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Acrr 2018
Acrr 2018
CANCER STATISTICS
This report includes patients registered at the centers affiliated with the Shaukat Khanum Memorial Trust and
accessioned into the hospital information system in Lahore. The affiliated centers include two hospitals called
the ‘Shaukat Khanum Memorial Cancer Hospital and Research Center’ (SKMCH&RC) in Lahore and Peshawar
and the Karachi Diagnostic Center (KDC). SKMCH&RC Lahore is the oldest center and has been functioning
since December 29, 1994, SKMCH&RC Peshawar since December 29, 2015, and the KDC since 2010. For the
purpose of presenting the results, all of these centers are referred to as SKMCH&RC/hospital in this report.
Distribution of neoplasms
Of a total of 6,851 new neoplasms diagnosed or treated at the aforementioned facilities in Pakistan, from
January 1, 2018 to December 31, 2018, 3254 were seen in male (47.5%) and 3597 (52.5%) in female patients.
Six thousand, two hundred and seventy five (6275 (91.6%)) neoplasms were found in adults, whereas, 576
(8.4%) were seen in children. Children were classified as those 18-years or less and adults as more than 18-
years of age. Table 1 shows the stratification of cases by behavior and age-group.
Table 1. Distribution of neoplasms by behavior and age-group, from Jan. 2018 to Dec. 2018.
The difference in the number of registered patients and reported neoplasms is attributed to multiple malignancies and benign
neoplasms diagnosed in 70 and 34 patients, respectively. Further, 119 patients have both malignant and benign neoplasm
simultaneously.
Cases with behavior code /3 and /2 are considered as malignant cases.
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Cases with behavior code /0 and /1 are considered as benign and uncertain, respectively.
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According to the Facility Oncology Revised Data Standards (FORDS), Revised for 2004, Class of Case 0 to 2 are analytical cases
and included in treatment and survival analysis, whereas, Class of Case 3 to 9 are non-analytical cases, usually not included in routine
treatment or survival statistics.
Page 1 of 28
Class of Case
Of a total of 6,378 malignant cases recorded in the Registry from January 2018 to December 2018, 6244
(97.9%) were analytical cases and 134 (2.1%) non-analytical. Figure 1 shows the stratification of analytical and
non-analytical cases¥.
Figure 1. Stratification of analytical and non-analytical cases, from Jan. 2018 to Dec. 2018.
Distribution of malignancies
In the year 2018, a total of 6,378 malignancies were diagnosed at the hospital with 3,151 seen amongst females
and 3,227 amongst males. Table 2 displays the distributions of female and male patients according to gender
and age-group.
Table 2 and figure 2. Distribution of cancer cases by gender and age-group (yrs.), from Jan. 2018 to Dec. 2018.
Age-range Female Male Total
0-4 86 141 227
5-9 49 120 169
10-14 21 44 65
15-19 47 95 142
20-24 135 198 333
25-29 193 207 400
30-34 319 260 579
35-39 439 263 702
40-44 417 259 676
45-49 292 256 548
50-54 320 293 613
55-59 317 302 619
60-64 265 270 535
65-69 157 214 371
70-74 103 121 224
75-79 37 68 105
80-84 24 27 51
85+ 6 13 19
Total 3227 3151 6378
Page 2 of 28
Demographics
Of the 6,378 malignant cancers, nearly 56.0% (3,574) belonged to the province of Punjab and approximately
25.2% (1,607) to Khyber Pakhtunkhwa (Table 3). The fact that the geographic area of residence of a vast
majority of patients was Punjab can be explained in light of the information that the oldest affiliate is situated in
the provincial capital of Punjab and that, this province accounts for almost 50% of the total population of the
country.
Table 3. Distribution of malignancies according to the geographic area of residence of the patients, from
Jan. 2018 to Dec. 2018.
[1]
Khyber Pakhtunkhwa and F.A.T.A merged on May 28, 2018.
Page 3 of 28
Top ten cancers
Tables 4 to 8 show the list of the ten commonest malignancies seen at SKMCH&RC during the year 2018. Of a
total of 6,378 malignancies, breast cancer was the leading malignancy with 1,270 cases accessioned into the
Registry. Cancers of the colon, rectum, anal canal and anus, and Hodgkin lymphoma were the second and third
most frequently seen cancers, respectively.
Table 4. Top 10 malignancies seen amongst all age-groups, both sexes combined, from Jan. 2018 to Dec. 2018.
Figure 3. Top 10 malignancies seen amongst all age-groups, both sexes combined, from Jan. 2018 to Dec.
2018.
Page 4 of 28
Amongst adults, during the year 2018, a total of 5,823 malignancies were diagnosed or treated at SKMCH&RC.
Cancers of the breast, colon, rectum, anal canal and anus, and lip and oral cavity were registered as the most
frequently seen cancers.
Table 5. Top 10 malignancies seen amongst adults (> 18 years), from Jan. 2018 to Dec. 2018.
Figure 4. Top 10 malignancies seen amongst adults (> 18 years), from Jan. 2018 to Dec. 2018.
Page 5 of 28
In 555 childhood malignancies, using the classification based on tumor morphology, Hodgkin lymphoma, acute
lymphoblastic leukemia and non-Hodgkin lymphoma were identified as the three most common malignancies
diagnosed or treated at SKMCH&RC. Table 6 shows the distributions of the top ten malignancies seen in
children at SKMCH&RC.
