California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures for Hospitals
SEER Summary Stage is a basic way of categorizing how far a cancer has spread from the organ of origin.
NOTES: Summary Stage is to be directly coded for date of diagnosis cases 1/1/2015 forward.
For additional information on Summary Stage, please see the presentation: Summary Stage Is Back, located on the California Cancer Registry website under Registrar Education and Training Webinars.
Refer to the most current SEER Summary Stage Manual for coding instructions and a complete list of staging guidelines.
The Summary Stage online manual is the recommended manual for coding stage.
If using a printed version, download errata from the SEER website.
Every anatomic site, including the lymphomas and leukemias can be staged using Summary Stage.
Summary Stage uses ambiguous terminology
Two lists of terms clarify whether or not a finding is part of the malignant .process. The manual instructs the registrar to either:
Consider as involvement or
Do not consider as involvement
Please Review the terminology lists in the Summary stage manual.
In the Summary Stage site specific schema, there are references to other staging system definitions, such as those for AJCC TNM stage, which are from the 5th Edition.
Currently the AJCC TNM 7th edition is in use, and there have been changes in the TNM definitions since Summary Stage was published.
This may also be true for other stage definitions referenced in Summary Stage.
Example: In prostate cancer, the AJCC TNM definition for T2b from the 5th edition meant “bilateral disease”. However, in the 7th edition, T2b means unilateral involvement.
Other staging documented by physician:
When a physician has assigned a stage using another staging system such as TNM, FIGO, DUKES’, etc., this information can be used as a guide for coding Summary stage, especially when information in the medical record is ambiguous or incomplete regarding the extent to which the tumor has spread.
However, take certain precautions: Other staging system definition/designations may have a different meaning than those listed in Summary Stage and vice/versa, which can affect the stage.
Disease representing the primary tumor or lymph node involvement which is considered distant in one staging system may be regional in another.
Pay close attention and do not try to directly convert another staging system into a Summary Stage code.
Text documentation should support the Summary stage code including cases unstageable. Text should include a tumor description for disease extent, and the names of involved lymph nodes.