**Collaborative Staging Codes**

**Nasal Cavity**\
**C30.0**

C30.0 Nasal cavity (excludes nose, NOS C76.0)

**Note:  ** Laterality must be coded for this site, except subsites
Nasal cartilage and Nasal septum, for which laterality is coded 0.

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | CS Tumor Size\   | **CS Site-Specific     | The following       |   |
| | CS Extension\    | Factor 1 -** Size of   | tables are          |   |
| | CS TS/Ext-Eval\  | Lymph Nodes\           | available at the    |   |
| | CS Lymph Nodes\  | **CS Site-Specific     | collaborative       |   |
| | CS Reg Nodes     | Factor 2 -**           | staging website:    |   |
| | Eval\            | Extracapsular          |                     |   |
| | Reg LN Pos\      | Extension, Lymph Nodes | Histology Exclusion |   |
| | Reg LN Exam\     | for Head and Neck\     | Table\              |   |
| | CS Mets at DX\   | **CS Site-Specific     | AJCC Stage\         |   |
| | CS Mets Eval     | Factor 3 -** Levels    | Lymph Nodes Size    |   |
| |                  | I-III, Lymph Nodes for | Table               |   |
| |                  | Head and Neck\         |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 4 -** Levels    |                     |   |
| |                  | IV-V and               |                     |   |
| |                  | Retropharyngeal Lymph  |                     |   |
| |                  | Nodes for Head and     |                     |   |
| |                  | Neck\                  |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 5 -** Levels    |                     |   |
| |                  | VI-VII and Facial      |                     |   |
| |                  | Lymph Nodes for Head   |                     |   |
| |                  | and Neck\              |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 6 -**           |                     |   |
| |                  | Parapharyngeal,        |                     |   |
| |                  | Parotid, Preauricular, |                     |   |
| |                  | and Sub-Occipital      |                     |   |
| |                  | Lymph Nodes, Lymph     |                     |   |
| |                  | Nodes for Head and     |                     |   |
| |                  | Neck                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Nasal Cavity**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive                    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to site of       | T1   | L    | L    |
|      | origin                                   |      |      |      |
|      |                                          |      |      |      |
|      | Meatus (superior, middle, inferior)      |      |      |      |
|      |                                          |      |      |      |
|      | Nasal chonchae (superior, middle,        |      |      |      |
|      | inferior)                                |      |      |      |
|      |                                          |      |      |      |
|      | Septum                                   |      |      |      |
|      |                                          |      |      |      |
|      | Tympanic membrane                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Extending to adjacent connective tissue  | T2   | RE   | RE   |
|      | within the nasoethomoidal complex        |      |      |      |
|      |                                          |      |      |      |
|      | Nasolacrimal duct                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures including:    | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Bone of skull                            |      |      |      |
|      |                                          |      |      |      |
|      | Choana                                   |      |      |      |
|      |                                          |      |      |      |
|      | Frontal sinus                            |      |      |      |
|      |                                          |      |      |      |
|      | Hard palate                              |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Cribriform plate                         | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 66   | Maxillary sinus                          | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 67   | Medial wall or floor of the orbit        | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Tumor invades:                           | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Anterior orbital contents                |      |      |      |
|      |                                          |      |      |      |
|      | Skin of cheek                            |      |      |      |
|      |                                          |      |      |      |
|      | Skin of nose                             |      |      |      |
|      |                                          |      |      |      |
|      | Minimal extension to:                    |      |      |      |
|      |                                          |      |      |      |
|      | Anterior cranial fossa                   |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Sphenoid or frontal sinuses              |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Tumor invades:                           | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Orbital apex                             |      |      |      |
|      |                                          |      |      |      |
|      | Dura                                     |      |      |      |
|      |                                          |      |      |      |
|      | Brain                                    |      |      |      |
|      |                                          |      |      |      |
|      | Middle cranial fossa                     |      |      |      |
|      |                                          |      |      |      |
|      | Cranial nerves other than (V2),          |      |      |      |
|      | nasopharynx, or clivus                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Nasal Cavity**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of nvolved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | None; no regional lymph node involvement | N0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level I node                             |      |      |     |
|      |                                          |      |      |     |
|      | Sublingual                               |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Submental                                |      |      |     |
|      |                                          |      |      |     |
|      | Level II node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulodigastric (subdigastric)           |      |      |     |
|      |                                          |      |      |     |
|      | Upper deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Upper jugular                            |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+-----+
| 10,  | Cervical, NOS                            |      |      |     |
|      |                                          |      |      |     |
| co   | Deep cervical, NOS                       |      |      |     |
| nt'd |                                          |      |      |     |
|      | Internal jugular, NOS                    |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Regional lymph node, NOS                 |      |      |     |
+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | \*   | D    | D   |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level III node                           |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level IV node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |     |
|      |                                          |      |      |     |
|      | Lower deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Lower jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VI node                            |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Laterotrachea                            |      |      |     |
|      |                                          |      |      |     |
|      | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 18   | Stated as N1, no other information       | N1   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN  |
|      | listed in code 10                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D   |
|      | listed in code 12                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral nodes(s), not       |      |      |     |
|      | stated if single or multiple or regional |      |      |     |
+------+------------------------------------------+------+------+-----+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+-----+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s), not stated if          |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s), not stated if          |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 60   | Stated as N2, NOS                        | N    | RN   | RN  |
|      |                                          | 2NOS |      |     |
+------+------------------------------------------+------+------+-----+
| 70   | Stated as N3, no other information       | N3   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 80   | Lymph nodes, NOS                         | \*   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NX   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

\*For codes 10, 12, 20, 22, 30, 32, 40, 42, 50, 52 and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Nasal Cavity**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**CS Mets at DX**\
**SEE STANDARD TABLE**\
\
**Nasal Cavity**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Nasal Cavity**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Nasal Cavity**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Nasal Cavity**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Nasal Cavity**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

  ------- ---------------------------------------------------------------
  Code    Description

  000     No lymph node involvement in Levels IV or V or retropharyngeal

  100     Level IV lymph node(s) involved

  010     Level V lymph node(s) involved

  001     Retropharyngeal nodes involved

  110     Level IV and V lymph nodes involved

  101     Level IV and retropharyngeal nodes involved

  011     Level V and retropharyngeal nodes involved
  ------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Nasal Cavity**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Nasal Cavity**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Collaborative Staging Codes**

**Middle Ear**\
**C30.1**

C30.1 Middle ear

**Note 1:  ** Laterality must be coded for this site.

**Note 2:  ** AJCC does not define TNM staging for this site.

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histology Exclusion |    |
| | Reg LN Exam\    | for Head and Neck\     | Table\              |    |
| | CS Mets at DX\  | **CS Site-Specific     | AJCC Stage          |    |
| | CS Mets Eval    | Factor 3 -** Levels    |                     |    |
| |                 | I-III, Lymph Nodes for |                     |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Middle Ear**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
**\
Middle Ear**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive                    | NA   | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | NA   | L    | L    |
|      |                                          |      |      |      |
|      | Cochlea                                  |      |      |      |
|      |                                          |      |      |      |
|      | Incus                                    |      |      |      |
|      |                                          |      |      |      |
|      | Malleus                                  |      |      |      |
|      |                                          |      |      |      |
|      | Semicircular ducts, NOS:                 |      |      |      |
|      |                                          |      |      |      |
|      | Ampullae                                 |      |      |      |
|      |                                          |      |      |      |
|      | Saccule                                  |      |      |      |
|      |                                          |      |      |      |
|      | Utricle                                  |      |      |      |
|      |                                          |      |      |      |
|      | Septum                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stapes                                   |      |      |      |
|      |                                          |      |      |      |
|      | Tympanic membrane                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue:              | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Auditory tube                            |      |      |      |
|      |                                          |      |      |      |
|      | Nerve(s)                                 |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngotympanic tube                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures:              | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | External auditory meatus                 |      |      |      |
|      |                                          |      |      |      |
|      | Internal carotid artery                  |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid antrum                           |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Temporal bone                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Meninges                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | NA   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Middle Ear**\
**CS TS/Ext-Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Middle Ear**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | NA   | RN   | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Sublingual                               |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | NA   | D    | D   |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level III node                           |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level IV node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |     |
|      |                                          |      |      |     |
|      | Lower deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Lower jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VI node                            |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Laterotrachea                            |      |      |     |
|      |                                          |      |      |     |
|      | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 80   | Lymph nodes, NOS                         | NA   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NA   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

**Middle Ear**\
**CS Reg Nodes Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Middle Ear**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Middle Ear**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Middle Ear**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | NA   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Cannot be assessed                       |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Middle Ear**\
**CS Mets Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Middle Ear**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Middle Ear**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Middle Ear**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Middle Ear**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Middle Ear**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Middle Ear**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Page left blank**

**Site-Specific Surgery Codes**

####### All Other Sites

C142--C148, C170--C179, C239, C240--C249, C260--C269, **C300--C301,**
C310--C319, C339, C379, C380--C388, C390--C399, C480--C488, C510--C519,
C529, C570--C579, C589, C600--C609, C630--C639, C680--C689, C690--C699,
C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**Collaborative Staging Codes**

**Maxillary Sinus**\
**C31.0**

C31.0 Maxillary sinus

**Note:  ** Laterality must be coded for this site.

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | CS Tumor Size\   | **CS Site-Specific     | The following       |   |
| | CS Extension\    | Factor 1 -** Size of   | tables are          |   |
| | CS TS/Ext-Eval\  | Lymph Nodes\           | available at the    |   |
| | CS Lymph Nodes\  | **CS Site-Specific     | collaborative       |   |
| | CS Reg Nodes     | Factor 2 -**           | staging website:    |   |
| | Eval\            | Extracapsular          |                     |   |
| | Reg LN Pos\      | Extension, Lymph Nodes | Histology Exclusion |   |
| | Reg LN Exam\     | for Head and Neck\     | Table\              |   |
| | CS Mets at DX\   | **CS Site-Specific     | AJCC Stage\         |   |
| | CS Mets Eval     | Factor 3 -** Levels    | Lymph Nodes Size    |   |
| |                  | I-III, Lymph Nodes for | Table               |   |
| |                  | Head and Neck\         |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 4 -** Levels    |                     |   |
| |                  | IV-V and               |                     |   |
| |                  | Retropharyngeal Lymph  |                     |   |
| |                  | Nodes for Head and     |                     |   |
| |                  | Neck\                  |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 5 -** Levels    |                     |   |
| |                  | VI-VII and Facial      |                     |   |
| |                  | Lymph Nodes for Head   |                     |   |
| |                  | and Neck\              |                     |   |
| |                  | **CS Site-Specific     |                     |   |
| |                  | Factor 6 -**           |                     |   |
| |                  | Parapharyngeal,        |                     |   |
| |                  | Parotid, Preauricular, |                     |   |
| |                  | and Sub-Occipital      |                     |   |
| |                  | Lymph Nodes, Lymph     |                     |   |
| |                  | Nodes for Head and     |                     |   |
| |                  | Neck                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Maxillary Sinus**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Maxillary Sinus**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa of     | T1   | L    | L    |
|      | maxillary antrum (sinus) without erosion |      |      |      |
|      | or destruction of bone                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Invasion of infrastructure:              | T2   | RE   | RE   |
|      |                                          |      |      |      |
|      | Hard palate except extension to          |      |      |      |
|      | posterior wall of sinus                  |      |      |      |
|      |                                          |      |      |      |
|      | pterygoid plates (code 68)               |      |      |      |
|      |                                          |      |      |      |
|      | Middle nasal meatus, except extension to |      |      |      |
|      | posterior wall of sinus                  |      |      |      |
|      |                                          |      |      |      |
|      | and pterygoid plates (code 68)           |      |      |      |
|      |                                          |      |      |      |
|      | Nasal cavity (floor, lateral wall,       |      |      |      |
|      | septum, turbinates)                      |      |      |      |
|      |                                          |      |      |      |
|      | Palatine bone                            |      |      |      |
|      |                                          |      |      |      |
|      | Tumor causing bone erosion or            |      |      |      |
|      | destruction, except for the posterior    |      |      |      |
|      | antral wall                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Invasion of suprastructure:              | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Ethmoid sinus, anterior                  |      |      |      |
|      |                                          |      |      |      |
|      | Floor or medial wall of orbit            |      |      |      |
|      |                                          |      |      |      |
|      | Floor or posterior wall of maxillary     |      |      |      |
|      | sinus                                    |      |      |      |
|      |                                          |      |      |      |
|      | Subcutaneous tissues                     |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 65   | Bone of the posterior wall of maxillary  | T3   | RE   | RE   |
|      | sinus                                    |      |      |      |
|      |                                          |      |      |      |
|      | Invasion of maxilla, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Ethmoid sinus                            | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Posterior ethmoid, NOS                   |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid sinus                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Anterior orbital contents                | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Cribriform plate                         |      |      |      |
|      |                                          |      |      |      |
|      | Frontal sinus                            |      |      |      |
|      |                                          |      |      |      |
|      | Infratemporal fossa                      |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Skin of cheek                            |      |      |      |
|      |                                          |      |      |      |
|      | Sphenoid sinus                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Base of skull                            | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Orbital contents, including eye          |      |      |      |
|      |                                          |      |      |      |
|      | Pterygomaxillary or temporal fossa       |      |      |      |
|      |                                          |      |      |      |
|      | Soft palate                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Brain                                    | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Clivus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Cranial nerves other than (V2)           |      |      |      |
|      |                                          |      |      |      |
|      | Dura                                     |      |      |      |
|      |                                          |      |      |      |
|      | Middle cranial fossa                     |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Orbital apex                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T    | D    | D    |
|      |                                          | 4NOS |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Maxillary Sinus**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

  ------- ------------------------------------------ ------- ------- --------
  Code    Description                                TNM     SS77    SS2000

  00      None; no regional lymph node involvement   N0      NONE    NONE
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulo-omohoyoid (supramohyoid)          |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level V node                             |      |      |      |
|      |                                          |      |      |      |
|      | Posterior cervical                       |      |      |      |
|      |                                          |      |      |      |
|      | Posterior triangle (spinal accessory and |      |      |      |
|      | transverse cervical)                     |      |      |      |
|      |                                          |      |      |      |
|      | (upper, middle, and lower corresponding  |      |      |      |
|      | to the levels that                       |      |      |      |
|      |                                          |      |      |      |
|      | define upper, middle, and lower jugular  |      |      |      |
|      | nodes)                                   |      |      |      |
|      |                                          |      |      |      |
|      | Level VI node                            |      |      |      |
|      |                                          |      |      |      |
|      | Anterior deep cervical                   |      |      |      |
|      |                                          |      |      |      |
|      | Laterotracheal                           |      |      |      |
|      |                                          |      |      |      |
|      | Paralaryngeal                            |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Prelaryngeal                             |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal                              |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal                      |      |      |      |
|      |                                          |      |      |      |
|      | Level VII node                           |      |      |      |
|      |                                          |      |      |      |
|      | Upper mediastinum (for other mediastinal |      |      |      |
|      | nodes see CS Mets                        |      |      |      |
|      |                                          |      |      |      |
|      | at DX)                                   |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Intraparotid                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Periparotid                              |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
|      | Supraclavicular, NOS (See Note 4)        |      |      |      |
+------+------------------------------------------+------+------+------+
| 18   | Stated as N1, no other information       | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN   |
|      | listed in code 10                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D    |
|      | listed in code 12                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive ipsilateral nodes(s), not       |      |      |      |
|      | stated if single or multiple or regional |      |      |      |
+------+------------------------------------------+------+------+------+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive ipsilateral node(s), not stated |      |      |      |
|      | if single or multiple                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s), not stated if          |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s), not stated if          |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Stated as N2, NOS                        | N    | RN   | RN   |
|      |                                          | 2NOS |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Stated as N3, no other information       | N3   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | \*   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For codes 10, 12, 20, 22, 30, 32, 40, 42, 50, 52 and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Maxillary Sinus**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**CS Mets at DX**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Maxillary Sinus**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Maxillary Sinus**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Maxillary Sinus**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Maxillary Sinus**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Maxillary Sinus**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Maxillary Sinus**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Collaborative Staging Codes**