Table 6. Top 10 malignancies seen in children (</= 18 years), from Jan. 2018 to Dec. 2018.
Sr. No. ICD-O-3 Category Count Percentage ICD-O-3 Morphology Code
1 Hodgkin lymphoma 118 21.3 M9650 - M9667
2 Acute lymphoblastic leukemia 89 16.0 M982 - M983
3 Non-Hodgkin lymphoma 72 13.0 M9590 - 91, M967 - 972
4 Osteosarcoma 57 10.3 M9180 - M9195
5 Ewing’s sarcoma/PNET 50 9.0 M9260
6 Retinoblastoma 41 7.4 M9510 - M9514
7 Germ cell tumor 39 7.0 M906 - M909
8 Nephroblastoma 27 4.9 M8960
9 Rhabdomyosarcoma 14 2.5 M8900 - M8921
10 Hepatoblastoma 11 2.0 M8970
Figure 5. Top 10 malignancies seen in children (</= 18 years), from Jan. 2018 to Dec. 2018.
Page 6 of 28
In adult males (2,785 malignancies), the commonest cancers were those of the colon, rectum, anal canal and
anus, prostate, and lip & oral cavity (Table 7).
Table 7. Top 10 malignancies seen amongst adult males, from Jan. 2018 to Dec. 2018.
Figure 6. Top 10 malignancies seen amongst adult males, from Jan. 2018 to Dec. 2018.
Page 7 of 28
The most frequent diagnosis in adult women (3,038) was breast cancer accounting for 41.4% of the cancers.
Cervix uteri was ranked as the second highest cancer (5.3%) and cancers of the colon, rectum, anal canal and
anus as the third common malignancy with 5.2% of the total malignancies, in females.
Table 8. Top 10 malignancies seen amongst adult females, from Jan. 2018 to Dec. 2018.
Figure 7. Top 10 malignancies seen amongst adult females, from Jan. 2018 to Dec. 2018.
Page 8 of 28
Staging
The Registry uses the American Joint Commission on Cancer TNM staging system for all analytical cancer
cases. TNM categorizes cancers in stages 0, 1, 2, 3, 4, unstageable, and not applicable on all analytical cases
(Class of Case 0, 1, 2). Cancers are classified as being unstageable as the patients may choose not to receive any
treatment or undergo further tests at the hospital needed to establish an appropriate stage. “Not applicable”
means non-availability of AJCC staging for that site. During the year 2018, cancer staging for 6,244 analytical
cases (Class of Case 0, 1, 2) showed that 37 (0.6%) cases fell into 0 or in situ category, 940 (15.1%) in Stage I,
1,613 (25.8%) in Stage II, 1,433 (25.8%) cases in Stage III, and 1138 (23.0%) in Stage IV, (table 9); 344 (5.5%)
cases were unstageable and 738 (11.8%) had no AJCC stage defined for that site.
Table 9. TNM Stage of cancer patients at SKMCH&RC, from Jan. 2018 to Dec. 2018.
Figure 8. TNM stage of cancer patients at SKMCH&RC, from Jan. 2018 to Dec. 2018.
Page 9 of 28
Summary Stage
The SEER Summary Staging Manual-2000 Codes and Coding Instructions were used to describe how far the
tumor had spread from the organ or the site of origin. This manual consists of a one digit hierarchical code for
each and every site. All analytical cases (Class of Case 0, 1, 2), were included to generate results. The cancer
data for the year 2018 reflects that there were 0.6% in situ cases, 20.5% localized cancers, 40.9% regional cases,
20.4% distant, and there were 17.6% cases in which the summary stage was unknown.
Table 10. Classification of patients according to the SEER summary stage, from Jan. 2018 to Dec. 2018.
Figure 9. Classification according to the SEER Summary Stage, from Jan. 2018 to Dec. 2018.
Page 10 of 28
Grade/Differentiation/Immunophenotype
The International Classification of Diseases for Oncology, Third Edition (ICD-O-3), codes and guidelines have
been used to categorize grade/differentiation/immunophenotype. All analytical cases (Class of Case 0, 1, 2),
were included to generate results.
SUPPLEMENTAL INFORMATION
Table 12 depicts the results stratified by primary site, age-group, and gender. According to this, cancers of the
breast, colon, rectum, anal canal and anus, lymphoma and lip and oral cavity and skin are the commonest
systems/site(s) for malignancies seen at SKMCH&RC. Table 13 shows the results stratified by gender, primary
site, and Morphology.
