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Newsletter Summer 2023



JUNE 2023


AJCC Cancer Staging Manual

Cases with a diagnosis date of 01/01/2018 and forward should be staged using AJCC 8th Edition Cancer Staging Manual. The 3rd printing 2018 Edition is now available.

Please visit for all 8th Edition updates and corrections. For all other information, visit de-fault.aspx.

Summary Stage 2018

The 2018 version of Summary Stage applies to every site and/or histology combination, including lym-pho-mas and leukemias. Summary Stage uses all information available in the medical record; in other words, it is a combination of the most precise clinical and pathological documentation of the extent of disease. The Summary Stage 2018 manual is available at

Site Specific Data Items (SSDI)

Site Specific Data Items (SSDI) are similar to the Site Specific Factors (SSF) collected with Collaborative Stage. These data items are specific to certain site/histology combinations. For example, the SSDI’s for breast will be used to collect information such as estrogen receptor status, progesterone receptor status, Her2 status, Nottingham grade, and additional information related to primary tumors of the breast. The in-formation collected in these data items are specific to breast. The SSDI manual is available at


Beginning with cases diagnosed in 2018 grade information will be collected in three fields; Clinical Grade, Pathological Grade, and Post-Therapy Grade. Within the Grade Manual you will find definitions for the three new grade data items, coding instructions, and the site/histology specific grade tables. The Grade manual is available at

SEER Hematopoietic and Lymphoid Neoplasm Database

This provides data collection rules for hematopoietic and lymphoid neoplasms for 2010+.The SEER Hematopoietic and Lymphoid Neoplasm manual is available at Hematopoietic_Instructions_and_Rules.pdf.

Solid Tumor Coding Manual

Use the 2018 Solid Tumor coding rules to determine the number of primaries to abstract and the histology to code for cases diagnosed 2018 and forward. The Solid Tumor coding rules replace the 2007 Multiple Prima-ry and Histology(MP/H) Rules. The manual is available at The change log contains updates made to the FINAL module sections. This does not include changes made to the drafts.

STORE Manual

The STORE Manual has replaced the FORDS Manual. The STORE is now available at



Mississippi Cancer Registry
Presents Its Annual Fall Educational Workshop
Falling Into Knowledge
Thursday, September, 28th
Jackson Medical Mall Community Room
(adjacent to Subway)
Jackson, MS
*physician and subject matter expert speakers*
*ce’s awarded*
breakfast and lunch
contact Lisa Hamel for more information, registration form coming soon
Co-sponsored by Mississippi Cancer Registry Association


06-16-2023 Prostate cM1a cM1b or cM1c

Scenario 2023:

Patient diagnosed with Prostate Adenocarcinoma was found to have mets to distant lymph nodes and bones on Scans.

Question: How would you assign the cM category?

M1a Nonregional lymph node(s)

M1b Bone(s)

M1c Other site(s) with or without bone disease

Answer: M1b Bone(s)


AJCC Cancer Staging Manual, Eighth Edition Chapter 58 Prostate

In my opinion, I personally found the instructions and note in the AJCC Cancer Staging Manual a little bit confusing, so I consulted the CAnswer forum for an explanation to help me understand whether to code a cM1b or cM1c.

After researching, this is the rationale behind the choice. The patient had distant lymph node mets which would be a cM1a, then they also had distant bone mets so that would be a cM1b.So, that is the most advanced category used, we would stop there and assign a cM1b.The category cM1c would be used for mets to sites other than non-regional nodes or bones, like lung or liver.

CAnswer Forum post


Omega Healthcare




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