**Ethmoid Sinus**\
**C31.1**

C31.1 Ethmoid sinus

+-----------------------------------------------------------------------+
| +-----------------+-------------------------+---------------------+   |
| | CS Tumor Size\  | **CS Site-Specific      | The following       |   |
| | CS Extension\   | Factor 1 -** Size of    | tables are          |   |
| | CS TS/Ext-Eval\ | Lymph Nodes\            | available at the    |   |
| | CS Lymph Nodes\ | **CS Site-Specific      | collaborative       |   |
| | CS Reg Nodes    | Factor 2 -**            | staging website:    |   |
| | Eval\           | Extracapsular           |                     |   |
| | Reg LN Pos\     | Extension, Lymph Nodes  | Histology Exclusion |   |
| | Reg LN Exam\    | for Head and Neck\      | Table\              |   |
| | CS Mets at DX\  | **CS Site-Specific      | AJCC Stage\         |   |
| | CS Mets Eval    | Factor 3 -** Levels     | Lymph Nodes Size    |   |
| |                 | I-III, Lymph Nodes for  | Table               |   |
| |                 | Head and Neck\          |                     |   |
| |                 | **CS Site-Specific      |                     |   |
| |                 | Factor 4 -** Levels     |                     |   |
| |                 | IV-V and                |                     |   |
| |                 | Retropharyngeal Lymph   |                     |   |
| |                 | Nodes for Head and      |                     |   |
| |                 | Neck\                   |                     |   |
| |                 | **CS Site-Specific      |                     |   |
| |                 | Factor 5 -** Levels     |                     |   |
| |                 | VI-VII and Facial Lymph |                     |   |
| |                 | Nodes for Head and      |                     |   |
| |                 | Neck\                   |                     |   |
| |                 | **CS Site-Specific      |                     |   |
| |                 | Factor 6 -**            |                     |   |
| |                 | Parapharyngeal,         |                     |   |
| |                 | Parotid, Preauricular,  |                     |   |
| |                 | and Sub-Occipital Lymph |                     |   |
| |                 | Nodes, Lymph Nodes for  |                     |   |
| |                 | Head and Neck           |                     |   |
| +-----------------+-------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Ethmoid Sinus**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 12   | Invasive tumor confined to left or right | T1   | L    | L    |
|      | ethmoid sinus without bone erosion       |      |      |      |
+------+------------------------------------------+------+------+------+
| 14   | Confined to both ethmoid sinuses without | T2   | L    | L    |
|      | bone erosion                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 16   | Confined to ethmoid, NOS without bone    | T1   | L    | L    |
|      | erosion                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 22   | Invasive tumor confined to either left   | T1   | L    | L    |
|      | or right ethmoid with bone erosion       |      |      |      |
|      | (cribriform plate)                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 24   | Confined ethmoid sinuses with bone       | T1   | L    | L    |
|      | erosion (cribriform plate)               |      |      |      |
+------+------------------------------------------+------+------+------+
| 26   | Confined ethmoid, NOS with bone erosion  | T1   | L    | L    |
|      | (cribriform plate)                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | More than one ethmoid sinus invaded WITH | T2   | RE   | RE   |
|      | or WITHOUT bony involvement:             |      |      |      |
|      |                                          |      |      |      |
|      | Nasal cavity, NOS                        |      |      |      |
|      |                                          |      |      |      |
|      | Floor                                    |      |      |      |
|      |                                          |      |      |      |
|      | Lateral wall                             |      |      |      |
|      |                                          |      |      |      |
|      | Nasal vestibule                          |      |      |      |
|      |                                          |      |      |      |
|      | Septum                                   |      |      |      |
|      |                                          |      |      |      |
|      | Turbinates                               |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 65   | Maxillary sinus                          | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 66   | Cribriform plate                         | T3   | D    | D    |
|      |                                          |      |      |      |
|      | Palate                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Anterior orbit                           | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Base of skull                            |      |      |      |
|      |                                          |      |      |      |
|      | Frontal sinus                            |      |      |      |
|      |                                          |      |      |      |
|      | Intracranial extension                   |      |      |      |
|      |                                          |      |      |      |
|      | Minimum extension to anterior cranial    |      |      |      |
|      | fossa                                    |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Orbital extension including apex         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plate                          |      |      |      |
|      |                                          |      |      |      |
|      | Skin of external nose or cheek           |      |      |      |
|      |                                          |      |      |      |
|      | Sphenoid                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | \(66\) + (70)                            | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 76   | Brain                                    | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Clivus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Cranial nerves other than (V2)           |      |      |      |
|      |                                          |      |      |      |
|      | Dura                                     |      |      |      |
|      |                                          |      |      |      |
|      | Middle cranial fossa                     |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Orbital extension including apex         |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | \(66\) + (76)                            | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T    | D    | D    |
|      |                                          | 4NOS |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Ethmoid Sinus**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Ethmoid Sinus**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

  ------- ------------------------------------------ ------- ------- --------
  Code    Description                                TNM     SS77    SS2000

  00      None; no regional lymph node involvement   N0      NONE    NONE
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+-----+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level I node                             |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Submental                                |      |      |     |
|      |                                          |      |      |     |
|      | Level II node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulodigastric (subdigastric)           |      |      |     |
|      |                                          |      |      |     |
|      | Upper deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Upper jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level III node                           |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level IV node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |     |
|      |                                          |      |      |     |
|      | Lower deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Lower jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Cervical, NOS                            |      |      |     |
|      |                                          |      |      |     |
|      | Deep cervical, NOS                       |      |      |     |
|      |                                          |      |      |     |
|      | Internal jugular, NOS                    |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
|      |                                          |      |      |     |
|      | Regional lymph node, NOS                 |      |      |     |
+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | \*   | D    | D   |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VI node                            |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Laterotracheal                           |      |      |     |
|      |                                          |      |      |     |
|      | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 18   | Stated as N1, no other information       | N1   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN  |
|      | listed in code 10                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D   |
|      | listed in code 12                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral nodes(s), not       |      |      |     |
|      | stated if single or multiple or regional |      |      |     |
+------+------------------------------------------+------+------+-----+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s), not stated if          |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s), not stated if          |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 60   | Stated as N2, NOS                        | N    | RN   | RN  |
|      |                                          | 2NOS |      |     |
+------+------------------------------------------+------+------+-----+
| 70   | Stated as N3, no other information       | N3   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 80   | Lymph nodes, NOS                         | \*   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NX   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

\*For codes 10, 12, 20, 22, 30, 32, 40, 42, 50, 52 and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Ethmoid Sinus**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Ethmoid Sinus**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Ethmoid Sinus**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Ethmoid Sinus**\
**CS Mets at DX**\
**SEE STANDARD TABLE**\
\
**Ethmoid Sinus**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Ethmoid Sinus**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Ethmoid Sinus**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

  ------- ---------------------------------------------------------------
  Code    Description

  000     No parapharyngeal, parotid (preauricular, periparotid, and/or
          intraparotid), or sub-occipital lymph node involvement

  100     Parapharyngeal lymph node(s) involved

  010     Parotid (preauricular, periparotid, and/or intraparotid) lymph
          node(s) involved
  ------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

# Collaborative Staging Codes

**Accessory (Paranasal) Sinuses**\
**C31.2-C31.3, C31.8-C31.9**

C31.2 Frontal sinus

C31.3 Sphenoid sinus

C31.8 Overlapping lesion of accessory sinuses

C31.9 Accessory sinus, NOS

**Note 1:  ** Laterality must be coded for Frontal sinus, C31.2

**Note 2:  ** AJCC does not define TNM staging for this site.

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histologies for     |    |
| | Reg LN Exam\    | for Head and Neck\     | Which AJCC Staging  |    |
| | CS Mets at DX\  | **CS Site-Specific     | Is Not Generated\   |    |
| | CS Mets Eval    | Factor 3 -** Levels    | AJCC Stage          |    |
| |                 | I-III, Lymph Nodes for |                     |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Accessory (Paranasal) Sinuses**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | NA   | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa of one | NA   | L    | L    |
|      | of the following:                        |      |      |      |
|      |                                          |      |      |      |
|      | Frontal sinus                            |      |      |      |
|      |                                          |      |      |      |
|      | Sphenoid sinus                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | More than one accessory sinus invaded    | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Destruction of bony wall of sinus        |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Palate                                   | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Nasal cavity, NOS:                       |      |      |      |
|      |                                          |      |      |      |
|      | Floor                                    |      |      |      |
|      |                                          |      |      |      |
|      | Lateral wall                             |      |      |      |
|      |                                          |      |      |      |
|      | Septum                                   |      |      |      |
|      |                                          |      |      |      |
|      | Turbinates                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Bone:                                    | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Facial bones                             |      |      |      |
|      |                                          |      |      |      |
|      | Maxilla                                  |      |      |      |
|      |                                          |      |      |      |
|      | Orbital structures                       |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid fossa                          |      |      |      |
|      |                                          |      |      |      |
|      | Zygoma                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Brain                                    | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Cranial nerves                           |      |      |      |
|      |                                          |      |      |      |
|      | Muscles:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Masseter                                 |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Orbital contents, including eye          |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissue                              |      |      |      |
|      |                                          |      |      |      |
|      | Skin                                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | NA   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Accessory (Paranasal) Sinuses**\
**CS TS/Ext-Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Accessory (Paranasal) Sinuses**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemes, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemes, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | None; no regional lymph node involvement | NA   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Single positive ipsilateral regional     | NA   | RN   | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level I node                             |      |      |     |
|      |                                          |      |      |     |
|      | Sublingual                               |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Submental                                |      |      |     |
|      |                                          |      |      |     |
|      | Level II node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulodigastric (subdigastric)           |      |      |     |
|      |                                          |      |      |     |
|      | Upper deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Upper jugular                            |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+-----+
| 10,  | Cervical, NOS                            |      |      |     |
|      |                                          |      |      |     |
| co   | Deep cervical, NOS                       |      |      |     |
| nt'd |                                          |      |      |     |
|      | Internal jugular, NOS                    |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Regional lymph node, NOS                 |      |      |     |
+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | NA   | D    | D   |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level III node                           |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level IV node                            |      |      |     |
|      |                                          |      |      |     |
|      | Jugulo-omohoyoid (supramohyoid)          |      |      |     |
|      |                                          |      |      |     |
|      | Lower deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Lower jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VI node                            |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Laterotrachea                            |      |      |     |
|      |                                          |      |      |     |
|      | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 80   | Lymph nodes, NOS                         | NA   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NA   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

**Accessory (Paranasal) Sinuses**\
**CS Reg Nodes Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Accessory (Paranasal) Sinuses**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Accessory (Paranasal) Sinuses**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Accessory (Paranasal) Sinuses**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | NA   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Cannot be assessed                       |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Accessory (Paranasal) Sinuses**\
**CS Mets Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

  --------- ---------------------------------------------------------------
  Code      Description

  000       No involved regional nodes

  001-988   001-988 millimeters (code exact size in millimeters)

  989       989 millimeters or larger

  990       Microscopic focus or foci only, no size of focus given

  991       Described as less than 1 cm

  992       Described as less than 2 cm

  993       Described as less than 3 cm

  994       Described as less than 4 cm

  995       Described as less than 5 cm

  996       Described as less than 6 cm
  --------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Accessory (Paranasal) Sinuses**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Page left blank**

**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
**C310--C319,** C339, C379, C380--C388, C390--C399, C480--C488,
C510--C519, C529, C570--C579, C589, C600--C609, C630--C639, C680--C689,
C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**Collaborative Staging Codes**

**Glottic Larynx**\
**C32.0**

C32.0 Glottis

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histology Exclusion |    |
| | Reg LN Exam\    | for Head and Neck\     | Table\              |    |
| | CS Mets at DX\  | **CS Site-Specific     | AJCC Stage\         |    |
| | CS Mets Eval    | Factor 3 -** Levels    | Lymph Nodes Size    |    |
| |                 | I-III, Lymph Nodes for | Table               |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Glottic Larynx**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Glottic Larynx**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor with normal vocal cord    | T    | L    | L    |
|      | mobility                                 | 1NOS |      |      |
|      |                                          |      |      |      |
|      | Confined to glottis, NOS; intrinsic      |      |      |      |
|      | larynx; laryngeal                        |      |      |      |
|      |                                          |      |      |      |
|      | commisure(s) anterior, posterior;        |      |      |      |
|      |                                          |      |      |      |
|      | vocal cord(s), NOS, true vocal cord(s),  |      |      |      |
|      | true cord(s)                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | One vocal cord                           | T1a  | L    | L    |
+------+------------------------------------------+------+------+------+
| 12   | Both vocal cords                         | T1b  | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Tumor involves adjacent regions(s) of    | T2   | L    | L    |
|      | larynx:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Subglottis                               |      |      |      |
|      |                                          |      |      |      |
|      | Supraglottis                             |      |      |      |
|      |                                          |      |      |      |
|      | False vocal cord (s)                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Impaired vocal cord mobility             | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor limited to larynx WITH vocal cord  | T3   | L    | L    |
|      | fixation                                 |      |      |      |
|      |                                          |      |      |      |
|      | Involvement of intrinsic muscle(s):      |      |      |      |
|      |                                          |      |      |      |
|      | Aryepiglottic:                           |      |      |      |
|      |                                          |      |      |      |
|      | Corniculate tubercle                     |      |      |      |
|      |                                          |      |      |      |
|      | Cuneiform tubercle                       |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 40,  | Arytenoid                                |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Cricoarytenoid                           |      |      |      |
|      |                                          |      |      |      |
|      | Cricothyroid                             |      |      |      |
|      |                                          |      |      |      |
|      | Thyroarytenoid                           |      |      |      |
|      |                                          |      |      |      |
|      | Thyroepiglottic                          |      |      |      |
|      |                                          |      |      |      |
|      | Vocalis                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Localized, NOS                           | T    | L    | L    |
|      |                                          | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Paraglottic space                        | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 52   | Minor thyroid cartilage erosion (e.g.,   | T3   | RE   | D    |
|      | inner cortex)                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Base of tongue                           | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Hypopharynx, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Pre-epiglottic tissues                   |      |      |      |
|      |                                          |      |      |      |
|      | Pyriform sinus                           |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Extension to/through                     | T4a  | RE   | D    |
|      |                                          |      |      |      |
|      | Cricoid cartilage                        |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid cartilage except minor erosion,  |      |      |      |
|      | see code 52                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension to/through tissues beyond      | T4a  | D    | D    |
|      | larynx:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Extrinsic (strap) muscles:               |      |      |      |
|      |                                          |      |      |      |
|      | Omohyoid                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sternohyoid                              |      |      |      |
|      |                                          |      |      |      |
|      | Sternothyroid                            |      |      |      |
|      |                                          |      |      |      |
|      | Thryohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Oropharynx                               |      |      |      |
|      |                                          |      |      |      |
|      | Skin                                     |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissue of neck                      |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Cervical esophagus                       | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 73   | Deep extrinsic muscle(s) of tongue       | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal structures                   |      |      |      |
|      |                                          |      |      |      |
|      | Prevertebral space                       |      |      |      |
|      |                                          |      |      |      |
|      | Tumor encases carotid artery             |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Glottic Larynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Glottic Larynx**\
**CS Lymph Nodes**

**Note 1:** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:** If laterality of lymph nodes is not specified, assume nodes
are ipsilateral. Midline nodes are considered ipsilateral.

Note 4: For head and neck cancers, if lymph nodes are described only as
\"supraclavicular\", try to determine if they are in Level IV (deep to
the sternocleidomastoid muscle, in the lower jugular chain) or Level V
(in the posterior triangle, inferior to the transverse cervical artery)
and code appropriately. If the specific level cannot be determined,
consider them as Level V nodes.