Page 11 of 28
Table 12. Distribution by gender, primary malignant site, and 5-year age-group, 2018
FEMALES
ICD-O-3 Code* Primary Site 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85+ Total
C00 Lip 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
C01-C02 Tongue 0 0 0 0 0 0 3 2 7 10 5 10 5 3 1 2 1 0 49
C03 Gum 0 0 0 0 0 0 1 0 2 2 1 2 0 1 0 0 0 1 10
C04-C06 Floor and other parts of mouth 0 0 0 0 0 1 2 2 2 1 3 4 2 1 2 0 0 0 20
C07-C08 Salivary gland 0 0 0 0 5 0 2 4 4 3 2 0 0 1 0 0 0 0 21
C09-C10 Tonsil & oropharynx 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 2
C11 Nasopharynx 0 0 0 3 3 5 2 5 2 4 2 1 1 0 0 0 0 0 28
C12-C13 Pyriform sinus & Hypopharynx 0 0 0 0 1 3 2 2 1 2 1 2 1 0 0 0 0 0 15
C14 Other & ill-defined lip, oral cavity, pharynx 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
C15 Esophagus 0 0 0 0 2 4 11 12 25 14 9 17 8 0 0 0 0 0 102
C16 Stomach 0 0 0 0 1 1 5 8 17 6 7 7 5 2 1 2 1 0 63
C17 Small intestine 0 0 0 1 0 0 0 2 0 0 2 0 1 0 0 0 0 0 6
C18 Colon 0 0 0 0 0 2 3 4 7 5 6 8 7 4 1 0 1 0 48
C19-C21 Rectosigmoid, rectum, anal canal, and anus 0 0 0 1 7 17 10 14 7 9 10 11 14 6 3 1 1 0 111
C22 Liver & intrahepatic bile duct 5 0 0 0 0 0 0 1 0 1 7 11 9 7 7 2 0 0 50
C23-C24 Gall bladder & extrahepatic bile duct 0 0 0 0 0 0 0 4 2 4 11 11 8 4 3 1 0 0 48
C25 Pancreas 0 0 0 0 1 0 0 2 3 2 3 4 7 4 4 1 1 0 32
C30-C31 Nasal cavity, middle ear and acc. sinuses 0 0 1 1 1 1 1 0 2 1 0 0 1 3 0 0 0 0 12
C32 Larynx 0 0 0 0 1 1 0 1 0 2 3 1 1 0 0 0 0 0 10
C33-C34 Trachea, bronchus & lung 0 0 0 0 0 2 1 2 6 4 3 7 7 4 5 2 1 1 45
C37-C38 Thymus, heart, mediastinum & pleura 1 0 0 0 0 1 1 1 0 0 0 0 0 2 0 0 0 0 6
C40-C41 Bone & articular cartilage 0 11 9 15 0 1 1 2 2 0 0 1 1 0 0 0 0 0 43
C44 Skin 0 0 0 0 1 1 4 10 4 7 18 8 16 13 12 5 5 0 104
C47 Peripheral & autoimmune nervous system 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 2
C48 Peritoneum & Retroperitoneum 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 3
C49 Connective & soft tissue 3 2 1 3 6 3 6 8 4 3 5 3 5 2 2 1 0 0 57
C50 Breast 0 0 0 2 18 57 149 242 227 118 130 112 86 59 37 13 9 2 1261
C51-C52 Vulva & vagina 0 0 0 0 0 4 0 1 1 0 5 1 4 1 1 0 0 0 18
C53 Cervix uteri 0 0 0 0 0 1 10 20 25 30 28 21 15 6 6 0 0 0 162
C54 Corpus uteri 0 0 0 1 1 1 6 3 10 16 4 16 22 13 6 3 0 0 102
C55 Uterus 0 0 0 0 1 3 0 1 0 0 1 2 0 0 1 0 0 0 9
C56-C57 Ovary & other female genital organs 0 4 4 8 16 11 18 10 14 5 9 10 4 3 1 0 1 0 118
C58 Placenta 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
C64-C66 Kidney & other urinary organ 9 3 0 0 3 2 5 2 4 12 4 10 9 2 1 0 0 0 66
C67 Urinary bladder 0 0 0 0 0 2 1 0 1 1 2 2 0 1 0 2 1 1 14
C69 Eye 18 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 23
C70-C71 Brain 0 0 0 1 8 16 14 13 7 8 3 9 5 4 1 0 0 0 89
C72 Other parts of nervous system 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
C73 Thyroid gland 0 0 1 2 6 21 21 19 14 8 8 4 4 2 2 0 0 0 112
C74-C75 Endocrine gland and related structure 0 0 1 1 4 5 8 3 3 1 2 2 2 1 0 0 0 0 33
C76 Other and ill-defined sites 2 0 0 0 1 0 0 3 0 0 0 0 0 0 1 0 0 0 7
C80 Unknown primary 0 0 0 1 0 0 0 1 1 4 3 5 2 1 2 1 0 0 21
M9650-M9667 Hodgkin lymphoma 2 17 0 4 25 17 13 10 2 1 0 1 0 1 0 0 0 0 93
M9590-91, 967-972 Non-Hodgkin lymphoma 10 7 0 1 11 6 17 16 3 1 10 4 5 3 1 0 1 1 97
M9731-M9732 Multiple myeloma & immuno. neoplasms 0 0 0 0 0 0 0 0 1 0 0 2 1 3 1 0 0 0 8
M982-M983 Lymphoid leukemia 35 3 0 1 6 3 0 5 2 3 9 6 3 0 0 0 0 0 76
M984-M993 Myeloid leukemia 0 0 2 1 2 0 1 1 0 2 0 0 3 0 0 0 0 0 12
M980 Other leukemia 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
C42.0, C42.2-4 Other lymphatic & hematopoietic tissue 0 0 1 0 0 0 0 1 0 0 0 1 1 0 1 1 0 0 6
~ Other reportable CNS neoplasms 0 0 0 0 2 0 1 0 2 1 3 1 0 0 0 0 0 0 10
Total 86 49 21 47 135 193 319 439 417 292 320 317 265 157 103 37 24 6 3227
