CS Extension: Ovary

Note 1: Ascites with malignant cells changes FIGO stages I and II to IC and IIC, respectively. Ascites, NOS is considered negative.

Note 2: "Both extension to and discontinuous metastasis to any of the following pelvic organs is considered FIGO Stage II and coded in the range 50-65: adnexae, NOS; bladder, bladder serosa; broad ligament (mesovarium); cul-de-sac; fallopian tubes; parametrium; pelvic peritoneum; pelvic wall; rectum; sigmoid colon; sigmoid mesentery; ureter; uterus; uterine serosa.

Note 3: Peritoneal implants outside the pelvis (codes 70-73) must be microscopically confirmed. Peritoneal implants may also be called seeding, salting, talcum powder appearance, or studding.

Note 4: If implants are mentioned, determine whether they are in the pelvis or in the abdomen and code appropriately (60-64) or (70-73). If the location is not specified, code as 75.

Note 5: Both extension to and discontinuous metastasis to any of the following abdominal organs is considered FIGO Stage III and coded in the range 70-75: abdominal mesentery; diaphragm; gallbladder; infracolic omentum; kidneys; large intestine except rectum and sigmoid colon; liver (peritoneal surface); omentum; pancreas; pericolic gutter; peritoneum, NOS; small intestine; spleen; stomach; ureters.

Note 6: Excludes parenchymal liver nodules, which are coded in CS Mets at DX

Note 7: Since "cancer cells in ascites or in peritoneal washings" was not specifically categorized in the 1977 Summary Stage Guide, it is unclear to which stage previous cases may have been coded.

Code Description TNM SS77 SS2000
00 In situ; pre-invasive; non-invasive; intraepithelia Tis IS IS
10 Tumor limited to one ovary, capsule intact, no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings
FIGO Stage IA		 T1a L L
20 Tumor limited to both ovaries, capsule(s) intact, no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings
FIGO Stage IB		 T1b L L
30 Tumor limited to ovaries, unknown if capsule(s) ruptured or if one or both ovaries involved
Localized, NOS
FIGO Stage I, NOS		 T1NOS L L
35 Tumor limited to ovary(ies), capsule(s) ruptured
FIGO Stage 1C		 T1c L RE
36 Tumor on ovarian surface
FIGO Stage 1C		 T1c D RE
41 Tumor limited to ovary(ies) with malignant cells in ascites or peritoneal washings
FIGO Stage IC		 T1c RE RE
43 (35) + (41)
FIGO Stage IC		 T1c RE RE
44 (36) + any of [(35) or (41)]
FIGO Stage 1C		 T1c D RE
50 Extension to or implants on (but no malignant cells in ascites or peritoneal washings):
  • Adnexa, NOS, ipsilateral or NOS
  • Fallopian tube(s), ipsilateral or NOS
FIGO Stage IIA		 T2a RE RE
52 Extension to or implants on (but no malignant cells in ascites or peritoneal washings):
  • Adnexa, NOS, contralateral
  • Fallopian tube(s), contralateral
  • Uterus
FIGO Stage IIA		 T2a D RE
60 Extension to or implants on other pelvic structures (but no malignant cells in ascites or peritoneal washings):
  • Pelvic tissue:
    • Adjacent peritoneum
    • Ligament(s):
    • Broad, ipsilateral, NOS
    • Ovarian
    • Round
    • Suspensory
    • Mesovarium, ipsilateral, NOS
  • Pelvic wall
FIGO Stage IIB		 T2b RE RE
61 Extension to or implants on other pelvic structures (but no malignant cells in ascites or peritoneal washings):
  • Broad ligament(s), contralateral
  • Mesovarium, contralateral
FIGO Stage IIB		 T2b D RE
62 [(50) and/or (60)] with malignant cells in ascites or peritoneal washings
FIGO Stage IIC		 T2c RE RE
63 [(52 and/or 60)] with malignant cells in ascites or peritoneal washings
FIGO Stage IIC		 T2c D RE
64 (61) with malignant cells in ascites or peritoneal washings
FIGO IIC		 T2c D RE
65 Tumor involves one OR both ovaries with pelvic extension, NOS
FIGO Stage II, NOS		 T2NOS RE RE
70 Microscopic peritoneal implants beyond pelvis, including peritoneal surface/capsule of liver
FIGO Stage IIIA (See Note 5)		 T3a D D
71 Macroscopic peritoneal implants beyond pelvis, less than or equal to 2 cm in diameter, including peritoneal surface of liver
FIGO Stage IIIB (See Note 5)		 T3b D D
72 Peritoneal implants beyond pelvis, greater than 2 cm in diameter, including peritoneal surface of liver (liver capsule)
FIGO Stage IIIC (See Note 5)		 T3c D D
73 Tumor involves one or both ovaries with microscopically confirmed peritoneal metastasis outside the pelvis, NOS
FIGO Stage III, NOS (See Note 5)		 T3NOS D D
75 Peritoneal implants, NOS (See Note 5) T3NOS D D
80 Further contiguous extension T3NOS D D
95 No evidence of primary tumor T0 U U
99
  • Unknown extension
  • Primary tumor cannot be assessed
  • Not documented in patient record
 TX U U
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