+-----+---------------------------------------------+-----+----+-----+
| C   | Description                                 | TNM | SS | SS2 |
| ode |                                             |     | 77 | 000 |
+-----+---------------------------------------------+-----+----+-----+
| 00  | None; no regional lymph node involvement    | N0  | NO | N   |
|     |                                             |     | NE | ONE |
+-----+---------------------------------------------+-----+----+-----+
| 10  | Single positive ipsilateral regional node:  | \*  | RN | RN  |
|     |                                             |     |    |     |
|     | Level II                                    |     |    |     |
|     |                                             |     |    |     |
|     | Jugulodigastric (subdigastric)              |     |    |     |
|     |                                             |     |    |     |
|     | Upper deep cervical                         |     |    |     |
|     |                                             |     |    |     |
|     | Upper jugular                               |     |    |     |
|     |                                             |     |    |     |
|     | Level III                                   |     |    |     |
|     |                                             |     |    |     |
|     | Middle deep cervical                        |     |    |     |
|     |                                             |     |    |     |
|     | Mid-jugular                                 |     |    |     |
|     |                                             |     |    |     |
|     | Level IV                                    |     |    |     |
|     |                                             |     |    |     |
|     | Jugulo-omohyoid (supraomohyoid)             |     |    |     |
|     |                                             |     |    |     |
|     | Lower deep cervical                         |     |    |     |
|     |                                             |     |    |     |
|     | Lower jugular                               |     |    |     |
|     |                                             |     |    |     |
|     | Level VI                                    |     |    |     |
|     |                                             |     |    |     |
|     | Anterior deep cervical                      |     |    |     |
|     |                                             |     |    |     |
|     | Delphian node                               |     |    |     |
|     |                                             |     |    |     |
|     | Laterotracheal                              |     |    |     |
|     |                                             |     |    |     |
|     | Paralaryngeal                               |     |    |     |
|     |                                             |     |    |     |
|     | Paratracheal                                |     |    |     |
|     |                                             |     |    |     |
|     | Prelaryngeal (Delphian)                     |     |    |     |
|     |                                             |     |    |     |
|     | Pretracheal                                 |     |    |     |
|     |                                             |     |    |     |
|     | Recurrent laryngeal                         |     |    |     |
|     |                                             |     |    |     |
|     | Cervical, NOS                               |     |    |     |
|     |                                             |     |    |     |
|     | Deep cervical, NOS                          |     |    |     |
|     |                                             |     |    |     |
|     | Internal jugular NOS:                       |     |    |     |
|     |                                             |     |    |     |
|     | Regional lymph node, NOS                    |     |    |     |
|     |                                             |     |    |     |
|     | Stated as N1, NOS                           |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 11  | Single positive ipsilateral regional node:  | \*  | D  | RN  |
|     |                                             |     |    |     |
|     | Level I                                     |     |    |     |
|     |                                             |     |    |     |
|     | Submandibular (submaxillary)                |     |    |     |
|     |                                             |     |    |     |
|     | Submental                                   |     |    |     |
|     |                                             |     |    |     |
|     | Other groups                                |     |    |     |
|     |                                             |     |    |     |
|     | Retropharyngeal                             |     |    |     |
|     |                                             |     |    |     |
|     | Mandibular, NOS                             |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 12  | Single positive ipsilateral regional node:  | \*  | D  | RN  |
|     |                                             |     |    |     |
|     | Level V node                                |     |    |     |
|     |                                             |     |    |     |
|     | Posterior cervical                          |     |    |     |
|     |                                             |     |    |     |
|     | Posterior triangle (spinal accessory and    |     |    |     |
|     | transverse cervical)                        |     |    |     |
|     |                                             |     |    |     |
|     | (upper, middle, and lower corresponding to  |     |    |     |
|     | the levels that                             |     |    |     |
|     |                                             |     |    |     |
|     | define upper, middle, and lower jugular     |     |    |     |
|     | nodes)                                      |     |    |     |
|     |                                             |     |    |     |
|     | Level VII node                              |     |    |     |
|     |                                             |     |    |     |
|     | Upper mediastinum (for other mediastinal    |     |    |     |
|     | nodes see CS Mets at DX)                    |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 12  | Other groups                                |     |    |     |
|     |                                             |     |    |     |
| con | Intraparotid                                |     |    |     |
| t'd |                                             |     |    |     |
|     | Parapharyngeal                              |     |    |     |
|     |                                             |     |    |     |
|     | Periparotid                                 |     |    |     |
|     |                                             |     |    |     |
|     | Sub-occipital                               |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
|     | Supraclavicular, NOS (See Note 4)           |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 18  | Stated as N1, no other information          | N1  | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 19  | Stated as N2a, no other information         | N2a | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 20  | Multiple positive ipsilateral nodes listed  | \*  | RN | RN  |
|     | in code 10                                  |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 21  | Multiple positive ipsilateral nodes listed  | \*  | D  | RN  |
|     | in code 11                                  |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 22  | Multiple positive ipsilateral nodes listed  | \*  | D  | D   |
|     | in code 12                                  |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 29  | Stated as N2b, no other information         | N2b | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 30  | Regional lymph nodes as listed in code 10:  | \*  | RN | RN  |
|     |                                             |     |    |     |
|     | Positive ipsilateral node(s), not stated if |     |    |     |
|     | single or multiple                          |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 31  | Regional lymph nodes as listed in code 11:  | \*  | D  | RN  |
|     |                                             |     |    |     |
|     | Positive ipsilateral node(s), not stated if |     |    |     |
|     | single or multiple                          |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 32  | Regional lymph nodes as listed in code 12:  | \*  | D  | D   |
|     |                                             |     |    |     |
|     | Positive ipsilateral node(s), not stated if |     |    |     |
|     | single or multiple                          |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 40  | Regional lymph nodes as listed in code 10:  | \*  | RN | RN  |
|     |                                             |     |    |     |
|     | Positive bilateral or contralateral nodes   |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 41  | Regional lymph nodes as listed in code 11:  | \*  | D  | RN  |
|     |                                             |     |    |     |
|     | Positive bilateral or contralateral nodes   |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 42  | Regional lymph nodes as listed in code 12:  | \*  | D  | D   |
|     |                                             |     |    |     |
|     | Positive bilateral or contralateral nodes   |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 49  | Stated as N2c, no other information         | N2c | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 50  | Regional lymph nodes as listed in code 10:  | \*  | RN | RN  |
|     |                                             |     |    |     |
|     | Positive node(s) not stated if ipsilateral, |     |    |     |
|     | or bilateral, or contralateral              |     |    |     |
|     |                                             |     |    |     |
|     | AND not stated if single or multiple        |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 51  | Regional lymph nodes as listed in code 11:  | \*  | D  | RN  |
|     |                                             |     |    |     |
|     | Positive node(s) not stated if ipsilateral, |     |    |     |
|     | or bilateral, or contralateral              |     |    |     |
|     |                                             |     |    |     |
|     | AND not stated if single or multiple        |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 52  | Regional lymph nodes as listed in code 12:  | \*  | D  | D   |
|     |                                             |     |    |     |
|     | Positive node(s), not stated if             |     |    |     |
|     | ipsilateral, or bilateral, or contralateral |     |    |     |
|     |                                             |     |    |     |
|     | AND not stated if single or multiple        |     |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 60  | Stated as N2NOS                             | N2  | RN | RN  |
|     |                                             | NOS |    |     |
+-----+---------------------------------------------+-----+----+-----+
| 70  | Stated as N3, no other information          | N3  | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 80  | Lymph nodes, NOS, no other information      | \*  | RN | RN  |
+-----+---------------------------------------------+-----+----+-----+
| 99  | Unknown; not stated                         | NX  | U  | U   |
|     |                                             |     |    |     |
|     | Regional lymph node(s) cannot be assessed   |     |    |     |
|     |                                             |     |    |     |
|     | Not documented in patient record            |     |    |     |
+-----+---------------------------------------------+-----+----+-----+

\* For codes 10-12, 20-22, 30-32, 40-42, 50-52, and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Glottic Larynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Glottic Larynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Glottic Larynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Glottic Larynx**\
**CS Mets at DX**

**Note:** Supraclavicular and transverse cervical lymph nodes are now
coded in CS Lymph Nodes because they are categorized as N rather than M
in AJCC TNM. Any cases coded to 10 or 50 can be reviewed and recoded.
The volume of cases affected should be small.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | No; none                                 | M0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Distant lymph node(s)                    | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Mediastinal                              |      |      |     |
|      |                                          |      |      |     |
|      | Distant lymph node(s), NOS               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Distant metastases except distant lymph  | M1   | D    | D   |
|      | node(s) (code 10)                        |      |      |     |
|      |                                          |      |      |     |
|      | Distant metastasis, NOS                  |      |      |     |
|      |                                          |      |      |     |
|      | Carcinomatosis                           |      |      |     |
+------+------------------------------------------+------+------+-----+
| 50   | \(10\) + (40)                            | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Distant lymph node(s) plus other distant |      |      |     |
|      | metastases                               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown if distant metastasis            | MX   | U    | U   |
|      |                                          |      |      |     |
|      | Distant metastasis cannot be assessed    |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

**Glottic Larynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Glottic Larynx**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

  --------- ---------------------------------------------------------------
  Code      Description

  000       No involved regional nodes

  001-988   001-988 millimeters (code exact size in millimeters)

  989       989 millimeters or larger

  990       Microscopic focus or foci only, no size of focus given

  991       Described as less than 1 cm
  --------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Glottic Larynx**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Glottic Larynx**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

  ------- ---------------------------------------------------------------
  Code    Description

  000     No lymph node involvement in Levels I, II, or III

  100     Level I lymph node(s) involved

  010     Level II lymph node(s) involved

  001     Level III lymph node(s) involved

  110     Level I and II lymph nodes involved
  ------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Glottic Larynx**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Glottic Larynx**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Glottic Larynx**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Collaborative Staging Codes**

**Supraglottic Larynx**\
**C32.1**

C32.1 Supraglottis

**Note:  ** Excludes Anterior Surface of Epiglottis - see separate
schema (C10.1).

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histology Exclusion |    |
| | Reg LN Exam\    | for Head and Neck\     | Table\              |    |
| | CS Mets at DX\  | **CS Site-Specific     | AJCC Stage\         |    |
| | CS Mets Eval    | Factor 3 -** Levels    | Lymph Nodes Size    |    |
| |                 | I-III, Lymph Nodes for | Table               |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Supraglottic Larynx**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor with normal vocal cord    | T1   | L    | L    |
|      | mobility confined to:                    |      |      |      |
|      |                                          |      |      |      |
|      | Supraglottis (one subsite):              |      |      |      |
|      |                                          |      |      |      |
|      | Aryepiglottic fold                       |      |      |      |
|      |                                          |      |      |      |
|      | Arytenoid cartilage                      |      |      |      |
|      |                                          |      |      |      |
|      | Corniculate cartilage                    |      |      |      |
|      |                                          |      |      |      |
|      | Cuneiform cartilage                      |      |      |      |
|      |                                          |      |      |      |
|      | Epilarynx, NOS                           |      |      |      |
|      |                                          |      |      |      |
|      | False cords                              |      |      |      |
|      |                                          |      |      |      |
|      | Ventricular bands                        |      |      |      |
|      |                                          |      |      |      |
|      | Ventricular cavity                       |      |      |      |
|      |                                          |      |      |      |
|      | Ventricular fold                         |      |      |      |
|      |                                          |      |      |      |
|      | Infrahyoid epiglottis                    |      |      |      |
|      |                                          |      |      |      |
|      | Laryngeal cartilage, NOS                 |      |      |      |
|      |                                          |      |      |      |
|      | Laryngeal (posterior) surface of         |      |      |      |
|      | epiglottis                               |      |      |      |
|      |                                          |      |      |      |
|      | Suprahyoid epiglottis (including tip,    |      |      |      |
|      | lingual {anterior} and                   |      |      |      |
|      |                                          |      |      |      |
|      | laryngeal surfaces)                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Tumor involves more than one subsite of  | T2   | L    | L    |
|      | supraglottis                             |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT fixation or NOS                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Tumor involves adjacent regions(s) of    | T2   | L    | L    |
|      | larynx                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Impaired vocal cord mobility             | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor limited to larynx WITH vocal cord  | T3   | L    | L    |
|      | fixation                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 52   | Paraglottic space                        | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Tumor involves region outside the        | T2   | RE   | RE   |
|      | supraglottis                             |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT fixation, including:             |      |      |      |
|      |                                          |      |      |      |
|      | Medial wall of pyriform sinus            |      |      |      |
|      |                                          |      |      |      |
|      | Mucosa of base of tongue                 |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Code 60 WITH fixation                    | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Hypopharynx, NOS                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Pre-epiglottic tissues                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Deep base of tongue                      | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 67   | Cricoid cartilage                        | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 68   | Minor thyroid cartilage erosion (e.g.,   | T3   | RE   | D    |
|      | inner cortex)                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension to/through:                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Oropharynx                               |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissues of neck                     |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid cartilage (except minor erosion, |      |      |      |
|      | see code 68)                             |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Extension to/through:                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Extrinsic (strap) muscle(s)              |      |      |      |
|      |                                          |      |      |      |
|      | Omohyoid                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sternohyoid                              |      |      |      |
|      |                                          |      |      |      |
|      | Sternothyroid                            |      |      |      |
|      |                                          |      |      |      |
|      | Thyrohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Skin                                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Extension to/through:                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Deep extrinsic muscle of tongue          |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal structures                   |      |      |      |
|      |                                          |      |      |      |
|      | Prevertebral space                       |      |      |      |
|      |                                          |      |      |      |
|      | Tumor encases carotid artery             |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Supraglottic Larynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Supraglottic Larynx**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level II                                 |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III                                |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid-jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level VI                                 |      |      |      |
|      |                                          |      |      |      |
|      | Anterior deep cervical                   |      |      |      |
|      |                                          |      |      |      |
|      | Delphian node                            |      |      |      |
|      |                                          |      |      |      |
|      | Laterotracheal                           |      |      |      |
|      |                                          |      |      |      |
|      | Paralaryngeal                            |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Prelaryngeal                             |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal                              |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal                      |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
|      |                                          |      |      |      |
|      | Stated as N1, NOS                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I                                  |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level V node                             |      |      |      |
|      |                                          |      |      |      |
|      | Posterior cervical                       |      |      |      |
|      |                                          |      |      |      |
|      | Posterior triangle (spinal accessory and |      |      |      |
|      | transverse cervical)                     |      |      |      |
|      |                                          |      |      |      |
|      | (upper, middle, and lower corresponding  |      |      |      |
|      | to the levels that                       |      |      |      |
|      |                                          |      |      |      |
|      | define upper, middle, and lower jugular  |      |      |      |
|      | nodes)                                   |      |      |      |
|      |                                          |      |      |      |
|      | Level VII node                           |      |      |      |
|      |                                          |      |      |      |
|      | Upper mediastinum (for other mediastinal |      |      |      |
|      | nodes see CS Mets                        |      |      |      |
|      |                                          |      |      |      |
|      | at DX)                                   |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 12   | Other groups                             |      |      |      |
|      |                                          |      |      |      |
| co   | Intraparotid                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Periparotid                              |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
|      | Supraclavicular, NOS (See Note 4)        |      |      |      |
+------+------------------------------------------+------+------+------+
| 18   | Stated as N1, no other information       | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN   |
|      | listed in code 10                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 21   | Multiple positive ipsilateral nodes      | \*   | D    | RN   |
|      | listed in code 11                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D    |
|      | listed in code 12                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive ipsilateral node(s), not stated |      |      |      |
|      | if single or multiple                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 31   | Regional lymph nodes as listed in code   | \*   | D    | RN   |
|      | 11:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive ipsilateral node(s), not stated |      |      |      |
|      | if single or multiple                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive ipsilateral node(s), not stated |      |      |      |
|      | if single or multiple                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 41   | Regional lymph nodes as listed in code   | \*   | D    | RN   |
|      | 11:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s) not stated if           |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Regional lymph nodes as listed in code   | \*   | D    | RN   |
|      | 11:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s) not stated if           |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s), not stated if          |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Stated as N2, NOS                        | N    | RN   | RN   |
|      |                                          | 2NOS |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Stated as N3, no other information       | N3   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS, no other information   | \*   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For codes 10-12, 20-22, 30-32, 40-42, 50-52, and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Supraglottic Larynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Supraglottic Larynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Supraglottic Larynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Supraglottic Larynx**\
**CS Mets at DX**

**Note:** Supraclavicular and transverse cervical lymph nodes are now
coded in CS Lymph Nodes because they are categorized as N rather than M
in AJCC TNM. Any cases coded to 10 or 50 can be reviewed and recoded.
The volume of cases affected should be small.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal                              |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | MX   | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Supraglottic Larynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Supraglottic Larynx**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

table begins on next page

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Supraglottic Larynx**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Collaborative Staging Codes**

