Major Vein Involvement
Description
Major vein involvement pertains to the invasion of the kidney tumor into major veins. Involvement of veins from a renal cancer has prognostic implications because tumor cells can more easily disseminate through the bloodstream. This data item records information about the presence and level of involvement of specific major blood vessels. Do not code microscopically identified involvement of small unnamed blood vessels within the kidney; this information is coded in the field Lymph-Vascular Invasion (LVI). The tumor may be described as a thrombus, a cluster of tumor cells presents in the center of the vein but not attached to the wall of the vein. Tumor spread may resemble mud extruding along the inside of a pipe. Direct tumor invasion of the wall of the inferior vena cava is not coded in this field. Record the code that best describes involvement of the renal vein and/or inferior vena cava (IVC) as described in the pathology report. Do not include clinical findings in this field.Notes
**Note 1:** **Physician Statement** * Physician statement of Major Vein Involvement can be used to code this data item when no other information is available. * The major veins include the renal vein or its segmental branches, and the inferior vena cava. **Note 2:** **Relevance to Staging** * Information about major vein involvement beyond the kidney is collected in primary tumor as an element in anatomic staging. It is also collected in this field as it may have an independent effect on prognosis. **Note 3:** **Major Vein Involvement** * Record the involvement of specific named veins as documented in the pathology report. Do not code invasion of small unnamed vein(s) of the type collected as lymph-vascular invasion. Lymph-vascular invasion is usually only seen microscopically.| Code | Description |
|---|---|
| 0 | Major vein involvement not present/not identified |
| 1 | Renal vein or its segmental branches |
| 2 | Inferior vena cava (IVC) |
| 3 | Major vein invasion, NOS |
| 4 | Any combination of codes 1-3 |
| 8 | Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error.) |
| 9 | Not documented in medical record Vein involvement not assessed or unknown if assessed No surgical resection of primary site is performed |