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Abstracting Keys

The terms lamina propria and submucosa can be used interchangeably because these structures tend to merge when there is no muscularis mucosae.

Invasion of the mucosa may be interpreted by the pathologist as either in situ or invasive; determine whether the pathologist is describing in situ or localized tumor.

If the depth of invasion is not specified by the pathology report, code as T1, invasion of subepithelial connective tissue.

CT scanning is as good as MRI for determining the size and extent of renal masses.

Superficial muscle invasion is defined as less than half-way through the muscle coat (three layers).

Deep muscle invasion is considered half-way or more through the muscle coat.

If the depth of muscle invasion is not stated by the surgeon or pathologist, stage as T2, invasion of superficial muscle.

There is a high degree of correlation between the grading (differentiation or aggressiveness) of the tumor and the stage (invasiveness).

It is important to have a good surgical or biopsy specimen so that muscle layers can be seen and assessed. The prognostic dividing line is between T2 and T3, so read carefully the description of the depth of muscle invasion.

In the AJCC staging system for Tumor, the suffix "m" may be added to indicate a multifocal tumor; such as T2m.

Cystectomy is usually not considered a treatment option unless the stage is at least Stage II, unless the tumor is superficially extensive.

Papillary and in-situ tumors can have a long protracted course with multiple recurrences and then suddenly become invasive.

Primary kidney and ureter cancer (hypernephroma) is more unpredictable than most solid tumors. Metastases have been identified in sites as finger tips, eyelids and nose. The primary tumor and/or distant metastases may spontaneously regress.