**Subglottic Larynx**\
**C32.2**

C32.2 Subglottis

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histology Exclusion |    |
| | Reg LN Exam\    | for Head and Neck\     | Table\              |    |
| | CS Mets at DX\  | **CS Site-Specific     | AJCC Stage\         |    |
| | CS Mets Eval    | Factor 3 -** Levels    | Lymph Nodes Size    |    |
| |                 | I-III, Lymph Nodes for | Table               |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Subglottic Larynx**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Subglottic Larynx**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor with normal vocal cord    | T1   | L    | L    |
|      | mobility confined to subglottis          |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Tumor involves adjacent regions(s) of    | T2   | L    | L    |
|      | larynx                                   |      |      |      |
|      |                                          |      |      |      |
|      | Vocal cords with normal or impaired      |      |      |      |
|      | mobility                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Tumor limited to larynx WITH vocal cord  | T3   | L    | L    |
|      | fixation                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 60   | Base of tongue                           | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Hypopharynx, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Pre-epiglottic tissues                   |      |      |      |
|      |                                          |      |      |      |
|      | Pyriform sinus (pyriform fossa)          |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Extension to/through cricoid cartilage   | T4a  | RE   | D    |
|      | or thyroid cartilage                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension to/through:                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Cervical esophagus                       |      |      |      |
|      |                                          |      |      |      |
|      | Deep extrinsic muscles of tongue         |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 70,  | Extrinsic (strap) muscles                |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Omohyoid                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sternohyoid                              |      |      |      |
|      |                                          |      |      |      |
|      | Sternothyroid                            |      |      |      |
|      |                                          |      |      |      |
|      | Thyrohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Oropharynx                               |      |      |      |
|      |                                          |      |      |      |
|      | Skin                                     |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissues of neck                     |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Contiguous extension to other tissues    | T4a  | D    | D    |
|      | beyond larynx not specified in codes 70  |      |      |      |
|      | or 80                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal structures                   |      |      |      |
|      |                                          |      |      |      |
|      | Prevertebral space                       |      |      |      |
|      |                                          |      |      |      |
|      | Tumor encases carotid artery             |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Subglottic Larynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Subglottic Larynx**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | None; no regional lymph node involvement | N0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level II                                 |      |      |     |
|      |                                          |      |      |     |
|      | Jugulodigastric (subdigastric)           |      |      |     |
|      |                                          |      |      |     |
|      | Upper deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Upper jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level III                                |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid-jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level VI                                 |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Delphian node                            |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+-----+
| 10,  | Laterotracheal                           |      |      |     |
| co   |                                          |      |      |     |
| nt'd | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Cervical, NOS                            |      |      |     |
|      |                                          |      |      |     |
|      | Deep cervical, NOS                       |      |      |     |
|      |                                          |      |      |     |
|      | Internal jugular, NOS:                   |      |      |     |
|      |                                          |      |      |     |
|      | Regional lymph node, NOS                 |      |      |     |
|      |                                          |      |      |     |
|      | Stated as N1, NOS                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level I                                  |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Submental                                |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | \*   | D    | D   |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 18   | Stated as N1, no other information       | N1   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN  |
|      | listed in code 10                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 21   | Multiple positive ipsilateral nodes      | \*   | D    | RN  |
|      | listed in code 11                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D   |
|      | listed in code 12                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 31   | Regional lymph nodes as listed in code   | \*   | D    | RN  |
|      | 11:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+------+
| 41   | Regional lymph nodes as listed in code   | \*   | D    | RN   |
|      | 11:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive bilateral or contralateral      |      |      |      |
|      | nodes                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN   |
|      | 10:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s) not stated if           |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Regional lymph nodes as listed in code   | \*   | D    | RN   |
|      | 11:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s) not stated if           |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D    |
|      | 12:                                      |      |      |      |
|      |                                          |      |      |      |
|      | Positive node(s), not stated if          |      |      |      |
|      | ipsilateral, or bilateral, or            |      |      |      |
|      | contralateral                            |      |      |      |
|      |                                          |      |      |      |
|      | AND not stated if single or multiple     |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Stated as N2NOS                          | N    | RN   | RN   |
|      |                                          | 2NOS |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Stated as N3, no other information       | N3   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS, no other information   | \*   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For codes 10-12, 20-22, 30-32, 40-42, 50-52, and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Subglottic Larynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Subglottic Larynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Subglottic Larynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Subglottic Larynx**\
**CS Mets at DX**

**Note:** Supraclavicular and transverse cervical lymph nodes are now
coded in CS Lymph Nodes because they are categorized as N rather than M
in AJCC TNM. Any cases coded to 10 or 50 can be reviewed and recoded.
The volume of cases affected should be small.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | No; none                                 | M0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Distant lymph node(s)                    | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Mediastinal                              |      |      |     |
|      |                                          |      |      |     |
|      | Supraclavicular (transverse cervical)    |      |      |     |
|      |                                          |      |      |     |
|      | Distant lymph node(s), NOS               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Distant metastases except distant lymph  | M1   | D    | D   |
|      | node(s) (code 10)                        |      |      |     |
|      |                                          |      |      |     |
|      | Distant metastasis, NOS                  |      |      |     |
|      |                                          |      |      |     |
|      | Carcinomatosis                           |      |      |     |
+------+------------------------------------------+------+------+-----+
| 50   | \(10\) + (40)                            | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Distant lymph node(s) plus other distant |      |      |     |
|      | metastases                               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown if distant metastasis            | MX   | U    | U   |
|      |                                          |      |      |     |
|      | Distant metastasis cannot be assessed    |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

**Subglottic Larynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Subglottic Larynx**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Subglottic Larynx**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Subglottic Larynx**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Subglottic Larynx**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Subglottic Larynx**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

  ------- ---------------------------------------------------------------
  Code    Description

  000     No lymph node involvement in Levels VI or VII or facial nodes

  100     Level VI lymph node(s) involved

  010     Level VII lymph node(s) involved

  001     Facial (buccinator, nasolabial) lymph node(s) involved

  110     Level VI and VII lymph nodes involved

  101     Level VI and facial (buccinator, nasolabial) nodes involved

  011     Level VII and facial (buccinator, nasolabial) nodes involved

  111     Level VI and VII and facial (buccinator, nasolabial) lymph
          nodes involved
  ------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Subglottic Larynx**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Collaborative Staging Codes**

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**C32.3, C32.8-C32.9**

C32.3 Laryngeal cartilage

C32.8 Overlapping lesion of larynx

C32.9 Larynx, NOS

+-----------------------------------------------------------------------+
| +-----------------+------------------------+---------------------+    |
| | CS Tumor Size\  | **CS Site-Specific     | The following       |    |
| | CS Extension\   | Factor 1 -** Size of   | tables are          |    |
| | CS TS/Ext-Eval\ | Lymph Nodes\           | available at the    |    |
| | CS Lymph Nodes\ | **CS Site-Specific     | collaborative       |    |
| | CS Reg Nodes    | Factor 2 -**           | staging website:    |    |
| | Eval\           | Extracapsular          |                     |    |
| | Reg LN Pos\     | Extension, Lymph Nodes | Histology Exclusion |    |
| | Reg LN Exam\    | for Head and Neck\     | Table\              |    |
| | CS Mets at DX\  | **CS Site-Specific     | AJCC Stage\         |    |
| | CS Mets Eval    | Factor 3 -** Levels    | Lymph Nodes Size    |    |
| |                 | I-III, Lymph Nodes for | Table               |    |
| |                 | Head and Neck\         |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 4 -** Levels    |                     |    |
| |                 | IV-V and               |                     |    |
| |                 | Retropharyngeal Lymph  |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck\                  |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 5 -** Levels    |                     |    |
| |                 | VI-VII and Facial      |                     |    |
| |                 | Lymph Nodes for Head   |                     |    |
| |                 | and Neck\              |                     |    |
| |                 | **CS Site-Specific     |                     |    |
| |                 | Factor 6 -**           |                     |    |
| |                 | Parapharyngeal,        |                     |    |
| |                 | Parotid, Preauricular, |                     |    |
| |                 | and Sub-Occipital      |                     |    |
| |                 | Lymph Nodes, Lymph     |                     |    |
| |                 | Nodes for Head and     |                     |    |
| |                 | Neck                   |                     |    |
| +-----------------+------------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive                     | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to site of       | T1   | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Tumor involves more than one subsite,    | T2   | L    | L    |
|      |                                          |      |      |      |
|      | WITHOUT fixation or NOS                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Tumor involves adjacent regions(s) of    | T2   | L    | L    |
|      | larynx                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Impaired vocal cord mobility             | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor limited to larynx                  | T3   | L    | L    |
|      |                                          |      |      |      |
|      | WITH vocal cord fixation                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 60   | Hypopharynx, NOS                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Pre-epiglottic tissues                   |      |      |      |
|      |                                          |      |      |      |
|      | Pyriform sinus (pyriform fossa)          |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Extension to/through cricoid cartilage   | T4a  | RE   | D    |
|      | and thyroid cartilage                    |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 70   | Extension to/through:                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Cervical esophagus                       |      |      |      |
|      |                                          |      |      |      |
|      | Deep muscle of tongue                    |      |      |      |
|      |                                          |      |      |      |
|      | Extrinsic (strap) muscles                |      |      |      |
|      |                                          |      |      |      |
|      | Omohyoid                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sternohyoid                              |      |      |      |
|      |                                          |      |      |      |
|      | Sternothyroid                            |      |      |      |
|      |                                          |      |      |      |
|      | Thyrohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Oropharynx                               |      |      |      |
|      |                                          |      |      |      |
|      | Skin                                     |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissues of neck                     |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal structures                   |      |      |      |
|      |                                          |      |      |      |
|      | Prevertebral space                       |      |      |      |
|      |                                          |      |      |      |
|      | Tumor encases carotid artery             |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Lymph Nodes**

**Note 1:  ** For head and neck schemas, this field includes all lymph
nodes defined as Levels I-VII and Other by AJCC. The complete
definitions are provided in the General Instructions.

**Note 2:  ** For head and neck schemas, additional information about
lymph nodes (size of involved nodes, extracapsular extension, and levels
involved) is coded in Site-Specific Factors 1-6.

**Note 3:  ** If laterality of lymph nodes is not specified, assume
nodes are ipsilateral. Midline nodes are considered ipsilateral.

**Note 4:** For head and neck cancers, if lymph nodes are described only
as \"supraclavicular\", try to determine if they are in Level IV (deep
to the sternocleidomastoid muscle, in the lower jugular chain) or Level
V (in the posterior triangle, inferior to the transverse cervical
artery) and code appropriately. If the specific level cannot be
determined, consider them as Level V nodes.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | None; no regional lymph node involvement | N0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN  |
|      | node:                                    |      |      |     |
| 10,  |                                          |      |      |     |
| co   | Level II                                 |      |      |     |
| nt'd |                                          |      |      |     |
|      | Jugulodigastric (subdigastric)           |      |      |     |
|      |                                          |      |      |     |
|      | Upper deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Upper jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level III                                |      |      |     |
|      |                                          |      |      |     |
|      | Middle deep cervical                     |      |      |     |
|      |                                          |      |      |     |
|      | Mid-jugular                              |      |      |     |
|      |                                          |      |      |     |
|      | Level IV                                 |      |      |     |
|      |                                          |      |      |     |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |     |
|      |                                          |      |      |     |
|      | Lower deep cervical                      |      |      |     |
|      |                                          |      |      |     |
|      | Lower jugular                            |      |      |     |
|      |                                          |      |      |     |
|      | Level VI                                 |      |      |     |
|      |                                          |      |      |     |
|      | Anterior deep cervical                   |      |      |     |
|      |                                          |      |      |     |
|      | Delphian node                            |      |      |     |
|      |                                          |      |      |     |
|      | Laterotracheal                           |      |      |     |
|      |                                          |      |      |     |
|      | Paralaryngeal                            |      |      |     |
|      |                                          |      |      |     |
|      | Paratracheal                             |      |      |     |
|      |                                          |      |      |     |
|      | Prelaryngeal                             |      |      |     |
|      |                                          |      |      |     |
|      | Pretracheal                              |      |      |     |
|      |                                          |      |      |     |
|      | Recurrent laryngeal                      |      |      |     |
|      |                                          |      |      |     |
|      | Cervical, NOS                            |      |      |     |
|      |                                          |      |      |     |
|      | Deep cervical, NOS                       |      |      |     |
|      |                                          |      |      |     |
|      | Internal jugular, NOS                    |      |      |     |
|      |                                          |      |      |     |
|      | Regional lymph node, NOS                 |      |      |     |
|      |                                          |      |      |     |
|      | Stated as N1, NOS                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level I                                  |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Submental                                |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Retropharyngeal                          |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
+------+------------------------------------------+------+------+-----+
| 12   | Single positive ipsilateral regional     | \*   | D    | RN  |
|      | node:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Level V node                             |      |      |     |
|      |                                          |      |      |     |
|      | Posterior cervical                       |      |      |     |
|      |                                          |      |      |     |
|      | Posterior triangle (spinal accessory and |      |      |     |
|      | transverse cervical)                     |      |      |     |
|      |                                          |      |      |     |
|      | (upper, middle, and lower corresponding  |      |      |     |
|      | to the levels that                       |      |      |     |
|      |                                          |      |      |     |
|      | define upper, middle, and lower jugular  |      |      |     |
|      | nodes)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Level VII node                           |      |      |     |
|      |                                          |      |      |     |
|      | Upper mediastinum (for other mediastinal |      |      |     |
|      | nodes see CS Mets                        |      |      |     |
|      |                                          |      |      |     |
|      | at DX)                                   |      |      |     |
|      |                                          |      |      |     |
|      | Other groups                             |      |      |     |
|      |                                          |      |      |     |
|      | Intraparotid                             |      |      |     |
|      |                                          |      |      |     |
|      | Parapharyngeal                           |      |      |     |
|      |                                          |      |      |     |
|      | Periparotid                              |      |      |     |
|      |                                          |      |      |     |
|      | Sub-occipital                            |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | Supraclavicular, NOS (See Note 4)        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 18   | Stated as N1, no other information       | N1   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 19   | Stated as N2a, no other information      | N2a  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 20   | Multiple positive ipsilateral nodes      | \*   | RN   | RN  |
|      | listed in code 10                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 21   | Multiple positive ipsilateral nodes      | \*   | D    | RN  |
|      | listed in code 11                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 22   | Multiple positive ipsilateral nodes      | \*   | D    | D   |
|      | listed in code 12                        |      |      |     |
+------+------------------------------------------+------+------+-----+
| 29   | Stated as N2b, no other information      | N2b  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 30   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 31   | Regional lymph nodes as listed in code   | \*   | D    | RN  |
|      | 11:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 32   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive ipsilateral node(s), not stated |      |      |     |
|      | if single or multiple                    |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+------+------+-----+
| 40   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 41   | Regional lymph nodes as listed in code   | \*   | D    | RN  |
|      | 11:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 42   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive bilateral or contralateral      |      |      |     |
|      | nodes                                    |      |      |     |
+------+------------------------------------------+------+------+-----+
| 49   | Stated as N2c, no other information      | N2c  | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 50   | Regional lymph nodes as listed in code   | \*   | RN   | RN  |
|      | 10:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s) not stated if           |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 51   | Regional lymph nodes as listed in code   | \*   | D    | RN  |
|      | 11:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s) not stated if           |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 52   | Regional lymph nodes as listed in code   | \*   | D    | D   |
|      | 12:                                      |      |      |     |
|      |                                          |      |      |     |
|      | Positive node(s), not stated if          |      |      |     |
|      | ipsilateral, or bilateral, or            |      |      |     |
|      | contralateral                            |      |      |     |
|      |                                          |      |      |     |
|      | AND not stated if single or multiple     |      |      |     |
+------+------------------------------------------+------+------+-----+
| 60   | Stated as N2, NOS                        | N    | RN   | RN  |
|      |                                          | 2NOS |      |     |
+------+------------------------------------------+------+------+-----+
| 70   | Stated as N3, no other information       | N3   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 80   | Lymph nodes, NOS, no other information   | \*   | RN   | RN  |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NX   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

\* For codes 10-12, 20-22, 30-32, 40-42, 50-52, and 80 ONLY, the N
category is assigned based on the value of Site-Specific Factor 1, Size
of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this
site.

