What is Summary Staging?
Summary staging is based on the theory of cancer growth previously described earlier in the section Disease Process of Cancer. Summary staging is also called General Staging, California Staging, SEER Staging. It is the most basic staging system and is applicable to all anatomic sites (solid tumors, not leukemias). Summary Staging uses all information available in the medical record, clinical, and pathological. It is frequently used by tumor registries, but not always understood by physicians.
There are limitations for the staging system: categories are so broad that there is a wide variety of cases included; detailed analysis of a case with specific characteristics is sometimes not possible.
Listed below are the five main categories of Summary Staging:
Guidelines For Summary Staging
- Rule out distant disease first. If metastases can be documented, there is no need to spend a great deal of time identifying local or regional spread.
- Carcinomas and melanomas are the only types of cancer that can be classified as in situ. Sarcomas are never described as in situ.
- If there is any evidence of invasion, nodal involvement or metastatic spread, the case is not in situ even if the pathology report so states. This is a common error in staging cervical cancer where the path report states that the cancer is "in situ with microinvasion"—such a case would be staged as localized.
- In order for a lesion to be classified as localized, it must not extend beyond the outer limits of the organ and there must be no evidence of metastases anywhere else.
- For carcinomas, if there are lymph nodes involved with the tumor, the stage is at least regionalized.
- If a specific chain of lymph nodes is not named and there is no indication in the chart of its location, assume that the nodes are regional.
- If nodes, organs, or adjacent tissues are not specifically mentioned in the description of the various categories, attempt to cross-reference the term you have with those outlined. If there is no match, assume the site in question represents distant disease.
- If there is not enough information in the record to categorize a case, it must be recorded as unstageable.