Page 12 of 28
MALES
ICD-O-3 Code Primary Site 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85+ Total
C00 Lip 0 0 0 0 0 0 1 1 2 0 4 0 0 2 0 0 0 0 10
C01-C02 Tongue 0 0 0 0 0 3 4 5 15 12 8 8 5 4 4 2 2 1 73
C03 Gum 0 0 0 0 0 1 1 2 2 7 6 7 1 3 1 1 1 0 33
C04-C06 Floor and other parts of mouth 0 0 0 0 0 5 6 9 4 7 6 8 2 2 3 1 1 0 54
C07-C08 Salivary gland 0 0 0 0 4 3 2 4 4 0 4 4 1 2 1 0 0 0 29
C9-C10 Tonsil & oropharynx 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 5
C11 Nasopharynx 0 0 0 4 5 1 2 4 5 11 5 2 0 1 0 0 0 0 40
C12-C13 Pyriform sinus & Hypopharynx 0 0 0 0 2 2 3 3 6 3 0 3 1 1 1 0 0 0 25
C14 Other & ill-defined lip, oral cavity, pharynx 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 2
C15 Esophagus 0 0 0 1 2 6 8 14 26 11 11 12 6 0 3 0 0 0 100
C16 Stomach 0 0 0 0 2 6 10 13 18 25 14 18 12 0 2 1 0 0 121
C17 Small intestine 0 0 0 0 1 1 0 3 1 4 3 2 1 2 1 0 0 0 19
C18 Colon 0 0 0 2 0 5 8 5 20 9 18 6 8 5 7 0 0 0 93
C19-C21 Rectosigmoid, rectum, anal canal, and anus 0 0 0 2 11 22 33 27 20 19 16 17 16 17 8 2 3 1 214
C22 Liver & intrahepatic bile duct 6 1 0 0 0 2 1 1 4 5 16 11 16 8 9 3 1 0 84
C23-C24 Gall Bladder & extrahepatic bile duct 0 0 0 0 0 0 1 2 5 5 9 12 12 4 1 2 0 1 54
C25 Pancreas 0 0 0 0 2 0 1 0 2 8 6 10 6 8 4 3 0 0 50
C30-C31 Nasal cavity, middle ear and acc. sinuses 0 0 0 0 1 2 1 1 2 0 1 1 2 2 0 0 0 0 13
C32 Larynx 0 0 0 0 0 2 1 2 3 7 12 9 7 2 3 3 0 0 51
C33-C34 Bronchus & Lung 0 0 0 1 0 0 0 3 3 10 14 21 30 21 6 10 4 2 125
C37-C38 Thymus, heart, mediastinum & pleura 0 0 0 2 0 2 2 1 3 1 0 0 3 0 0 0 0 0 14
C40-C41 Bone & articular cartilage 6 4 35 23 2 1 2 0 2 1 3 0 0 1 1 0 0 0 81
C44 Skin 1 0 0 0 1 2 9 13 8 14 15 23 17 21 16 13 7 4 164
C47 Peripheral. & autoimmune nervous system 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2
C48 Retroperitoneum and Peritoneum 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
C49 Connective & soft tissue 2 3 2 4 10 8 5 4 11 8 6 6 2 2 0 2 0 1 76
C50 Breast 0 0 0 0 0 0 1 0 2 1 0 1 2 1 0 1 0 0 9
C60 Penis 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2
C61 Prostate 0 0 0 0 0 0 0 0 2 4 20 41 62 78 36 16 4 1 264
C62 Testis 11 1 2 15 38 40 29 30 10 6 7 3 1 0 0 0 0 0 193
C63 Other & unspecified male genital organs 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 2
C64-C66 Kidney & other urinary organ 14 2 0 0 1 3 5 6 6 18 18 13 16 4 3 0 0 1 110
C67 Urinary bladder 0 0 0 0 2 0 2 4 10 14 11 14 9 4 1 3 1 0 75
C68 Other & unspecified urinary organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
C69 Eye 19 4 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 24
C70-C71 Brain 0 0 0 5 13 16 33 23 23 10 7 9 10 2 1 0 0 0 152
C72 Other parts of nervous system 0 0 0 0 1 2 0 2 0 1 0 1 1 0 0 0 0 0 8
C73 Thyroid gland 0 0 0 1 5 6 11 8 7 2 3 6 2 2 0 1 0 0 54
C74-C75 Endocrine gland and related structure 0 0 0 0 1 4 3 6 0 5 3 1 1 3 0 0 0 0 27
C76 Other and ill-defined sites 2 0 0 0 1 1 0 0 2 0 2 0 0 1 1 0 0 0 10
C80 Unknown primary 0 0 0 1 0 1 2 1 1 0 1 2 0 2 1 0 0 0 12
M9650-M9667 Hodgkin lymphoma 21 67 0 20 45 25 29 34 4 3 3 0 1 0 0 0 0 0 252
M9590-91,967-972 Non-Hodgkin lymphoma 16 35 0 5 20 24 35 25 15 7 13 8 9 3 2 3 1 0 221
M9731-M9732 Multiple myeloma & immuno. neoplasms 0 0 0 0 0 0 0 0 0 1 2 1 1 2 2 1 1 0 11
M982-M983 Lymphoid leukemia 43 3 2 7 21 3 3 2 5 12 19 20 1 0 2 0 0 0 143
M984-M993 Myeloid leukemia 0 0 3 1 2 4 2 0 1 0 4 1 2 2 1 0 0 0 23
M994 Other leukemia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
C42.0, C42.2-4 Other lymphatic & hematopoietic tissue 0 0 0 0 2 0 0 0 0 0 0 1 4 1 0 0 1 0 9
~ Other reportable CNS neoplasms 0 0 0 0 3 3 4 2 2 1 1 0 0 1 0 0 0 0 17
Total 141 120 44 95 198 207 260 263 259 256 293 302 270 214 121 68 27 13 3151
*Diseases are listed according to the International Classification of Diseases for Oncology, Third edition (ICD-O-3) codes.