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Mets at DX**

Note: Supraclavicular and transverse cervical lymph nodes are now coded
in CS Lymph Nodes because they are categorized as N rather than M in
AJCC TNM. Any cases coded to 10 or 50 can be reviewed and recoded. The
volume of cases affected should be small.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | No; none                                 | M0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Distant lymph node(s)                    | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Mediastinal                              |      |      |     |
|      |                                          |      |      |     |
|      | Supraclavicular (transverse cervical)    |      |      |     |
|      |                                          |      |      |     |
|      | Distant lymph node(s), NOS               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 40   | Distant metastases except distant lymph  | M1   | D    | D   |
|      | node(s) (code 10)                        |      |      |     |
|      |                                          |      |      |     |
|      | Distant metastasis, NOS                  |      |      |     |
|      |                                          |      |      |     |
|      | Carcinomatosis                           |      |      |     |
+------+------------------------------------------+------+------+-----+
| 50   | \(10\) + (40)                            | M1   | D    | D   |
|      |                                          |      |      |     |
|      | Distant lymph node(s) plus other distant |      |      |     |
|      | metastases                               |      |      |     |
+------+------------------------------------------+------+------+-----+
| 99   | Unknown if distant metastasis            | MX   | U    | U   |
|      |                                          |      |      |     |
|      | Distant metastasis cannot be assessed    |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 1 Size of Lymph Nodes**

**Note:  ** Code the largest diameter, whether measured clinically or
pathologically, of any involved regional lymph node(s). Do not code the
size of any nodes coded in CS Mets at DX.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No involved regional nodes                                    |
+------+---------------------------------------------------------------+
| 001  | 001-988 millimeters (code exact size in millimeters)          |
| -988 |                                                               |
+------+---------------------------------------------------------------+
| 989  | 989 millimeters or larger                                     |
+------+---------------------------------------------------------------+
| 990  | Microscopic focus or foci only, no size of focus given        |
+------+---------------------------------------------------------------+
| 991  | Described as less than 1 cm                                   |
+------+---------------------------------------------------------------+
| 992  | Described as less than 2 cm                                   |
+------+---------------------------------------------------------------+
| 993  | Described as less than 3 cm                                   |
+------+---------------------------------------------------------------+
| 994  | Described as less than 4 cm                                   |
+------+---------------------------------------------------------------+
| 995  | Described as less than 5 cm                                   |
+------+---------------------------------------------------------------+
| 996  | Described as less than 6 cm                                   |
+------+---------------------------------------------------------------+
| 997  | Described as more than 6 cm                                   |
+------+---------------------------------------------------------------+
| 999  | Regional lymph node(s) involved, size not stated              |
|      |                                                               |
|      | Unknown if regional lymph node(s) involved                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 2 Extracapsular Extension, Lymph Nodes for
Head and Neck**

**Note 1:  ** Code the status of extracapsular extension whether
assessed clinically or pathologically of any involved regional lymph
node(s) coded in the CS Lymph Nodes field. Do not code the status of any
nodes coded in CS Mets at DX. Pathologic assessment takes priority over
clinical assessment.

**Note 2:  ** According to AJCC (page 24), \"Imaging studies showing
amorphous spiculated margins of involved nodes or involvement of
internodal fat resulting in loss of normal oval-to-round nodal shape
strongly suggest extracapsular (extranodal) tumor spread; however,
pathologic examination is necessary for documentation of the extent of
such disease.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No extracapsular extension                                    |
+------+---------------------------------------------------------------+
| 001  | Extracapsular extension clinically, not assessed              |
|      | pathologically                                                |
|      |                                                               |
|      | Nodes described as \"fixed\", not assessed pathologically     |
+------+---------------------------------------------------------------+
| 005  | Extracapsular extension present pathologically                |
+------+---------------------------------------------------------------+
| 888  | Not applicable; no lymph node involvement                     |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and
Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels I, II, or III             |
+------+---------------------------------------------------------------+
| 100  | Level I lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 010  | Level II lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 001  | Level III lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 110  | Level I and II lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level I and III lymph nodes involved                          |
+------+---------------------------------------------------------------+
| 011  | Level II and III lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 111  | Level I, II and III lymph nodes involved                      |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes
for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels IV or V or                |
|      | retropharyngeal                                               |
+------+---------------------------------------------------------------+
| 100  | Level IV lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level V lymph node(s) involved                                |
+------+---------------------------------------------------------------+
| 001  | Retropharyngeal nodes involved                                |
+------+---------------------------------------------------------------+
| 110  | Level IV and V lymph nodes involved                           |
+------+---------------------------------------------------------------+
| 101  | Level IV and retropharyngeal nodes involved                   |
+------+---------------------------------------------------------------+
| 011  | Level V and retropharyngeal nodes involved                    |
+------+---------------------------------------------------------------+
| 111  | Level IV and V and retropharyngeal lymph nodes involved       |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for
Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node involvement in Levels VI or VII or facial nodes |
+------+---------------------------------------------------------------+
| 100  | Level VI lymph node(s) involved                               |
+------+---------------------------------------------------------------+
| 010  | Level VII lymph node(s) involved                              |
+------+---------------------------------------------------------------+
| 001  | Facial (buccinator, nasolabial) lymph node(s) involved        |
+------+---------------------------------------------------------------+
| 110  | Level VI and VII lymph nodes involved                         |
+------+---------------------------------------------------------------+
| 101  | Level VI and facial (buccinator, nasolabial) nodes involved   |
+------+---------------------------------------------------------------+
| 011  | Level VII and facial (buccinator, nasolabial) nodes involved  |
+------+---------------------------------------------------------------+
| 111  | Level VI and VII and facial (buccinator, nasolabial) lymph    |
|      | nodes involved                                                |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Larynx, Overlapping Lesion or Not Otherwise Specified**\
**CS Site-Specific Factor 6 Parapharyngeal, Parotid, Preauricular, and
Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck**

**Note:  ** Site-Specific Factors 3-6 are used to code the presence or
absence of lymph node involvement in each of 7 different levels and
other groups defined by AJCC. The definitions of the levels are the same
for all applicable head and neck sites. One digit is used to represent
lymph nodes of a single level, with the three digits of Site-Specific
Factor 3 representing lymph nodes of, respectively, Levels I-III; the
digits of Site-Specific Factor 4 representing lymph nodes of Levels IV
and V and the retropharyngeal nodes; the digits of Site-Specific Factor
5 representing lymph nodes of Levels VI and VII and the facial nodes;
and the digits of Site-Specific Factor 6 representing the remaining
Other groups as defined by AJCC. In each digit, a code 1 means Yes, the
nodes are involved.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No parapharyngeal, parotid (preauricular, periparotid, and/or |
|      | intraparotid), or sub-occipital lymph node involvement        |
+------+---------------------------------------------------------------+
| 100  | Parapharyngeal lymph node(s) involved                         |
+------+---------------------------------------------------------------+
| 010  | Parotid (preauricular, periparotid, and/or intraparotid)      |
|      | lymph node(s) involved                                        |
+------+---------------------------------------------------------------+
| 001  | Sub-occipital lymph node(s) involved                          |
+------+---------------------------------------------------------------+
| 110  | Parapharyngeal and parotid (preauricular, periparotid, and/or |
|      | intraparotid) lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 101  | Parapharyngeal and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 011  | Parotid (preauricular, periparotid, and/or intraparotid) and  |
|      | sub-occipital lymph nodes involved                            |
+------+---------------------------------------------------------------+
| 111  | Parapharyngeal, parotid (preauricular, periparotid, and/or    |
|      | intraparotid), and sub-occipital lymph nodes involved         |
+------+---------------------------------------------------------------+
| 999  | Unknown if regional lymph node(s) involved, not stated        |
|      |                                                               |
|      | Regional lymph node(s) cannot be assessed                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Site-Specific Surgery Codes**

**Larynx**

**C320--C329**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

15 Stripping

**No** specimen sent to **pathology** from surgical events 10--15

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any combination of 20 or 26--27 WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

28 Stripping

> \[***SEER Note:*** Codes 21 to 25 and 28 above combine 20 Local tumor
> excision, 26 Polypectomy or 27 Excisional biopsy with 21 PDT,
> 22 Electrocautery, 23 Cryosurgery, 24 Laser ablation, 25 Laser
> excision, or 28 Stripping\]

**Specimen** sent to **pathology** from surgical events 20--28

30 Partial excision of the primary site, NOS; subtotal/partial
laryngectomy NOS; hemilaryngectomy NOS

31 Vertical laryngectomy

32 Anterior commissure laryngectomy

33 Supraglottic laryngectomy

> \[***SEER Note:*** Vertical laryngectomy: Removal of involved true
> vocal cord, ipsilateral false vocal cord, intervening ventricle,
> ipsilateral thyroid and may include removal of the arytenoids.
>
> Supraglottic laryngectomy: Conservative surgery intended to preserve
> the laryngeal function. Standard procedure involves removal of
> epiglottis, false vocal cords, aryepiglottic folds, arytenoid
> cartilages, ventricle, upper one third of thyroid cartilage, thyroid
> membrane. The true vocal cords and arytenoids remain in place to allow
> vocalization and deglutition.\]

40 Total or radical laryngectomy, NOS

41 Total laryngectomy ONLY

42 Radical laryngectomy ONLY

> \[***SEER Note:*** Radical laryngectomy: Includes removal of adjacent
> sites. Do not code the removal of adjacent sites in Surgical Procedure
> of Other Site.\]

50 Pharyngolaryngectomy

80 Laryngectomy, NOS

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Collaborative Staging Codes**

**Trachea**\
**C33.9**

C33.9 Trachea

**Note:  ** AJCC does not define TNM staging for this site.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histologies for     |   |
| | CS Mets at DX\      | Factor 4\           | Which AJCC Staging  |   |
| | CS Mets Eval        | CS Site-Specific    | Is Not Generated\   |   |
| |                     | Factor 5\           | AJCC Stage          |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Trachea**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Trachea**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | NA   | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to trachea       | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue               | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Arch of aorta                            |      |      |      |
|      |                                          |      |      |      |
|      | Azygos vein, right                       |      |      |      |
|      |                                          |      |      |      |
|      | Brachiocephalic vein                     |      |      |      |
|      |                                          |      |      |      |
|      | Carotid sheath                           |      |      |      |
|      |                                          |      |      |      |
|      | Common carotid artery(ies)               |      |      |      |
|      |                                          |      |      |      |
|      | Jugular arch                             |      |      |      |
|      |                                          |      |      |      |
|      | Phrenic nerves                           |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal fascia                       |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal nerve                |      |      |      |
|      |                                          |      |      |      |
|      | Subclavian artery(ies)                   |      |      |      |
|      |                                          |      |      |      |
|      | Vagus nerve                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures               | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Cricoid cartilage                        |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Pleura                                   |      |      |      |
|      |                                          |      |      |      |
|      | Right and left main bronchi              |      |      |      |
|      |                                          |      |      |      |
|      | Sternum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Thymus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Vertebral column                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | NA   | D    | D    |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | NA   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Trachea**\
**CS TS/Ext-Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Trachea**\
**CS Lymph Nodes**

**Note:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | NA   | RN   | RN   |
|      |                                          |      |      |      |
|      | Mediastinal, NOS:                        |      |      |      |
|      |                                          |      |      |      |
|      | Posterior (tracheoesophageal)            |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal                              |      |      |      |
|      |                                          |      |      |      |
|      | Tracheal, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | NA   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Trachea**\
**CS Reg Nodes Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Trachea**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Trachea**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Trachea**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | NA   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Cannot be assessed                       |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Trachea**\
**CS Mets Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Trachea**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Trachea**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Trachea**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Trachea**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Trachea**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Trachea**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
C310--C319, **C339,** C379, C380--C388, C390--C399, C480--C488,
C510--C519, C529, C570--C579, C589, C600--C609, C630--C639, C680--C689,
C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 **Local** tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

> \[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor
> excision, 26 Polypectomy or 27 Excisional biopsy with 21 PDT,
> 22 Electrocautery, 23 Cryosurgery, 24 Laser ablation, or 25 Laser
> excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**SEER Site-Specific Coding Guidelines**

**LUNG**

C340--C349

**Primary Site**

C340 Main bronchus

Carina

Hilum

C341 **Upper** **lobe**, lung

Lingula

Apex

C342 **Middle** **lobe**, lung (Right lung only)

C343 **Lower lobe**, lung

Base

C348 **Overlapping** lesion of lung

C349 Lung, NOS

Bronchus, NOS

**Laterality**

Laterality **must** be **coded** for all subsites except carina.

# 

**Tumor Size**

Priorities for coding size

1\. **Pathology** report

2\. **Operative** report

3\. **Endoscopic** examination, where applicable

4\. **Imaging** reports

Imaging reports do not have a priority

Code the largest size of tumor recorded on any of the imaging reports

General Instructions for Coding Tumor Size

DO **NOT** CODE size of **hilar mass** unless primary is stated to be in
the hilum.

**Page left blank**

**Collaborative Staging Codes**

**Lung**\
**C34.0-C34.3, C34.8-C34.9**

C34.0 Main bronchus

C34.1 Upper lobe, lung

C34.2 Middle lobe, lung

C34.3 Lower lobe, lung

C34.8 Overlapping lesion of lung

C34.9 Lung, NOS

**Note:  ** Laterality must be coded for this site (except carina).

+-----------------------------------------------------------------------+
| +---------------------+--------------------+---------------------+    |
| | CS Tumor Size\      | CS Site-Specific   | The following       |    |
| | CS Extension\       | Factor 1\          | tables are          |    |
| | CS TS/Ext-Eval\     | CS Site-Specific   | available at the    |    |
| | CS Lymph Nodes\     | Factor 2\          | collaborative       |    |
| | CS Reg Nodes Eval\  | CS Site-Specific   | staging website:    |    |
| | Reg LN Pos\         | Factor 3\          |                     |    |
| | Reg LN Exam\        | CS Site-Specific   | Histology Exclusion |    |
| | CS Mets at DX\      | Factor 4\          | Table\              |    |
| | CS Mets Eval        | CS Site-Specific   | AJCC Stage\         |    |
| |                     | Factor 5\          | Extension Size      |    |
| |                     | CS Site-Specific   | Table\              |    |
| |                     | Factor 6           | Mets Size Table for |    |
| |                     |                    | Mets at DX 00\      |    |
| |                     |                    | Mets Size Table for |    |
| |                     |                    | Mets at DX 99       |    |
| +---------------------+--------------------+---------------------+    |
+-----------------------------------------------------------------------+

**Lung**\
**CS Tumor Size**

**Note:  ** Do not code size of hilar mass unless primary is stated to
be in the hilum.

+-------+--------------------------------------------------------------+
| Code  | Description                                                  |
+-------+--------------------------------------------------------------+
| 000   | No mass/tumor found                                          |
+-------+--------------------------------------------------------------+
| 00    | 001 - 988 millimeters (code exact size in millimeters)       |
| 1-988 |                                                              |
+-------+--------------------------------------------------------------+
| 989   | 989 millimeters or larger                                    |
+-------+--------------------------------------------------------------+
| 990   | Microscopic focus or foci only, no size of focus given       |
+-------+--------------------------------------------------------------+
| 991   | Described as less than 1 cm                                  |
+-------+--------------------------------------------------------------+
| 992   | Described as less than 2 cm                                  |
+-------+--------------------------------------------------------------+
| 993   | Described as less than 3 cm                                  |
+-------+--------------------------------------------------------------+
| 994   | Described as less than 4 cm                                  |
+-------+--------------------------------------------------------------+
| 995   | Described as less than 5 cm                                  |
+-------+--------------------------------------------------------------+
| 996   | Malignant cells present in bronchopulmonary secretions,      |
|       |                                                              |
|       | but no tumor seen radiographically or during bronchoscopy;   |
|       | \"occult\" carcinoma                                         |
+-------+--------------------------------------------------------------+
| 997   | Diffuse (entire lobe)                                        |
+-------+--------------------------------------------------------------+
| 998   | Diffuse (entire lung or NOS)                                 |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Lung**\
**CS Extension**

**Note 1:  ** Direct extension to or other involvement of structures
considered M1 in AJCC staging is coded in the data item CS Mets at DX.
This includes: sternum; skeletal muscle; skin of chest; contralateral
lung or mainstem bronchus; separate tumor nodule(s) in different lobe,
same lung, or in contralateral lung.

**Note 2:  ** Distance from Carina. Assume tumor is greater than or
equal to 2 cm from carina if lobectomy, segmental resection, or wedge
resection is done.

**Note 3:  ** Opposite Lung. If no mention is made of the opposite lung
on a chest x-ray, assume it is not involved.

**Note 4:  ** Bronchopneumonia. \"Bronchopneumonia\" is not the same
thing as \"obstructive pneumonitis\" and should not be coded as such.

**Note 5:  ** Pulmonary Artery/Vein. An involved pulmonary artery/vein
in the mediastinum is coded to 70 (involvement of major blood vessel).
However, if the involvement of the artery/vein appears to be only within
lung tissue and not in the mediastinum, it would not be coded to 70.

**Note 6:  ** Pleural Effusion.

A. Note from SEER manual: Ignore pleural effusion that is negative for
tumor. Assume that a pleural effusion is

negative if a resection is done.

B. Note from AJCC manual: Most pleural effusions associated with lung
cancers are due to tumor. However, there

are a few patients in whom multiple cytoopathologic examinations of
pleural fluid are negative for tumor.

