Basically, all brain tumors are considered
localized unless they cross the midline or the tentorium or
unless they are described as having "drop" metastases
in the spinal cord.
There was a TNM staging for brain tumors in the fourth edition
of the AJCC Manual for Staging of Cancer based heavily on
the tumor grade, but this was withdrawn in subsequent editions.
Summary Staging 2000
Local
confined to:
one hemisphere in one part of brain (infra/supratentorial);
meninges; invading/encroaching on ventricular system
Regional
crossing midline or tentorium invades bone, blood vessel,
nerves, spinal cord
Distant
circulating cells in CSF; extension to nasal cavity, nasopharynx,
posterior pharynx; outside CNS
TNM
None in 5th or 6th editions.
Collaborative Staging
The Collaborative Staging System uses two fields to code
the extent of disease for tumors of the brain and cerebral
meninges. The extension field includes a code for benign brain
tumors to meet the needs of cases that will be reported as
of 2004.
The Collaborative Staging code structure is based on what
area of the brain is involved and how far the tumor has spread.
Collaborative Staging -- Extension
CNS (C70.0,
C71._) |
| 05 |
Benign brain tumors |
| 10 |
Supratentorial tumor confined to:
Cerebral hemisphere (cerebrum) or
meninges of cerebral hemisphere on one side:
Lobe(s): Frontal -- Occipital
-- Parietal -- Temporal |
| 11 |
Infratentorial tumor confined to:
Cerebellum or meninges of cerebellum on one side:
Vermis: Lateral lobes -- Median
lobe of cerebellum |
| 12 |
Infratentorial tumor confined to:
Brain stem or meninges of brain stem on one side:
Medulla oblongata -- Midbrain
(mesencephalon) --
Pons --
Hypothalamus -- Thalamus |
| 15 |
Confined to brain, NOS -- Confined to meninges,
NOS |
| 20 |
Infratentorial tumor:
Both
cerebellum and brain stem involved with tumor on one side |
| 30 |
Confined to ventricles
Tumor invades or encroaches upon
ventricular system |
| 40 |
Tumor crosses the midline
Tumor involves contralateral
hemisphere
Tumor involves corpus callosum
(including splenium) |
| 50 |
Supratentorial tumor extends infratentorially
to involve cerebellum or brain stem |
| 51 |
Infratentorial tumor extends supratentorially
to involve cerebrum (cerebral hemisphere) |
| 60 |
Tumor invades:
Bone
(skull) -- Major blood vessel(s) -- Meninges (dura) --
Nerves, NOS {Cranial nerves} --
Spinal cord/canal |
| 70 |
Circulating cells in cerebral spinal
fluid (CSF)
Nasal cavity
Nasopharynx
Posterior pharynx
Outside central nervous system (CSF) |
| 80 |
Further contiguous extension |
| 95 |
No evidence of primary tumor |
| 99 |
Unknown extension
Primary tumor cannot be assessed
Not documented in patient record |
Other CNS (C71.1,
C71.9, C72.0-C72.5, C72.8, C72.9)
|
| 05 |
Benign brain tumors |
| 10 |
Tumor confined to tissue or site of
origin |
| 30 |
Localized, NOS |
| 40 |
Meningeal tumor infiltrates nerve
Nerve tumor infiltrates meninges (dura) |
| 50 |
Adjacent connective/soft tissue
Adjacent muscle |
| 60 |
Brain, for cranial nerve tumors
Major blood vessel(s)
Sphenoid and frontal sinuses (skull) |
| 70 |
Brain except for cranial nerve tumors
Bone, other than skull -- Eye |
| 80 |
Further contiguous extension |
| 95 |
No evidence of primary tumor |
| 99 |
Unknown extension; Primary tumor cannot
be assessed; Not documented in record |
CNS (Endocrine)
C75.1-C75.3 (from the Collab. Stage schema for Thymus,
Adrenal (Suprarenal) Gland, and Other Endocrine Glands) |
| 00 |
In situ; non-invasive; intraepithelial |
| 05 |
For C75.1 pituitary gland, C75.2 craniopharyngeal
duct, and C75.3 pineal gland ONLY: Benign |
| 10 |
Invasive carcinoma confined to gland of
origin |
| 30 |
Localized, NOS |
| 40 |
Adjacent connective tissue
(see definition in General Instructions)
Adjacent organs/structures
Thymus and aortic body:
Organs/structures in mediastinum
Adrenal (suprarenal):
Kidney
Retroperitoneal structures
Parathyroid
Thyroid
Thyroid cartilage
|
| 60 |
Pituitary and craniopharyngeal duct:
Cavernous sinus
Infundibulum
Pons
Sphenoid body and sinuses
Pineal:
Infratentorial and central
brain
Carotid body:
Upper neck
|
| 80 |
Further contiguous extension |
| 95 |
No evidence of primary tumor
Unknown extension |
| 99 |
Primary tumor cannot be assessed
Not documented in patient record |
|