~Non-malignant primary intracranial and CNS tumors are also included in the count.
Page 13 of 28
Table 13 - Morphology, site, and gender, 2018
Page 14 of 28
Carcinoma, Undifferentiated, Nos 12 16 28
Squamous Cell Carcinoma, Nos 1 3 4
Squamous Cell Carcinoma, Large Cell, Nonkeratinizing,
Nos 2 2
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Malignant Melanoma, Nos 1 1
Squamous Cell Carcinoma, Keratinizing, Nos 1 1
Squamous Cell Carcinoma, Nos 12 23 35
C12-C13 Pyriform sinus &
Hypopharynx Squamous Cell Carcinoma, Keratinizing, Nos 3 1 4
Basaloid Squamous Cell Carcinoma 1 1
Page 15 of 28
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Mucinous Adenocarcinoma 1 1
Signet Ring Cell Carcinoma 1 1
Adenocarcinoma, Nos 35 63 98
Mucinous Adenocarcinoma 6 16 22
Signet Ring Cell Carcinoma 2 6 8
Adenocarcinoma In Tubulovillous Adenoma 3 4 7
Malignant Lymphoma, Large B-Cell Diffuse Nos 2 3 5
C18 Colon Adenocarcinoma In Villous Adenoma 2 2
Adenocarcinoma In Adenomatous Polyp 1 1
Burkitt Lymphoma, Nos 1 1
Gastrointestinal Stromal Sarcoma 1 1
Neuroendocrine Carcinoma, Nos 1 1
Tubular Adenocarcinoma 1 1
Adenocarcinoma, Nos 54 120 174
Signet Ring Cell Carcinoma 27 47 74
Adenocarcinoma In Tubulovillous Adenoma 17 16 33
Mucinous Adenocarcinoma 10 14 24
Neoplasm, Malignant 1 2 3
Squamous Cell Carcinoma, Nos 3 3
C19-C21 Rectosigmoid Adenocarcinoma In Adenomatous Polyp 2 2
junction, rectum, anal canal,
and anus Adenocarcinoma In Villous Adenoma 1 1 2
Carcinoma, Nos 1 1 2
Neuroendocrine Carcinoma, Nos 2 2
Squamous Cell Carcinoma, Keratinizing, Nos 2 2
Squamous Cell Carcinoma, Large Cell, Nonkeratinizing,
Nos 2 2
Gastrointestinal Stromal Sarcoma 1 1
Malignant Melanoma, Nos 1 1
Hepatocellular Carcinoma, Nos 36 66 102
Cholangiocarcinoma 9 10 19
C22 Liver & intrahepatic Hepatoblastoma 4 7 11
bile ducts
Adenocarcinoma, Nos 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Yolk Sac Tumor 1 1
C23-C24 Gallbladder & Adenocarcinoma, Nos 31 33 64
Page 16 of 28
other and unspecified parts
Cholangiocarcinoma 6 4 10
of biliary tract
Adenocarcinoma, Intestinal Type 2 5 7
Neoplasm, Malignant 4 3 7
Carcinoma, Nos 1 2 3
Signet Ring Cell Carcinoma 1 2 3
Adenocarcinoma In Villous Adenoma 2 2
Adenosquamous Carcinoma 2 2
Adenocarcinoma In Tubulovillous Adenoma 1 1
Klatskin Tumor 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Neuroendocrine Carcinoma, Nos 1 1
Squamous Cell Carcinoma, Nos 1 1
Adenocarcinoma, Nos 19 35 54
Neuroendocrine Carcinoma, Nos 7 10 17
Neoplasm, Malignant 4 1 5
C25 Pancreas Carcinoma, Nos 1 3 4
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Mucinous Adenocarcinoma 1 1
Solid Pseudopapillary Carcinoma 1 1
Squamous Cell Carcinoma, Nos 6 3 9
Adenoid Cystic Carcinoma 3 4 7
Carcinoma, Nos 1 1 2
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1 2
Carcinoma, Undifferentiated, Nos 1 1
C30-C31 Nasal cavity, Ewing Sarcoma 1 1
middle ear and accessory