In these cases, fluid is non-bloody and is not an exudate. When these
elements and clinical judgement dictate

that the effusion is not related to the tumor, the effusion should be
excluded as a staging element and the patient

should be staged T1, T2, or T3.

**Note 7:  ** Vocal cord paralysis (resulting from involvement of
recurrent branch of the vagus nerve), superior vena cava obstruction, or
compression of the trachea or the esophagus may be related to direct
extension of the primary tumor or to lymph node involvement. The
treatment options and prognosis associated with these manifestations of
disease extent fall within the T4-Stage IIIB category; therefore,
generally use code 70 for these manifestations. HOWEVER, if the primary
tumor is peripheral and clearly unrelated to vocal cord paralysis, vena
cava obstruction, or compression of the trachea or the esophagus, code
these manifestations as mediastinal lymph node involvement (code 20) in
CS Lymph Nodes unless there is a statement of involvement by direct
extension from the primary tumor.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Tumor confined to one lung,              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | WITHOUT extension or conditions          |      |      |      |
|      | described in codes 20-80                 |      |      |      |
|      |                                          |      |      |      |
|      | (excluding primary in main stem          |      |      |      |
|      | bronchus)                                |      |      |      |
|      |                                          |      |      |      |
|      | (EXCLUDES superficial tumor as described |      |      |      |
|      | in code 11)                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Superficial tumor of any size with       | T1   | L    | L    |
|      | invasive component limited to bronchial  |      |      |      |
|      | wall, WITH or WITHOUT proximal extension |      |      |      |
|      | to the main stem bronchus                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Extension from other parts of lung to    | T2   | L    | L    |
|      | main stem bronchus, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | (EXCLUDES superficial tumor as described |      |      |      |
|      | in code 11)                              |      |      |      |
|      |                                          |      |      |      |
|      | Tumor involving main stem bronchus       |      |      |      |
|      | greater than or equal                    |      |      |      |
|      |                                          |      |      |      |
|      | to 2.0 cm from carina (primary in lung   |      |      |      |
|      | or main stem bronchus)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 21   | Tumor involving main stem bronchus, NOS  | T2   | L    | L    |
|      | (distance from carina not stated and no  |      |      |      |
|      | surgery as described in Note 2)          |      |      |      |
+------+------------------------------------------+------+------+------+
| 23   | Tumor confined to hilus                  | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 25   | Tumor confined to the carina             | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Atelectasis/obstructive pneumonitis that | T2   | RE   | RE   |
|      | extends to the hilar region but does not |      |      |      |
|      | involve the entire lung (or              |      |      |      |
|      | atelectasis/obstructive pneumonitis,     |      |      |      |
|      | NOS)                                     |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT pleural effusion                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Extension to:                            | T2   | RE   | RE   |
|      |                                          |      |      |      |
|      | Pleura, visceral or NOS (WITHOUT pleural |      |      |      |
|      | effusion)                                |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament (WITHOUT pleural      |      |      |      |
|      | effusion)                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Tumor of/involving main stem bronchus    | T3   | L    | RE   |
|      | less                                     |      |      |      |
|      |                                          |      |      |      |
|      | than 2.0 cm from carina                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | \(40\) + (50)                            | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 53   | \(45\) + (50)                            | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 55   | Atelectasis/obstructive pneumonitis      | T3   | RE   | RE   |
|      | involving entire lung                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 56   | Parietal pericardium or pericardium, NOS | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 59   | Invasion of phrenic nerve                | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Direct extension to:                     | T3   | D    | RE   |
|      |                                          |      |      |      |
|      | Brachial plexus, inferior branches or    |      |      |      |
|      | NOS, from superior sulcus                |      |      |      |
|      |                                          |      |      |      |
|      | Chest (thoracic) wall                    |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm                                |      |      |      |
|      |                                          |      |      |      |
|      | Pancoast tumor (superior sulcus          |      |      |      |
|      | syndrome), NOS                           |      |      |      |
|      |                                          |      |      |      |
|      | Parietal pleura                          |      |      |      |
|      |                                          |      |      |      |
|      | Note: For separate lesion in chest wall  |      |      |      |
|      | or diaphragm, see CS Mets at DX.         |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Superior sulcus tumor                    | T4   | D    | RE   |
|      |                                          |      |      |      |
|      | WITH encasement of subclavian vessels    |      |      |      |
|      |                                          |      |      |      |
|      | OR                                       |      |      |      |
|      |                                          |      |      |      |
|      | WITH unequivocal involvement of superior |      |      |      |
|      | branches of brachial plexus (C8 or       |      |      |      |
|      | above)                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Multiple masses/separate tumor nodule(s) | T4   | L    | RE   |
|      | in the SAME lobe                         |      |      |      |
|      |                                          |      |      |      |
|      | \"Satellite nodules\" in SAME lobe       |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Blood vessel(s), major (EXCEPT aorta and | T4   | RE   | RE   |
|      | inferior vena cava, see codes 74 and 77) |      |      |      |
|      |                                          |      |      |      |
|      | Azygos vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary artery or vein                 |      |      |      |
|      |                                          |      |      |      |
|      | Superior vena cava (SVC syndrome)        |      |      |      |
|      |                                          |      |      |      |
|      | Carina from lung/mainstem bronchus       |      |      |      |
|      |                                          |      |      |      |
|      | Compression of esophagus or trachea not  |      |      |      |
|      | specified as direct extension            |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinum, extrapulmonary or NOS       |      |      |      |
|      |                                          |      |      |      |
|      | Nerve(s):                                |      |      |      |
|      |                                          |      |      |      |
|      | Cervical sympathetic (Horner\'s          |      |      |      |
|      | syndrome)                                |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal (vocal cord          |      |      |      |
|      | paralysis)                               |      |      |      |
|      |                                          |      |      |      |
|      | Vagus                                    |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Heart                                    | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Visceral pericardium                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Malignant pleural effusion               | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Pleural effusion, NOS                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Adjacent rib                             | T3   | D    | D    |
+------+------------------------------------------+------+------+------+
| 74   | Aorta                                    | T4   | D    | RE   |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 75   | Vertebra(s)                              | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Neural foramina                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Pleural tumor foci separate from direct  | T4   | D    | D    |
|      | pleural invasion                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | Inferior vena cava                       | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 79   | Pericardial effusion, NOS; malignant     | T4   | D    | D    |
|      | pericardial effusion                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | \(73\) plus any of \[(61-72) or          | T4   | D    | D    |
|      | (74-77)\]                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension (except to  | T4   | D    | D    |
|      | structures specified in CS Mets at DX)   |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 98   | Tumor proven by presence of malignant    | TX   | U    | U    |
|      | cells in sputum or bronchial washings    |      |      |      |
|      | but not visualized by imaging or         |      |      |      |
|      | bronchoscopy; \"occult\" carcinoma       |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For Extension codes 10, 23, and 25 ONLY, the T category is assigned
based on the value of tumor size, as shown in the Extension Size table
for this site.

**Lung**\
**CS TS/Ext-Eval**

+------+--------------------------------------------------------+------+
| Code | Description                                            | Sta  |
|      |                                                        | ging |
|      |                                                        | B    |
|      |                                                        | asis |
+------+--------------------------------------------------------+------+
| 0    | No surgical resection done. Evaluation based on        | c    |
|      | physical examination, imaging examination, or other    |      |
|      | non-invasive clinical evidence. No autopsy evidence    |      |
|      | used.                                                  |      |
+------+--------------------------------------------------------+------+
| 1    | No surgical resection done. Evaluation based on        | p    |
|      | endoscopic examination, diagnostic biopsy, including   |      |
|      | fine needle aspiration biopsy, or other invasive       |      |
|      | techniques including surgical observation without      |      |
|      | biopsy. No autopsy evidence used.                      |      |
+------+--------------------------------------------------------+------+
| 2    | No surgical resection done, but evidence derived from  | p    |
|      | autopsy (tumor was suspected or diagnosed prior to     |      |
|      | autopsy)                                               |      |
+------+--------------------------------------------------------+------+
| 3    | Surgical resection performed WITHOUT pre-surgical      | p    |
|      | systemic treatment or radiation OR surgical resection  |      |
|      | performed, unknown if pre-surgical systemic treatment  |      |
|      | or adiation performed. Evidence acquired before        |      |
|      | treatment, supplemented or modified by the additional  |      |
|      | evidence acquired during and from surgery,             |      |
|      | particularly from pathologic examination of the        |      |
|      | resected specimen                                      |      |
+------+--------------------------------------------------------+------+
| 5    | Surgical resection performed WITH pre-surgical         | c    |
|      | systemic treatment or radiation, BUT tumor             |      |
|      | size/extension based on clinical evidence.             |      |
+------+--------------------------------------------------------+------+
| 6    | Surgical resection performed WITH pre-surgical         | y    |
|      | systemic treatment or radiation; tumor size/extension  |      |
|      | based on pathologic evidence                           |      |
+------+--------------------------------------------------------+------+
| 8    | Evidence from autopsy only (tumor was unsuspected or   | a    |
|      | undiagnosed prior to autopsy)                          |      |
+------+--------------------------------------------------------+------+
| 9    | Unknown if surgical resection done                     | c    |
|      |                                                        |      |
|      | Not assessed; cannot be assessed                       |      |
|      |                                                        |      |
|      | Unknown if assessed                                    |      |
|      |                                                        |      |
|      | Not documented in patient record                       |      |
+------+--------------------------------------------------------+------+

**Lung**\
**CS Lymph Nodes**

Note 1:   Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

Note 2: If at mediastinoscopy/x-ray, the description is \"mass\",
\"adenopathy\", or \"enlargement\" of any of the lymph nodes named as
regional in codes 10 and 20, assume that at least regional lymph nodes
are involved.

Note 3:   The words \"no evidence of spread\" or \"remaining examination
negative\" are sufficient information to consider regional lymph nodes
negative in the absence of any statement about nodes.

Note 4:   Vocal cord paralysis (resulting from involvement of recurrent
branch of the vagus nerve), superior vena cava obstruction, or
compression of the trachea or the esophagus may be related to direct
extension of the primary tumor or to lymph node involvement. The
treatment options and prognosis associated with these manifestations of
disease extent fall within the T4-Stage IIIB category; therefore,
generally use code 70 for these manifestations. HOWEVER, if the primary
tumor is peripheral and clearly unrelated to vocal cord paralysis, vena
cava obstruction, or compression of the trachea or the esophagus, code
these manifestations as mediastinal lymph node involvement (code 20) in
CS Lymph Nodes unless there is a statement of involvement by direct
extension from the primary tumor.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s), ipsilateral:     | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Bronchial                                |      |      |      |
|      |                                          |      |      |      |
|      | Hilar (bronchopulmonary) (proximal       |      |      |      |
|      | lobar) (pulmonary root)                  |      |      |      |
|      |                                          |      |      |      |
|      | Intrapulmonary nodes, including          |      |      |      |
|      | involvement by direct extension:         |      |      |      |
|      |                                          |      |      |      |
|      | Interlobar                               |      |      |      |
|      |                                          |      |      |      |
|      | Lobar                                    |      |      |      |
|      |                                          |      |      |      |
|      | Segmental                                |      |      |      |
|      |                                          |      |      |      |
|      | Subsegmental                             |      |      |      |
|      |                                          |      |      |      |
|      | Peri/parabronchial                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s), ipsilateral:     | N2   | RN   | RN   |
|      |                                          |      |      |      |
|      | Aortic \[above diaphragm\], NOS:         |      |      |      |
|      |                                          |      |      |      |
|      | Peri/para-aortic, NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Ascending aorta (phrenic)                |      |      |      |
|      |                                          |      |      |      |
|      | Subaortic (aortico-pulmonary window)     |      |      |      |
|      |                                          |      |      |      |
|      | Carinal (tracheobronchial) (tracheal     |      |      |      |
|      | bifurcation)                             |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal, NOS:                        |      |      |      |
|      |                                          |      |      |      |
|      | Anterior                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior (tracheoesophageal)            |      |      |      |
|      |                                          |      |      |      |
|      | Pericardial                              |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paraesophageal                      |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paratracheal, NOS:                  |      |      |      |
|      |                                          |      |      |      |
|      | Azygos (lower peritracheal)              |      |      |      |
|      |                                          |      |      |      |
|      | Pre- and retrotracheal, NOS:             |      |      |      |
|      |                                          |      |      |      |
|      | Precarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Subcarinal                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph node(s), NOS              | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 60   | Contralateral/bilateral hilar            | N3   | D    | D    |
|      | (bronchopulmonary) (proximal lobar)      |      |      |      |
|      | (pulmonary root)                         |      |      |      |
|      |                                          |      |      |      |
|      | Contralateral/bilateral mediastinal      |      |      |      |
|      |                                          |      |      |      |
|      | Scalene (inferior deep cervical),        |      |      |      |
|      | ipsilateral or contralateral             |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical),   |      |      |      |
|      | ipsilateral or contralateral             |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Lung**\
**CS Reg Nodes Eval**

**Note:  ** This item reflects the validity of the classification of the
item CS Lymph Nodes only according to diagnostic methods employed.

+------+--------------------------------------------------------+------+
| Code | Description                                            | Sta  |
|      |                                                        | ging |
|      |                                                        | B    |
|      |                                                        | asis |
+------+--------------------------------------------------------+------+
| 0    | No regional lymph nodes removed for examination.       | c    |
|      | Evidence based on physical examination, imaging        |      |
|      | examination, or other non-invasive clinical evidence.  |      |
|      | No autopsy vidence used.                               |      |
+------+--------------------------------------------------------+------+
| 1    | No regional lymph nodes removed for examination.       | p    |
|      | Evidence based on endoscopic examination, diagnostic   |      |
|      | biopsy including fine needle aspiration of lymph       |      |
|      | node(s) or ther invasive techniques, including         |      |
|      | surgical observation without biopsy. No autopsy        |      |
|      | evidence used.                                         |      |
+------+--------------------------------------------------------+------+
| 2    | No regional lymph nodes removed for examination, but   | p    |
|      | evidence derived from autopsy (tumor was suspected or  |      |
|      | diagnosed prior to autopsy)                            |      |
+------+--------------------------------------------------------+------+
| 3    | Regional lymph nodes removed for examination (removal  | p    |
|      | of at least 1 lymph node) WITHOUT pre-surgical         |      |
|      | systemic treatment or radiation OR lymph nodes removed |      |
|      | for xamination, unknown if pre-surgical systemic       |      |
|      | treatment or radiation performed                       |      |
+------+--------------------------------------------------------+------+
| 5    | Regional lymph nodes removed for examination WITH      | c    |
|      | pre-surgical systemic treatment or radiation, BUT      |      |
|      | lymph node evaluation based on clinical evidence.      |      |
+------+--------------------------------------------------------+------+
| 6    | Regional lymph nodes removed for examination WITH      | y    |
|      | pre-surgical systemic treatment or radiation, and      |      |
|      | lymph node evaluation based on pathologic evidence     |      |
+------+--------------------------------------------------------+------+
| 8    | Evidence from autopsy; tumor was unsuspected or        | a    |
|      | undiagnosed prior to autopsy                           |      |
+------+--------------------------------------------------------+------+
| 9    | Unknown if lymph nodes removed for examination         | c    |
|      |                                                        |      |
|      | Not assessed; cannot be assessed                       |      |
|      |                                                        |      |
|      | Unknown if assessed                                    |      |
|      |                                                        |      |
|      | Not documented in patient record                       |      |
+------+--------------------------------------------------------+------+

**Lung**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Lung**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Lung**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | \*   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), including         | M1   | D    | D    |
|      | cervical nodes                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Separate tumor nodule(s) in different    | M1   | L    | D    |
|      | lobe, same lung                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 37   | Extension to:                            | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Sternum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscle                          |      |      |      |
|      |                                          |      |      |      |
|      | Skin of chest                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 39   | Extension to:                            | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Contralateral lung                       |      |      |      |
|      |                                          |      |      |      |
|      | Contralateral main stem bronchus         |      |      |      |
|      |                                          |      |      |      |
|      | Separate tumor nodule(s) in              |      |      |      |
|      | contralateral lung                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Abdominal organs                         | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant metastases except distant lymph  |      |      |      |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | except those specified in codes 35 to    |      |      |      |
|      | 39, including separate lesion in chest   |      |      |      |
|      | wall or diaphragm                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Distant metastases + Distant node(s)     | M1   | D    | D    |
|      |                                          |      |      |      |
|      | \(10\) + any of \[(35) to (40)\]         |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | \*\* | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For CS Mets at DX code 00 only, the M category is assigned based on
the value of CS Tumor Size, using the Mets Size Table for Mets at DX
code 00 for this site.

