How To Use The AJCC Cancer Staging Manual

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ific Fields – no more “factors” – but similar instructions and codes7Intro to AJCC Staging Manual, 8th ed. New Sections or Features within Chapters AJCC Levels of Evidence for Changes to Staging CriteriaGuidance on the Use of Imaging to Evaluate Stage for Each ChapterPrognostic Factors Factors Required to Assign Prognostic Stage GroupFactors Recommended for Managing Patient CareEmerging FactorsRisk Assessment ModelsClinical Stratification Recommendations Chapter‐Specific Histology Codes – No longer uses range of acceptable codes – Histology Code List updated with 2018 MPH Rules to ensure all new for 2018 histologycodes are included in appropriate chapter(s) – and to keep up with WHO Classifications84

8/3/2017Intro to AJCC Staging Manual, 8th ed. New Chapters for 8th edition Head and NeckCervical Lymph Nodes with Unknown Primary – check for EBV or HPV StatusHPV‐Mediated (p16 ) Oropharynx Cancer – When p16‐ Use Oropharynx (p16 ) or Hypopharynx Cutaneous Squamous Cell Carcinoma of Head and Neck Thorax Endocrine System ThymusParathyroidAdrenal Neuroendocrine TumorsHematologic Malignancies Leukemia9Intro to AJCC Staging Manual, 8th ed. Split Chapters for 8th edition Pancreas Exocrine Pancreas – Hepatobiliary SystemNeuroendocrine Tumor of Pancreas – see Neuroendocrine Tumors (NET)Neuroendocrine Tumors (NET) NET of StomachNET of Duodenum and Ampulla of VaterNET of Jejunum and IleumNET of AppendixNET of Colon and RectumNET of Pancreas105

8/3/2017Intro to AJCC Staging Manual, 8th ed. Split Chapters for 8th edition Bone – multiple staging tables with T Category Code based on type/location of primaryAppendicular SkeletonPelvis Spine Soft Tissue Sarcoma Introduction to Soft Tissue SarcomaSoft Tissue Sarcoma of Head and NeckSoft Tissue Sarcom of Trunk and ExtremetiesSoft Tissue Sarcoma of Abdomen and Thoracic Visceral OrgansSoft Tissue Sarcoma of RetroperitoneumSoft Tissue Sarcoma – Unusual Histologies and SitesGIST is now in Soft Tissue Sarcoma Section11Intro to AJCC Staging Manual, 8th ed. Merged Chapters for 8th edition Ovary, Fallopian Tube, Primary Peritoneal CarcinomaConsistent with WHO Classification, 4th editionAllows GYN Staging of C48.2 CasesSurface Epithelial – Epithelial Stromal TumorsSerous tumors: Benign (cystadenoma) Borderline tumors (serous borderline tumor) Malignant (serous adenocarcinoma)Mucinous tumors, endocervical‐like and intestinal type: Benign (cystadenoma) Borderline tumors (mucinous borderline tumor) Malignant (mucinous adenocarcinoma)Endometrioid tumors: Benign (cystadenoma) Borderline tumors (endometrioid borderline tumor) Malignant (endometrioid adenocarcinoma)Clear cell tumors: Benign Borderline tumors Malignant (clear cell adenocarcinoma)Transitional cell tumors: Brenner tumor Brenner tumor of borderline malignancy Malignant Brenner tumor Transitional cell carcinoma (non‐Brenner type)Epithelial‐stromal: Adenosarcoma Carcinosarcoma (formerly mixed Mullerian tumors)126

8/3/2017Changes from AJCC Staging Manual, 7th ed.13AJCC 8th Edition Staging Rules – Chapter 1 Entire 30 pages devoted to Staging Rules and is Table‐Driven with User Notes Definitions are included for vocabulary related to cancer staging Clarification on Use of “X”, blank and Zero (0) Clarification on Use of Clinical & Pathological Stage Descriptors Clarification on “Response to Neoadjuvant Therapy” Explanation for How to Apply Tables to Assign New Prognostic Stage Groups AJCC will be hosting webinar(s) on Key Elements of Chapter 1 – General Rules 2018 FCDS Abstractor Code Test Absolutely WILL Have Questions from Chapter 1147

8/3/2017AJCC 8th Edition Stagi

8/3/2017 2 Outline History, Purpose and Background Purchase and Ordering Information & Errata Introduction to AJCC Cancer Staging Manual, 8th ed. AJCC Cancer Staging Manual Organization General Chapter Outline and Contents Specific Neoplasms Included by Chapter Neoplasms Not Included in the AJCC Manual

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