sinuses Malignant Melanoma, Nos 1 1
Malignant Myoepithelioma 1 1
Nk/T-Cell Lymphoma, Nasal And Nasal-Type 1 1
Small Cell Carcinoma, Nos 1 1
Squamous Cell Carcinoma, Large Cell, Nonkeratinizing,
Nos 1 1
Squamous Cell Carcinoma, Spindle Cell 1 1
Squamous Cell Carcinoma, Nos 6 41 47
Squamous Cell Carcinoma, Keratinizing, Nos 1 5 6
C32 Larynx
Adenoid Cystic Carcinoma 2 2
Carcinoma In Situ, Nos 2 2
Page 17 of 28
Squamous Cell Carcinoma In Situ, Nos 1 1 2
Basaloid Squamous Cell Carcinoma 1 1
Chondrosarcoma, Nos 1 1
Adenocarcinoma, Nos 21 30 51
Squamous Cell Carcinoma, Nos 2 48 50
Small Cell Carcinoma, Nos 2 29 31
Acinar Cell Carcinoma 8 2 10
Neoplasm, Malignant 5 3 8
Neuroendocrine Carcinoma, Nos 2 5 7
Non-Small Cell Carcinoma 3 3
C33-C34 Trachea, bronchus Carcinoma, Nos 2 2
and lung
Ewing Sarcoma 1 1 2
Adenocarcinoma With Mixed Subtypes 1 1
Combined Small Cell Carcinoma 1 1
Fetal Adenocarcinoma 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Mucinous Adenocarcinoma 1 1
Mucoepidermoid Carcinoma 1 1
Squamous Cell Carcinoma, Keratinizing, Nos 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 6 7
Neuroendocrine Carcinoma, Nos 3 3
Thymoma, Type B2, Malignant 3 3
Yolk Sac Tumor 1 2 3
Germ Cell Tumor, Nonseminomatous 2 2
Mesothelioma, Malignant 2 2
C37-C38 Thymus, heart, Follicular Lymphoma, Grade 2 1 1
mediastinum & pleura
Hodgkin Lymphoma, Nos 1 1
Mixed Germ Cell Tumor 1 1
Neoplasm, Malignant 1 1
Small Cell Carcinoma, Nos 1 1
Thymoma, Type Ab, Malignant 1 1
Thymoma, Type B2, Nos 1 1
Thymoma, Type B3, Malignant 1 1
C40-41 Bones, Joints & Osteosarcoma, Nos 19 34 53
Articular Cartilage
Ewing Sarcoma 17 28 45
Page 18 of 28
Chondrosarcoma, Nos 5 6 11
Malignant Lymphoma, Large B-Cell Diffuse Nos 2 6 8
Chondroblastic Osteosarcoma 5 5
Spindle Cell Sarcoma 1 1 2
Burkitt Lymphoma, Nos 1 1
Dedifferentiated Chondrosarcoma 1 1
Hodgkin Lymphoma, Nos 1 1
Langerhans Cell Histiocytosis, Multifocal 1 1
Langerhans Cell Histiocytosis, Nos 1 1
Plasmacytoma, Nos 1 1
Sarcoma, Nos 1 1
Telangiectatic Osteosarcoma 1 1
Page 19 of 28
Refractory Cytopenia With Multilineage Dysplasia 1 1
Basal Cell Carcinoma, Nodular 45 44 89
Squamous Cell Carcinoma, Nos 19 62 81
Malignant Melanoma, Nos 12 17 29
Basal Cell Carcinoma, Nos 9 17 26
Squamous Cell Carcinoma, Keratinizing, Nos 8 5 13
Dermatofibrosarcoma, Nos 1 6 7
Sebaceous Adenocarcinoma 3 1 4
Adenoid basal Cell Carcinoma, Nos 3 3
Squamous Cell Carcinoma In Situ, Nos 1 2 3
Basaloid Squamous Cell Carcinoma 1 1 2
Nodular Hidradenoma, Malignant 1 1 2
C44 Skin
Adenosquamous Carcinoma 1 1
Basosquamous Carcinoma 1 1
Carcinoma In Situ, Nos 1 1
Carcinoma, Nos 1 1
Cutaneous T-Cell Lymphoma, Nos 1 1
Langerhans Cell Histiocytosis, Nos 1 1
Mycosis Fungoides 1 1
Myeloid Sarcoma 1 1
Nodular Melanoma 1 1
Skin Appendage Carcinoma 1 1
Squamous Cell Carcinoma, Spindle Cell 1 1
C47 Periph. nerves & auto- Malignant Peripheral Nerve Sheath Tumor 2 1 3
immune N.S.