\*\*For CS Mets at DX code 99 only, the M category is assigned on the
valueof CS Tumor Size, using the Mets Size Table for Mets at DX code 99
for this site.

**Lung**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Lung**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Lung**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Lung**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Lung**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Lung**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Lung**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**Lung**

**C340--C349**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no surgery** of primary site; **autopsy** ONLY

19 **Local** tumor **destruction** or excision, NOS

**Unknown** whether a specimen was sent to **pathology** for surgical
events coded 19 (Used principally for cases diagnosed prior to January
1, 2003)

15 Local tumor destruction, NOS

12 Laser ablation or cryosurgery

13 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

[]{.mark}

**No** specimen sent to **pathology** from surgical events 12-13 and 15

20 Excision or resection of less than one lobe, NOS

23 Excision, NOS

24 Laser excision

25 Bronchial sleeve resection ONLY

21 Wedge resection

22 Segmental resection, including lingulectomy

**Specimen** sent to **pathology** from surgical events 20--25

30 **Resection** of \[at least one\] **lobe** or **bilobectomy**, but
less than the whole lung (partial pneumonectomy, NOS)

33 Lobectomy WITH mediastinal lymph node dissection

The lymph node dissection should also be coded under *Scope of Regional
Lymph Node Surgery* (NAACCR Item \# 1292).

45 Lobe or bilobectomy extended, NOS

46 WITH chest wall

47 WITH pericardium

48 WITH diaphragm

55 Pneumonectomy, NOS

\[***SEER Note:*** Code 55 includes complete pneumonectomy, Sleeve
pneumonectomy, Standard pneumonectomy, Total pneumonectomy, Resection of
whole lung\]

56 WITH mediastinal lymph node dissection (radical pneumonectomy)

The lymph node dissection should also be coded under *Scope of Regional
Lymph Node Surgery* (NAACCR Item \# 1292).

65 Extended pneumonectomy

66 Extended pneumonectomy plus pleura or diaphragm

70 Extended radical pneumonectomy

The lymph node dissection should also be coded under *Scope of Regional
Lymph Node Surgery* (NAACCR Item \# 1292).

\[***SEER Note:*** An extended radical pneumonectomy is a radical
pneumonectomy (including removal of mediastinal nodes) and the removal
of other tissues or nodes\]

80 Resection of lung, NOS

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Collaborative Staging Codes**

**Heart, Mediastinum**\
**C38.0-C38.3, C38.8**

C38.0 Heart

C38.1 Anterior mediastinum

C38.2 Posterior mediastinum

C38.3 Mediastinum, NOS

C38.8 Overlapping lesion of heart, mediastinum and pleura

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage\         |   |
| |                     | Factor 5\           | Extension Size      |   |
| |                     | CS Site-Specific    | Table               |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Heart, Mediastinum**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Heart, Mediastinum**\
**CS Extension**

**Note:  ** Sarcomas of the heart and mediastinum are classified as deep
tumors. A deep tumor is located either exclusively beneath the
superficial fascia, superficial to the fascia with invasion of or
through the fascia, or both superficial yet beneath the fascia.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to site of       | \*   | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue:              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Heart:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Visceral pericardium (epicardium)        |      |      |      |
|      |                                          |      |      |      |
|      | (See note in General Instructions on     |      |      |      |
|      | adjacent connective tissue)              |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures:              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Heart:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Ascending aorta                          |      |      |      |
|      |                                          |      |      |      |
|      | Parietal pericardium                     |      |      |      |
|      |                                          |      |      |      |
|      | Vena cava                                |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinum:                             |      |      |      |
|      |                                          |      |      |      |
|      | Descending aorta                         |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Large (named) artery(ies)                |      |      |      |
|      |                                          |      |      |      |
|      | Large (named) vein(s)                    |      |      |      |
|      |                                          |      |      |      |
|      | Pericardium, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Parietal                                 |      |      |      |
|      |                                          |      |      |      |
|      | Visceral (epicardium)                    |      |      |      |
|      |                                          |      |      |      |
|      | Phrenic nerve(s)                         |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 60,  | Pleura, NOS                              |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Parietal pleura                          |      |      |      |
|      |                                          |      |      |      |
|      | Visceral pleura of lung                  |      |      |      |
|      |                                          |      |      |      |
|      | Sternum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Sympathetic nerve trunk(s)               |      |      |      |
|      |                                          |      |      |      |
|      | Thoracic duct                            |      |      |      |
|      |                                          |      |      |      |
|      | Thymus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Trachea, parietal pleura                 |      |      |      |
|      |                                          |      |      |      |
|      | Vertebra(e)                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | \*   | D    | D    |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For Extension codes 10-80 ONLY, the T category is assigned based on
value of CS Tumor Size from the Extension Size Table for this site.

**Heart, Mediastinum**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Heart, Mediastinum**\
**CS Lymph Nodes**

**Note 1:  ** Regional lymph nodes are defined as those in the vicinity
of the primary tumor.

**Note 2:  ** Regional lymph node involvement is rare. For this schema,
if there is no mention of lymph node involvement clinically, assume that
lymph nodes are negative (code 00). Use code 99 (Unknown) only when
there is no available information on the extent of the patient\'s
disease, for example, when a lab-only case is abstracted from a biopsy
report and no clinical history is available.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Aortic (above diaphragm), NOS:           |      |      |      |
|      |                                          |      |      |      |
|      | Peri/para-aortic, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Ascending aorta (phrenic)                |      |      |      |
|      |                                          |      |      |      |
|      | Subaortic (aortico-pulmonary window)     |      |      |      |
|      |                                          |      |      |      |
|      | Carinal (tracheobronchial) (tracheal     |      |      |      |
|      | bifurcation)                             |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal, NOS:                        |      |      |      |
|      |                                          |      |      |      |
|      | Anterior                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior (tracheoesophageal)            |      |      |      |
|      |                                          |      |      |      |
|      | Pericardial                              |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paraesophageal                      |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paratracheal, NOS:                  |      |      |      |
|      |                                          |      |      |      |
|      | Azygos (lower peritracheal)              |      |      |      |
|      |                                          |      |      |      |
|      | Pre- and retrotracheal, NOS:             |      |      |      |
|      |                                          |      |      |      |
|      | Precarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Subcarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+

  ------- ------------------------------------------ ------- ------- -------
  80      Lymph nodes, NOS                           N1      RN      RN

  99      Unknown (see Note 2)                       NX      U       U
  ------- ------------------------------------------ ------- ------- -------

**Heart, Mediastinum**

**CS Reg Nodes Eval**

**SEE STANDARD TABLE**

**Heart, Mediastinum**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Heart, Mediastinum**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Heart, Mediastinum**\
**CS Mets at DX**\
**SEE STANDARD TABLE**\
\
**Heart, Mediastinum**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Heart, Mediastinum**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Heart, Mediastinum**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Heart, Mediastinum**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Heart, Mediastinum**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Heart, Mediastinum**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Heart, Mediastinum**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Collaborative Staging Codes**

**Pleura**\
**C38.4**

C38.4 Pleura, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -**        | tables are          |   |
| | CS TS/Ext-Eval\     | Pleural Effusion\   | available at the    |   |
| | CS Lymph Nodes\     | CS Site-Specific    | collaborative       |   |
| | CS Reg Nodes Eval\  | Factor 2\           | staging website:    |   |
| | Reg LN Pos\         | CS Site-Specific    |                     |   |
| | Reg LN Exam\        | Factor 3\           | Histology Exclusion |   |
| | CS Mets at DX\      | CS Site-Specific    | Table\              |   |
| | CS Mets Eval        | Factor 4\           | AJCC Stage\         |   |
| |                     | CS Site-Specific    | Pleural Effusion    |   |
| |                     | Factor 5\           | Extension Table     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Pleura**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**CS Extension**

**Note:  ** Pleural effusion does not affect the coding of the CS
Extension field, but is coded as Site-Specific Factor 1.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor (mesothelioma) confined   | T    | \*   | \*   |
|      | to pleura, NOS                           | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Ipsilateral parietal pleura, including   | T1a  | \*   | \*   |
|      | mediastinal or diaphragmatic pleura,     |      |      |      |
|      | WITHOUT involvement of visceral pleura   |      |      |      |
+------+------------------------------------------+------+------+------+
| 14   | Ipsilateral parietal pleura, including   | T1b  | \*   | \*   |
|      | mediastinal or diaphragmatic pleura,     |      |      |      |
|      | WITH focal involvement of visceral       |      |      |      |
|      | pleura                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 16   | Ipsilateral parietal pleura, including   | T    | \*   | \*   |
|      | mediastinal or diaphragmatic pleura,     | 1NOS |      |      |
|      | involvement of visceral pleura not       |      |      |      |
|      | stated                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Ipsilateral pleura WITH nodule(s)        | T2   | \*   | \*   |
|      | beneath visceral pleural surface         |      |      |      |
|      |                                          |      |      |      |
|      | Ipsilateral pleural surface with         |      |      |      |
|      | confluent visceral pleural tumor         |      |      |      |
|      | (including fissure)                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T    | \*   | \*   |
|      |                                          | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Diaphragm (diaphragmatic muscle)         | T2   | \*   | \*   |
+------+------------------------------------------+------+------+------+
| 50   | Mesothelioma nodule(s) which have broken | T2   | \*   | \*   |
|      | through the visceral pleural surface to  |      |      |      |
|      | the lung surface                         |      |      |      |
|      |                                          |      |      |      |
|      | Lung parenchyma, or lung involvement,    |      |      |      |
|      | NOS                                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | Adjacent connective tissue:              | T3   | \*   | \*   |
|      |                                          |      |      |      |
|      | Endothoracic fascia                      |      |      |      |
|      |                                          |      |      |      |
|      | Pericardium, non-transmural or NOS       |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Chest wall, solitary focus of tumor ONLY | T3   | \*   | \*   |
|      |                                          |      |      |      |
|      | Mediastinal tissues, mediastinal fat     |      |      |      |
+------+------------------------------------------+------+------+------+
| 63   | Diffuse or multifocal invasion of soft   | T4   | \*   | \*   |
|      | tissues of chest wall                    |      |      |      |
|      |                                          |      |      |      |
|      | Heart muscle, myocardium                 |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 63,  | Medistinal organs                        |      |      |      |
|      |                                          |      |      |      |
| co   | Rib                                      |      |      |      |
| nt'd |                                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Extension to internal surface of         | T4   | \*   | \*   |
|      | pericardium                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 69   | Pericardial effusion with positive       | T4   | \*   | \*   |
|      | cytology                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | Contralateral pleura (For contralateral  | T4   | \*   | \*   |
|      | lung, see CS Mets at DX)                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4   | \*   | \*   |
|      |                                          |      |      |      |
|      | Brachial plexus                          |      |      |      |
|      |                                          |      |      |      |
|      | Cervical tissues                         |      |      |      |
|      |                                          |      |      |      |
|      | Intra-abdominal organs                   |      |      |      |
|      |                                          |      |      |      |
|      | Peritoneum                               |      |      |      |
|      |                                          |      |      |      |
|      | Spine                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | \*   | \*   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | \*   | \*   |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* The mapping to Summary Stage 1977 and Summary Stage 2000 depends on
the value of Site-Specific Factor 1, Pleural Effusion. See the extra
table, Extension Pleural Effusion Table, for details.

**Pleura**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**CS Lymph Nodes**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s), ipsilateral,     | N1   | RN   | RN   |
|      | intrapulmonary:                          |      |      |      |
|      |                                          |      |      |      |
|      | Hilar:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Bronchopulmonary                         |      |      |      |
|      |                                          |      |      |      |
|      | Proximal lobar                           |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary root                           |      |      |      |
|      |                                          |      |      |      |
|      | Intrapulmonary:                          |      |      |      |
|      |                                          |      |      |      |
|      | Interlobar                               |      |      |      |
|      |                                          |      |      |      |
|      | Lobar                                    |      |      |      |
|      |                                          |      |      |      |
|      | Segmental                                |      |      |      |
|      |                                          |      |      |      |
|      | Subsegmental                             |      |      |      |
|      |                                          |      |      |      |
|      | Peri/parabronchial                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s), ipsilateral,     | N2   | RN   | RN   |
|      | mediastinal:                             |      |      |      |
|      |                                          |      |      |      |
|      | Aortic \[above diaphragm\], NOS:         |      |      |      |
|      |                                          |      |      |      |
|      | Aorto-pulmonary window                   |      |      |      |
|      |                                          |      |      |      |
|      | Ascending aorta                          |      |      |      |
|      |                                          |      |      |      |
|      | Peri/para-aortic                         |      |      |      |
|      |                                          |      |      |      |
|      | Phrenic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Subaortic                                |      |      |      |
|      |                                          |      |      |      |
|      | Carinal:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Tracheobronchial                         |      |      |      |
|      |                                          |      |      |      |
|      | Tracheal bifurcation                     |      |      |      |
|      |                                          |      |      |      |
|      | Internal mammary (parasternal)           |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 20,  | Mediastinal, NOS:                        |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Anterior                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior (tracheoesophageal)            |      |      |      |
|      |                                          |      |      |      |
|      | Pericardial                              |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paraesophageal \[below carina\]     |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paratracheal, NOS:                  |      |      |      |
|      |                                          |      |      |      |
|      | Lower peritracheal (azygos)              |      |      |      |
|      |                                          |      |      |      |
|      | Upper paratracheal                       |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal and retrotracheal, NOS:      |      |      |      |
|      |                                          |      |      |      |
|      | Precarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Prevascular                              |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Subcardial                               |      |      |      |
|      |                                          |      |      |      |
|      | Subcarinal                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph node(s), NOS              | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 70   | Contralateral or bilateral nodes         | N3   | D    | D    |
|      | specified in codes 10 or 20              |      |      |      |
|      |                                          |      |      |      |
|      | Ipsilateral, contralateral or bilateral  |      |      |      |
|      | nodes:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Scalene (inferior deep cervical)         |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pleura**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), including         | M1   | D    | D    |
|      | cervical nodes                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Direct extension to contralateral lung   | M1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases, except code \[(10)   | M1   | D    | D    |
|      | or (35)\]                                |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS (includes        |      |      |      |
|      | discontinuous involvement of             |      |      |      |
|      | contralateral pleura/chest wall)         |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus distant       |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | MX   | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pleura**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Pleura**\
**CS Site-Specific Factor 1 Pleural Effusion**

  ------- ---------------------------------------------------------------
  Code    Description

  000     No pleural effusion

  010     Pleural effusion, non-malignant

  020     Pleural effusion, malignant

  030     Pleural effusion, NOS

  999     Unknown if pleural effusion
  ------- ---------------------------------------------------------------

**Pleura**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Pleura**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Pleura**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Pleura**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Pleura**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Page left blank**

**Collaborative Staging Codes**

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**C39.0, C39.8-C39.9**

C39.0 Upper respiratory tract, NOS

C39.8 Overlapping lesion of respiratory system and intrathoracic organs

C39.9 Ill-defined sites within respiratory system

**Note:  ** AJCC does not define TNM staging for this site.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histologies for     |   |
| | CS Mets at DX\      | Factor 4\           | Which AJCC Staging  |   |
| | CS Mets Eval        | CS Site-Specific    | Is Not Generated\   |   |
| |                     | Factor 5\           | AJCC Stage          |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | NA   | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to site of       | NA   | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue               | NA   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures               | NA   | RE   | RE   |
|      |                                          |      |      |      |
|      | Descending aorta                         |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Large (named) artery(ies)                |      |      |      |
|      |                                          |      |      |      |
|      | Large (named) vein(s)                    |      |      |      |
|      |                                          |      |      |      |
|      | Pericardium, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Parietal                                 |      |      |      |
|      |                                          |      |      |      |
|      | Visceral (epicardium)                    |      |      |      |
|      |                                          |      |      |      |
|      | Phrenic nerve(s)                         |      |      |      |
|      |                                          |      |      |      |
|      | Pleura, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Parietal                                 |      |      |      |
|      |                                          |      |      |      |
|      | Visceral                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sternum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Sympathetic nerve trunk(s)               |      |      |      |
|      |                                          |      |      |      |
|      | Thoracic duct                            |      |      |      |
|      |                                          |      |      |      |
|      | Thymus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
|      |                                          |      |      |      |
|      | Vertebra(e)                              |      |      |      |
|      |                                          |      |      |      |
|      | Visceral pleura of lung                  |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | NA   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS TS/Ext-Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Lymph Nodes**

