found in adhesion(s) if microscopic examination performed + Peritonealized pericolic/perirectal tissues invaded (see Localized for non-peritonealized pericolic/perirectal tissues invaded. + Mesentery (including mesenteric fat, mesocolon) + Adherent to other organs or structures clinically with no microscopic examination Pericolic/perirectal tissues invaded, NOS (unknown whether non-peritonealized or peritonealized. Non-peritonealized pericolic/perirectal tissues invaded (see Regional for peritonealized pericolic/perirectal tissues invaded. Intraluminal extension to colon and/or anal canal/anus (rectum only) Confined to colon, rectum, rectosigmoid, NOS **Note 8:** Tumors characterized by involvement of the serosal surface (visceral peritoneum) by direct extension or perforation in which the tumor cells are continuous with the serosal surface through inflammation are coded to regional (code 2). However, if no tumor is present in the adhesion, microscopically, the classification should be coded to localized (code 1) or regional (code 2). **Note 7:** Tumor that is adherent to other organs or structures, macroscopically, is coded as regional (code 2) or distant (code 7). + If the pathologist does not further describe the “pericolic/perirectal tissues” as either “non-peritonealized pericolic/perirectal tissues” vs “peritonealized pericolic/perirectal tissues” fat and the gross description does not describe the tumor relation to the serosa/peritoneal surface, and it cannot be determined whether the tumor arises in a peritonealized portion of the colon, code Localized. Peritonealized pericolic/perirectal tissues invaded Subserosal tissue/(sub)serosal fat invaded Non-peritonealized pericolic/perirectal tissues invaded Invasion through muscularis propria or muscularis, NOS Localized may not be used for sites that are entirely peritonealized (cecum, transverse colon, sigmoid colon, rectosigmoid colon, upper third of rectum). Some sites are entirely peritonealized some sites are only partially peritonealized or have no peritoneum. **Note 6:** Invasion into "pericolonic/pericolorectal tissue" can be either Localized or Regional, depending on the primary site. **Note 5:** 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. * Confined to, but not through muscularis mucosa SS2018 stages these as localized (behavior code 3) **Note 4:** For the following, AJCC 8th edition stages these as in situ tumors. **Note 3:** Code 0 (behavior code 2) includes cancer cells confined within the glandular basement membrane (intraepithelial), or described as in situ. **Note 2:** See the following chapters for the listed histologies Used with permission of the American College of Surgeons, Chicago, Illinois. * Chapter 33 *Neuroendocrine Tumors of the Colon and Rectum*, in the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. * Chapter 20 *Colon and Rectum*, in the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. * Collaborative Stage Data Collection System, version 02.05: * SEER Summary Staging Manual-2000: Codes and Coding Instructions () * SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998) ()
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