Angiomyosarcoma 1 1
Dysgerminoma 2 2
C48 Retroperitoneum &
Peritoneum Embryonal Rhabdomyosarcoma, Nos 1 1
Liposarcoma, Nos 1 1
Synovial Sarcoma, Nos 11 16 27
Spindle Cell Sarcoma 13 8 21
Page 20 of 28
Liposarcoma, Well Differentiated 4 4
Dedifferentiated Liposarcoma 3 3
Epithelioid Sarcoma 2 1 3
Myxoid Liposarcoma 2 1 3
Pleomorphic Liposarcoma 1 2 3
Synovial Sarcoma, Biphasic 2 1 3
Clear Cell Sarcoma, Nos 1 1 2
Giant Cell Sarcoma 2 2
Rhabdomyosarcoma, Nos 1 1 2
Sarcoma, Nos 1 1 2
Spindle Cell Rhabdomyosarcoma 2 2
Synovial Sarcoma, Spindle Cell 2 2
Alveolar Rhabdomyosarcoma 1 1
Angiomyosarcoma 1 1
Dermatofibrosarcoma, Nos 1 1
Epithelioma, Malignant 1 1
Kaposi Sarcoma 1 1
Liposarcoma, Nos 1 1
Malignant Fibrous Histiocytoma 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Pleomorphic Rhabdomyosarcoma, Adult Type 1 1
Infiltrating Duct Carcinoma, Nos 1082 8 1090
Lobular Carcinoma, Nos 64 64
Infiltrating Duct Mixed With Other Types Of Carcinoma 23 23
Ductal Carcinoma In Situ, Solid Type 14 14
Carcinoma, Nos 12 12
Metaplastic Carcinoma, Nos 11 11
Infiltrating Duct And Lobular Carcinoma 8 8
C50 Breast
Inflammatory Carcinoma 6 6
Mucinous Adenocarcinoma 6 6
Paget Disease And Infiltrating Duct Carcinoma Of Breast 5 1 6
Comedocarcinoma, Noninfiltrating 5 5
Neoplasm, Malignant 5 5
Papillary Carcinoma, Nos 5 5
Phyllodes Tumor, Malignant 4 4
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Malignant Lymphoma, Large B-Cell Diffuse Nos 3 3
Intraductal Micropapillary Carcinoma 2 2
Lobular Carcinoma In Situ, Nos 2 2
Paget Disease And Intraductal Carcinoma Of Breast 2 2
Paget Disease, Mammary 2 2
Apocrine Adenocarcinoma 1 1
Intraductal Carcinoma, Noninfiltrating, Nos 1 1
Papillary Carcinoma In Situ 1 1
Squamous Cell Carcinoma, Keratinizing, Nos 5 5
Clear Cell Adenocarcinoma, Nos 4 4
Squamous Cell Carcinoma, Nos 4 4
C51-C52 Vulva & Vagina Adenocarcinoma, Nos 2 2
Epithelioid Sarcoma 1 1
Malignant Melanoma, Nos 1 1
Squamous Cell Carcinoma, Large Cell, Nonkeratinizing,
Nos 1 1
Squamous Cell Carcinoma, Large Cell, Nonkeratinizing,
Nos 42 42
Squamous Cell Carcinoma, Nos 42 42
Squamous Cell Carcinoma, Keratinizing, Nos 39 39
Adenocarcinoma, Nos 10 10
Carcinoma, Nos 6 6
Adenocarcinoma, Endocervical Type 4 4
Endometrioid Adenocarcinoma, Nos 4 4
Clear Cell Adenocarcinoma, Nos 3 3
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Granular Cell Tumor, Malignant 1 1
Mixed Cell Adenocarcinoma 1 1
Mucinous Cystadenocarcinoma, Nos 1 1
Squamous Cell Carcinoma, Nos 1 1
Carcinosarcoma, Nos 1 1
C57 Other and unspecified
female genital organs Clear Cell Adenocarcinoma, Nos 1 1
Serous Cystadenocarcinoma, Nos 1 1
C58 Placenta Choriocarcinoma, Nos 1 1
Squamous Cell Carcinoma, Keratinizing, Nos 1 1
C60 Penis
Squamous Cell Carcinoma, Nos 1 1
Adenocarcinoma, Nos 253 253
Neoplasm, Malignant 7 7
C61 Prostate Carcinoma, Nos 2 2
Neuroendocrine Carcinoma, Nos 1 1
Transitional Cell Carcinoma, Nos 1 1
Mixed Germ Cell Tumor 72 72
Seminoma, Nos 65 65
Yolk Sac Tumor 17 17
Embryonal Carcinoma, Nos 16 16
Teratoma, Malignant, Nos 6 6
Neoplasm, Malignant 5 5
Germ Cell Tumor, Nonseminomatous 2 2
Germinoma 2 2
C62-63 Testis & other male Squamous Cell Carcinoma, Nos 2 2
genital organs
Burkitt Lymphoma, Nos 1 1
Carcinoma, Nos 1 1
Dedifferentiated Liposarcoma 1 1
Embryonal Rhabdomyosarcoma, Nos 1 1
Granulosa Cell Tumor, Malignant 1 1
Leiomyosarcoma Nos 1 1
Neuroendocrine Carcinoma, Nos 1 1
Spermatocytic Seminoma 1 1
Stromal Sarcoma, Nos 1 1
C64-C66 Kidney, renal Renal Cell Carcinoma, Nos 47 70 117
pelvis and ureter
Nephroblastoma, Nos 12 15 27
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Renal Cell Carcinoma, Chromophobe Type 4 9 13
Neoplasm, Malignant 1 3 4
Clear Cell Adenocarcinoma, Nos 1 2 3
Papillary Adenocarcinoma, Nos 1 2 3
Carcinoma, Nos 2 2
Renal Cell Carcinoma, Sarcomatoid 2 2
Transitional Cell Carcinoma, Nos 2 2
Clear Cell Sarcoma Of Kidney 1 1
Ewing Sarcoma 1 1
Papillary Transitional Cell Carcinoma 1 1
Papillary Transitional Cell Carcinoma 9 48 57
Transitional Cell Carcinoma, Nos 4 24 28
C67 Bladder Squamous Cell Carcinoma, Nos 1 1 2
Neuroendocrine Carcinoma, Nos 1 1
