Tumor Tip of the Week-03-14-2025 New Terms for CRM

03-14-2025 New Terms for CRM

2025 diagnosis of Colon Cancer. The Synoptic report stated this:

• • Margin Status for Invasive Carcinoma: All margins negative for invasive carcinoma
  • Closest Margin(s) to Invasive Carcinoma:   Proximal
  • Distance from Invasive Carcinoma to Closest Margin: 1.8 cm

[Tip: Review the GROSS Section of the path report, often it will contain the information you need to code the SSDI Circumferential Margin if it is missing from the synoptic report.]

GROSS DESCRIPTION

Upon sectioning, the tumor extends through the full thickness of the wall and superficially invades the pericolonic fat.  It is 2 cm from the pericolonic resection margin.

Question: How will you assign the SSDI Circumferential Margin?

• 1.8
• 2.0
• 20.0
• XX.1
• XX.9

Answer: 20.0 [2cm from pericolonic resection margin =2×10=20mm]

Rationale:

• SSDI Manual v3.2 Circumferential Margin
  • Other names include circumferential radial margin, mesenteric (mesocolon) (mesorectal) margin, mesenteric excision plane, pericolonic resection margin, radial margin, soft tissue margin.
  • Coding Guidelines
    • 2) If the value is recorded in Centimeters, multiply by 10 to get the value in Millimeters (mm).
    • Example: CRM recorded as 0.2 cm. Multiply 0.2 x 10 and record 2.0

Discussion:

• The SSDI Manual v3.2 has been restructured, and new terms were added to other names for circumferential margin.  After your software has been updated to NAACCR Version 25, be sure to utilize the SSDI instructions for v3.2. Be sure to view the New Version Release-Changes and known issues in Version 3.2 (NAACCR 2025) prior to abstracting cases after your software has been updated to v25.