Item # Length Source of Standard Year Implemented Version Implemented Year Retired Version Retired
1192 1 NAACCR/SEER 2025 25

NAACCR XML: Tumor.pretextClinicalStaging

Description

PRETEXT stands for PRE-Treatment Extent of tumor. This field describes the extent of involvement within the four lobes of the liver at time of a pediatric liver tumor diagnosis. It is based off clinical imaging and was originally designed to standardize imaging evaluation and risk stratification of hepatoblastoma before neoadjuvant chemotherapy or tumor resection.

Rationale

After initially being created by the International Childhood Liver Tumours Strategy Group (SIOPEL) in 1990, PRETEXT was introduced for use within the United States in 2014 by the Children’s Oncology Group (COG) once radiographic imaging became more sophisticated and exploratory surgery at diagnosis was no longer advisable. It is used as a central component of risk stratification schemes that define treatment of hepatoblastoma.

Source documents: imaging

Codes
1One section involved; three adjoining sections are tumor free Stage I, Pretext 1
2One or two sections involved; two adjoining sections are tumor free Stage 2, Pretext 2
3Two or three sections involved; one adjoining section is tumor free Stage 3, Pretext 3
4Four sections involved Stage 4, Pretext 4
8Not 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.)
9Not documented in medical record Cannot be determined by pathologist PRETEXT not assessed or unknown if assessed

Note 1: Effective years

Note 2: Criteria for coding

Note 3: Pretext Staging-Segments of the liver