Transitional Cell Carcinoma, Spindle Cell 1 1
Retinoblastoma, Nos 16 22 38
Embryonal Rhabdomyosarcoma, Nos 2 2
Retinoblastoma, Differentiated 1 1 2
Adenoid Cystic Carcinoma 1 1
C69 Eye and Adnexa Carcinoma, Nos 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Retinoblastoma, Undifferentiated 1 1
Spindle Cell Melanoma, Nos 1 1
Squamous Cell Carcinoma, Nos 1 1
Glioma, Malignant 26 53 79
Astrocytoma, Nos 24 36 60
Glioblastoma, Nos 13 37 50
Oligodendroglioma, Nos 8 6 14
Meningioma, Nos 6 5 11
C70-C71 Meninges and
brain Astrocytoma, Anaplastic 5 2 7
Neoplasm, Malignant 4 4
Oligodendroglioma, Anaplastic 1 3 4
Ependymoma, Nos 3 3
Hemangioblastoma 1 2 3
Medulloblastoma, Nos 3 3
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Neoplasm, Uncertain Whether Benign Or Malignant 2 1 3
Central Neurocytoma 2 2
Hemangiopericytoma, Malignant 1 1 2
Meningioma, Malignant 2 2
Pilocytic Astrocytoma 2 2
Gemistocytic Astrocytoma 1 1
Gliosarcoma 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Malignant Lymphoma, Non-Hodgkin, Nos 1 1
Neurilemoma, Nos 1 1
Pilomyxoid Astrocytoma 1 1
Ependymoma, Nos 3 7 10
Neurilemoma, Nos 1 4 5
Myxopapillary Ependymoma 3 3
C72 Spinal cord, cranial Glioma, Malignant 1 1 2
nerves & other parts of CNS
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1 2
Neoplasm, Malignant 2 2
Burkitt Lymphoma, Nos 1 1
Plasmacytoma, Nos 1 1
Papillary Carcinoma, Nos 84 43 127
Follicular Adenocarcinoma, Nos 8 3 11
Medullary Carcinoma, Nos 10 1 11
Oxyphilic Adenocarcinoma 2 3 5
Carcinoma, Anaplastic, Nos 2 2
Carcinoma, Nos 2 2
C73 Thyroid Papillary Microcarcinoma 2 2
Adenocarcinoma, Nos 1 1
Follicular Carcinoma, Minimally Invasive 1 1
Micropapillary Carcinoma,Nos 1 1
Neoplasm, Malignant 1 1
Papillary Carcinoma, Encapsulated 1 1
Papillary Carcinoma, Oxyphilic Cell 1 1
Adrenal Cortical Carcinoma 4 2 6
C74 Adrenal gland
Pheochromocytoma, Malignant 1 1
C75 Other endocrine glands Pituitary Adenoma, Nos 25 23 48
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& related structures
Prolactinoma 2 1 3
Craniopharyngioma 1 1
Pineoblastoma 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 3 1 4
Burkitt Lymphoma, Nos 1 2 3
Gastrointestinal Stromal Sarcoma 1 2 3
Yolk Sac Tumor 1 2 3
Carcinoma, Nos 2 2
Seminoma, Nos 2 2
C76 Other & ill-defined
sites Adenoid Cystic Carcinoma 1 1
Dysgerminoma 1 1
Embryonal Carcinoma, Nos 1 1
Malignant Tumor, Clear Cell Type 1 1
Mixed Germ Cell Tumor 1 1
Neoplasm, Malignant 1 1
Small Cell Carcinoma, Nos 1 1
Hodgkin Lymphoma, Mixed Cellularity, Nos 43 150 193
Malignant Lymphoma, Large B-Cell Diffuse Nos 43 106 149
Hodgkin Lymphoma, Nodular Sclerosis, Nos 39 54 93
Burkitt Lymphoma, Nos 5 30 35
Hodgkin Lymphoma, Nos 7 20 27
Hodgkin Lymphoma, Nodular Lymphocyte
Predominance 4 21 25
Hodgkin Lymphoma, Lymphocyte-Rich 7 7
Precursor T-Cell Lymphoblastic Lymphoma 2 5 7
Follicular Lymphoma, Grade 3 2 3 5
C77 Lymph nodes,
(NHL,HL) Malignant Lymphoma, Non-Hodgkin, Nos 3 2 5
Marginal Zone B-Cell Lymphoma, Nos 3 2 5
Anaplastic Large Cell Lymphoma, T Cell And Null Cell
Type 1 3 4
T-Cell/Histiocyte Rich Large B-Cell Lymphoma 1 3 4
Alk Positive Large B-Cell Lymphoma 1 2 3
Composite Hodgkin And Non-Hodgkin Lymphoma 3 3
Follicular Lymphoma, Grade 1 1 2 3
Follicular Lymphoma, Grade 2 1 2 3
Mantle Cell Lymphoma 3 3
Precursor B-Cell Lymphoblastic Lymphoma 3 3
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Mature T-Cell Lymphoma, Nos 2 2
Angioimmunoblastic T-Cell Lymphoma 1 1
B-Cell Chronic Lymphocytic Leukemia/Small
Lymphocytic Lymphoma 1 1
Langerhans Cell Histiocytosis, Nos 1 1
Malignant Lymphoma, Small B Lymphocytic, Nos 1 1
Precursor Cell Lymphoblastic Lymphoma, Nos 1 1
Neoplasm, Malignant 9 5 14
Adenocarcinoma, Nos 5 3 8
Carcinoma, Nos 5 1 6
Yolk Sac Tumor 2 2
Embryonal Carcinoma, Nos 1 1
C80 Unknown primary site
Germinoma 1 1
Malignant Lymphoma, Large B-Cell Diffuse Nos 1 1
Malignant Lymphoma, Non-Hodgkin, Nos 1 1
Marginal Zone B-Cell Lymphoma, Nos 1 1
Squamous Cell Carcinoma, Nos 1 1
Grand Total 3227 3151 6378
"NOS" is an abbreviation for Not Otherwise Specified
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