CS Extension-Clinical Extension: Prostate

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 is EXCLUDED from this field and coded only in Site-Specific Factor 3.

Note 2:

  1. Codes 10-15: CODES 10 to 15 are used only for clinically inapparent tumor not palpable or visible by imaging and incidentally found microscopic carcinoma (latent, occult) in one or both lobes.Within this range, give priority to codes 13-15 over code 10.When tumor is found in one lobe, both lobes or in prostatic apexby needle biopsy but is not palpable or visible by imaging, use code 15.
  2. CODES 20 to 24 are used only for clinically/radiographically apparent tumor, i.e., that which is palpable or visible by imaging.Codes 21 and 22 have precedence over code 20. Code 20 has precedence over code 24.
  3. CODE 30 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.
  4. CODES 31, 33 and 34 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.
  5. CODES 41 to 49 are used for extension beyond the prostate.

Note 3: Prostate Apex Involvement:This field and Site-Specific Factor 4, Prostate Apex Involvement, are both coded whether or not a prostatectomy was performed.

Note 4: Use codes 13-14 when a TURP is done, not for a biopsy only. Do not use code 15 when a TURP is done.

Note 5: Involvement of the prostatic urethra does not alter the extension code.

Note 6: "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 60.

Note 7: 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 8: This schema includes evaluation of other pathologic tissue such as a biopsy of the rectum.

Note 9: For the extension fields for this site, the mapping values for TNM, SS77, and SS2000 and the associated c, p, y, or a indicator are assigned based on the values in CS Extension, CS TS/Eval, and Site-Specific Factor 3.If the value of Site-Specific Factor 3: Pathologic Extension is greater than 000 and less than 095 (i.e., prostatectomy was done, extension information is available for staging, and invasive tumor was present in the prostatectomy specimen), the mapping values are taken from the Site-Specific Factor 3 mapping, and the T category is identified as a pT.If Site-Specific Factor 3: Pathologic Extension code is 95 or greater (meaning that prostatectomy was not performed, or it was performed but the information is not usable for staging), the mapping values are taken from the CS Extension (Clinical Extension) mapping, and the c, p, y, or a indicator is taken from the TS/Ext Eval mapping.If Site-Specific Factor 3: Pathologic Extension code is 000 (in situ), and if CS Extension code (Clincal Extension) is greater than 00 and less than 95 (not in situ) , the mapping values are taken from the CS Extension (Clinical Extension) mapping, and the c, p, y, or a indicator is taken from the TS/Ext Eval mapping. If Site-Specific Factor 3 code is 000 (in situ) and CS Extension code is 00 (in situ) or greater than 94, the mapping values are taken from the Site-Specific Factor 3 mapping, and the T category is identified as a pT.

Code Description TNM SS77 SS2000
00 In situ: noninvasive; intraepithelial Tis IS IS
10 Clinically inapparent tumor, number of foci or percent involved tissue not specified
Stage A, NOS
T1NOS L L
13 Incidental histologic finding in 5% or less of tissue resected (clinically inapparent) T1a L L
14 Incidental histologic finding more than 5% of tissue resected (clinically inapparent) T1b L L
15 Tumor identified by needle biopsy, e.g., for elevated PSA (clinically inapparent) T1c L L
20 Involvement in one lobe, NOS (clinically apparent only) T2NOS L L
21 Involves one half of one lobe or less (clinically apparent only) T2a L L
22 Involves more than one half of one lobe, but not both lobes (clinically apparent only) T2b L L
23 Involves both lobes (clinically apparent only) T2c L L
24 Clinically apparent tumor confined to prostate, NOS
Stage B, NOS
T2NOS L L
30
  • Localized, NOS
  • Confined to prostate, NOS
  • Intracapsular involvement only
  • Not stated if Stage A or B, T1 or T2, clinically apparent OR inapparent
T2NOS L L
31 OBSOLETE (See Notes 2, 3 and Site-Specific Factor 4) T2NOS L L
33 OBSOLETE (See Notes 2, 3 and Site-Specific Factor 4) T2NOS L L
34 OBSOLETE (See Notes 2, 3 and Site-Specific Factor 4) T2NOS L L
41
  • Extension to periprostatic tissue (Stage C1)
  • Extracapsular extension (beyond prostatic capsule), NOS
  • Through capsule, NOS
T3NOS RE RE
42 Unilateral extracapsular extension T3a RE RE
43 Bilateral extracapsular extension T3a RE RE
45 Extension to seminal vesicle(s) (Stage C2) T3b RE RE
49 Periprostatic extension, NOS (Unknown if seminal vesicle(s) involved)
Stage C, NOS
T3NOS RE RE
50 Extension to or fixation to adjacent structures other than seminal vesicles:
  • Bladder neck
    • Bladder, NOS
    • Fixation, NOS
    • Rectovesical (Denonvillier's) fascia
    • Rectum; external sphincter
T4 RE RE
52
  • Levator muscles
  • Skeletal muscle, NOS
  • Ureter(s)
T4 D RE
60
  • Extension to or fixation to pelvic wall or pelvic bone
  • "Frozen pelvis", NOS (See Note 6)
T4 D D
70 Further contiguous extension (Stage D2) including to:
  • Bone
    • Other organs
    • Penis
    • Sigmoid colon
    • Soft Tissue other than periprostatic
T4 D D
95 No evidence of primary tumor T0 U U
99
  • Extension unknown
  • Primary tumor cannot be assessed
  • Not documented in patient record
TX U U
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