**Note:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph nodes:                    | NA   | RN   | RN   |
|      |                                          |      |      |      |
|      | Aortic \[above diaphragm\], NOS:         |      |      |      |
|      |                                          |      |      |      |
|      | Peri/para-aortic, NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Ascending aorta (phrenic)                |      |      |      |
|      |                                          |      |      |      |
|      | Subaortic (aortico-pulmonary window)     |      |      |      |
|      |                                          |      |      |      |
|      | Carinal (tracheobronchial) (tracheal     |      |      |      |
|      | bifurcation)                             |      |      |      |
|      |                                          |      |      |      |
|      | Hilar (bronchopulmonary) (proximal       |      |      |      |
|      | lobar) (pulmonary root)                  |      |      |      |
|      |                                          |      |      |      |
|      | Intrapulmonary, NOS:                     |      |      |      |
|      |                                          |      |      |      |
|      | Interlobar                               |      |      |      |
|      |                                          |      |      |      |
|      | Lobar                                    |      |      |      |
|      |                                          |      |      |      |
|      | Segmental                                |      |      |      |
|      |                                          |      |      |      |
|      | Subsegmental                             |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal, NOS:                        |      |      |      |
|      |                                          |      |      |      |
|      | Anterior                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior (tracheoesophageal)            |      |      |      |
|      |                                          |      |      |      |
|      | Peri/parabronchial                       |      |      |      |
|      |                                          |      |      |      |
|      | Pericardial                              |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paraesophageal                      |      |      |      |
|      |                                          |      |      |      |
|      | Peri/paratracheal, NOS:                  |      |      |      |
|      |                                          |      |      |      |
|      | Azygos (lower peritracheal)              |      |      |      |
|      |                                          |      |      |      |
|      | Pre- and retrotracheal, NOS:             |      |      |      |
|      |                                          |      |      |      |
|      | Precarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Subcarinal                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | NA   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Reg Nodes Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | NA   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | NA   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + (40)                            | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | NA   | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Mets Eval**

  ------- -------------------------------------------------------- ---------
  Code    Description                                              Staging
                                                                   Basis

  9       Not applicable for this site                             NA
  ------- -------------------------------------------------------- ---------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Other and Ill-Defined Respiratory Sites and Intrathoracic Organs**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
C310--C319, C339, C379, **C380--C388, C390--C399**, C480--C488,
C510--C519, C529, C570--C579, C589, C600--C609, C630--C639, C680--C689,
C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor excision,
26 Polypectomy or 27 Excisional

biopsy with 21 PDT, 22 Electrocautery, 23 Cryosurgery, 24 Laser
ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**SEER Site-Specific Coding Guidelines**

**BONES, JOINTS, AND ARTICULAR CARTILAGE C400--C419**

**PERIPHERAL NERVES AND AUTONOMIC NERVOUS SYSTEM C470--C479**

**CONNECTIVE, SUBCUTANEOUS, AND OTHER SOFT TISSUES C490--C499**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

**Laterality**

# 

Laterality is required for sites C40.0-C40.3, C41.3-C41.4, C47.1-C47.2,
and C49.1-C49.2.

# 

**Three Grade System (Nuclear Grade)**

There are several sites for which a three-grade system is used. The
patterns of cell growth are measured on a scale of 1, 2, and 3 (also
referred to as low, medium, and high grade). This system measures the
proportion of cancer cells that are growing and making new cells and how
closely they resemble the cells of the host tissue. Thus, it is similar
to a four-grade system, but simply divides the spectrum into three
rather than four categories (see comparison table below). The expected
outcome is more favorable for lower grades. Soft tissue sarcomas are
evaluated using a three-grade system.

If a grade is written as 2/3 that means this is a grade 2 of a
three-grade system. Do not simply code the numerator. Use the following
table to convert the grade to SEER codes.

  -----------------------------------------------------------------------
  Term            Grade                            SEER Code
  --------------- -------------------------------- ----------------------
  1/3, 1/2        Low grade                        2

  2/3             Intermediate grade               3

  3/3, 2/2        High grade                       4
  -----------------------------------------------------------------------

# 

# Sarcoma

Sarcomas are graded low, intermediate or high grade by the pathologist.
Use the following table to convert these terms to a histologic grade.

  -----------------------------------------------------------------------
  Term                                            Grade    SEER Code
  ----------------------------------------------- -------- --------------
  Well differentiated                             I        1

                                                           

  Fairly well differentiated                      II       2

  Low grade                                       I-II     2

  Mid differentiated                              II       2

  Moderately differentiated                       II       2

  Partially differentiated                        II       2

  Partially well differentiated                   I-II     2

  Partially well differentiated                   II       2

  Relatively or generally well differentiated     II       2

                                                           

  Medium grade, intermediate grade                II-III   3

  Moderately poorly differentiated                III      3

  Moderately undifferentiated                     III      3

  Pleomorphic                                     III      3

  Poorly differentiated                           III      3

  Relatively poorly differentiated                III      3

  Relatively undifferentiated                     III      3

  Slightly differentiated                         III      3

                                                           

  High grade                                      III-IV   4

  Undifferentiated, anaplastic, not               IV       4
  differentiated                                           
  -----------------------------------------------------------------------

**Page left blank**

**Collaborative Staging Codes**

**Bone**\
**C40.0-C40.3, C40.8-C40.9, C41.0-C41.4, C41.8-C41.9**

C40.0 Long bones of upper limb, scapula and associated joints

C40.1 Short bones of upper limb and associated joints

C40.2 Long bones of lower limb and associated joints

C40.3 Short bones of lower limb and associated joints

C40.8 Overlapping lesion of bones, joints and articular cartilage of
limbs

C40.9 Bone of limb, NOS

C41.0 Bones of skull and face and associated joints (excludes mandible
C41.1)

C41.1 Mandible

C41.2 Vertebral column (excludes sacrum and coccyx C41.4)

C41.3 Rib, sternum, clavicle and associated joints

C41.4 Pelvic bones, sacrum, coccyx and associated joints

C41.8 Overlapping lesion of bones, joints and articular cartilage

C41.9 Bone, NOS

**Note:  ** Laterality must be coded for C40.0-C40.3, and C41.3-C41.4.
For sternum, sacrum, coccyx, and symphysis pubis, laterality is coded 0.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage\         |   |
| |                     | Factor 5\           | Extension Size      |   |
| |                     | CS Site-Specific    | Table               |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Bone**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Bone**\
**CS Extension**

**Note:  ** The cortex of a bone is the dense outer shell that provides
strength to the bone; the spongy center of a bone is the cancellous
portion. The periosteum of the bone is the fibrous membrane covering of
a bone that contains the blood vessels and nerves; the periosteum is
similar to the capsule on a visceral organ.

  ------- ------------------------------------------ ------- ------- --------
  Code    Description                                TNM     SS77    SS2000

  10      Invasive tumor confined to cortex of bone  \*      L       L

  20      Extension beyond cortex to periosteum (no  \*      L       L
          break in periosteum)                                       

  30      Localized, NOS                             \*      L       L

  40      Extension beyond periosteum to surrounding \*      RE      RE
          tissues, including adjacent skeletal                       
          muscle(s)                                                  

  60      Adjacent bone/cartilage                    \*      RE      RE

  70      Skin                                       \*      D       D

  80      Further contiguous extension               \*      D       D
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+------+
| 82   | Skip metastases or discontinuous tumors  | T3   | D    | D    |
|      | in the same bone                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For codes 10, 20, 30, 40, 60, 70, and 80 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Bone**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Bone**\
**CS Lymph Nodes**

**Note 1:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

**Note 2:  ** Regional lymph nodes are defined as those in the vicinity
of the primary tumor.

**Note 3:  ** Regional lymph node involvement is rare. If there is no
mention of lymph node involvement clinically, assume that lymph nodes
are negative.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s)                   | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Bone**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Bone**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Bone**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Bone**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 30   | Distant metastasis to lung only          | M1a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1b  | D    | D    |
|      | node(s) or lung                          |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(10\) + \[(30) + 40)\]                  | M1b  | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Stated as M1, NOS                        | M    | D    | D    |
|      |                                          | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | MX   | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Bone**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Bone**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Bone**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Bone**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Bone**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Bone**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Bone**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**Bones,** Joints, And Articular Cartilage **C400--C419**

Peripheral Nerves And Autonomic Nervous System C470--C479

Connective, Subcutaneous, And Other Soft Tissues C490--C499

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

19 Local tumor destruction or excision, NOS

**Unknown** whether a specimen was sent to **pathology** for surgical
events coded 19 (Principally for cases

diagnosed prior to January 1, 2003)

15 Local tumor destruction

**No** specimen sent to **pathology** from surgical event 15

25 Local excision

[]{.mark}

26 Partial resection

**Specimen** sent to **pathology** from surgical events 25--26

30 **Radical** **excision** or **resection** of lesion WITH limb salvage

40 Amputation of limb

41 Partial amputation of limb

42 Total amputation of limb

50 Major amputation, NOS

51 Forequarter, including scapula

52 Hindquarter, including ilium/hip bone

53 Hemipelvectomy, NOS

54 Internal hemipelvectomy

90 Surgery, NOS

99 **Unknown** if surgery performed; **death certificate** ONLY

**Page left blank**

**Collaborative Staging Codes**

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**C44.0, C44.2-C44.9**

C44.0 Skin of lip, NOS

C44.2 External ear

C44.3 Skin of ear and unspecified parts of face

C44.4 Skin of scalp and neck

C44.5 Skin of trunk

C44.6 Skin of upper limb and shoulder

C44.7 Skin of lower limb and hip

C44.8 Overlapping lesion of skin

C44.9 Skin, NOS

**Note:  ** Laterality must be coded for C44.2-C44.3 and C44.5-C44.7.
For codes C44.3 and C44.5, if the tumor is midline (e.g., chin), code as
9, midline, in the laterality field.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage\         |   |
| |                     | Factor 5\           | Extension Size      |   |
| |                     | CS Site-Specific    | Table               |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Tumor Size**\
**SEE STANDARD TABLE**

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis**\
**Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Extension**

**Note 1:  ** In the case of multiple simultaneous tumors, code the
tumor with greatest extension.

**Note 2:  ** Skin ulceration does not alter the Collaborative Stage
classification.

**Note 3:  ** Skin of genital sites is not included in this schema.
These sites are skin of vulva (C51.0-C51.2, C51.8-C51.9), skin of penis
(C60.0-C60.1, C60.8, C60.9) and skin of scrotum (C63.2).

  ------- ------------------------------------------ ------- ------- --------
  Code    Description                                TNM     SS77    SS2000

  00      In situ: noninvasive; intraepidermal;      Tis     IS      IS
          Bowen disease                                              

  10      Lesion(s) confined to dermis               \*      L       L

  40      Localized, NOS                             \*      L       L

  50      Subcutaneous tissue (through entire        \*      L       L
          dermis)                                                    

  70      Underlying cartilage, bone, skeletal       T4      D       RE
          muscle                                                     

  80      Further contiguous extension               T4      D       D

  95      No evidence of primary tumor               T0      U       U
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For Extension codes 10, 40 and 50 ONLY, the T category is assigned
based on value of CS Tumor Size from Extension Size Table for this site.

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Lymph Nodes**

**Note:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s) by primary site   | N1   | RN   | RN   |
|      | (includes bilateral or contralateral     |      |      |      |
|      | nodes for head, neck, and trunk)         |      |      |      |
|      |                                          |      |      |      |
|      | Head and Neck:                           |      |      |      |
|      |                                          |      |      |      |
|      | All subsites: Cervical                   |      |      |      |
|      |                                          |      |      |      |
|      | Lip:                                     |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | External ear/auditory canal:             |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (post-/retro-auricular)          |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Face, Other (cheek, chin, forehead, jaw, |      |      |      |
|      | nose and temple):                        |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Scalp:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (post-/retro-auricular)          |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory (posterior cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Neck:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (post-/retro-auricular)          |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory (posterior cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 10,  | Upper Trunk:                             |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Cervical                                 |      |      |      |
|      |                                          |      |      |      |
|      | Internal mammary (parasternal)           |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Lower Trunk:                             |      |      |      |
|      |                                          |      |      |      |
|      | Femoral (superficial inguinal)           |      |      |      |
|      |                                          |      |      |      |
|      | Arm/Shoulder:                            |      |      |      |
|      |                                          |      |      |      |
|      | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Epitrochlear for hand/forearm            |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory for shoulder            |      |      |      |
|      |                                          |      |      |      |
|      | Leg/Hip:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Femoral (superficial inguinal)           |      |      |      |
|      |                                          |      |      |      |
|      | Popliteal for heel and calf              |      |      |      |
|      |                                          |      |      |      |
|      | All sites: Regional lymph node(s), NOS   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Head and Neck:                           | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Lip:                                     |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Face, Other (cheek, chin, forehead, jaw, |      |      |      |
|      | nose, and temple):                       |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Neck:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | \(10\) + (20)                            | N1   | D    | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Mets at DX**

**SEE STANDARD TABLE**

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin \[excl. Skin of Eyelid\] \[excl. Malignant Melanoma, Kaposi
Sarcoma, Mycosis Fungoides, Sezary Disease, and Other Lymphomas\]**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Page left blank**

**Collaborative Staging Codes**

**Skin of Eyelid**\
**C44.1**

C44.1 Eyelid

**Note:  ** Laterality must be coded for this site.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage for TNM  |   |
| |                     | Factor 5\           | sites with no stage |   |
| |                     | CS Site-Specific    | groupings\          |   |
| |                     | Factor 6            | Extension Size      |   |
| |                     |                     | Table               |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Skin of Eyelid**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Skin of Eyelid**\
**CS Extension**

**Note 1:  ** In the case of multiple simultaneous tumors, code the
tumor with greatest extension.

**Note 2:  ** Skin ulceration does not alter the Collaborative Stage
classification.

**Note 3:  ** Presence of tumor at eyelid margin takes priority over
depth of invasion in dermis/tarsal plate; i.e., code 25 takes priority
over codes 10-20.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
|      |                                          |      |      |      |
|      | Bowen disease; intraepidermal            |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Lesion(s) confined to dermis             | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Minimal infiltration of dermis (not      |      |      |      |
|      | invading tarsal plate)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Infiltrates deeply into dermis (invading | T2   | L    | L    |
|      | tarsal plate)                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 25   | Tumor at eyelid margin                   | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Involves full eyelid thickness           | T3   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Subcutaneous tissue (through entire      | T3   | L    | L    |
|      | dermis)                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent structures, including           | T4   | D    | RE   |
|      |                                          |      |      |      |
|      | Bulbar conjunctiva                       |      |      |      |
|      |                                          |      |      |      |
|      | Globe                                    |      |      |      |
|      |                                          |      |      |      |
|      | Perineural space                         |      |      |      |
|      |                                          |      |      |      |
|      | Sclera                                   |      |      |      |
|      |                                          |      |      |      |
|      | Soft tissues of orbit                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Bone/periosteum of orbit                 | T4   | D    | RE   |
|      |                                          |      |      |      |
|      | Skeletal muscle                          |      |      |      |
|      |                                          |      |      |      |
|      | Underlying cartilage                     |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 72   | Nasal cavity                             | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Paranasal sinuses                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 74   | Central nervous system                   | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 75   | Metastatic skin lesion(s)                | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For Extension code 25 ONLY, the T category is assigned based on value
of CS Tumor Size as shown in Extension Size Table. Tumors 5mm or less
are T1, tumors 6-10mm are T2, and tumors more than 10mm are T3.

**Skin of Eyelid**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Skin of Eyelid**\
**CS Lymph Nodes**

**Note:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s)                   | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Skin of Eyelid**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Skin of Eyelid**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Skin of Eyelid**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Skin of Eyelid**\
**CS Mets at DX**\
**SEE STANDARD TABLE**

**Skin of Eyelid**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Skin of Eyelid**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin of Eyelid**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin of Eyelid**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin of Eyelid**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin of Eyelid**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Skin of Eyelid**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**Skin**

**C440--C449**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser ablation

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 Local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

\[***SEER Notes:*** Code UVB phototherapy for mycosis fungoides
primaries under Surgery of Primary Site for skin. Assign code 11 if
there is no pathology specimen. Assign code 21 if there is a pathology
specimen.

Codes 20-27 include shave and wedge resection\]

30 **Biopsy** of primary tumor **followed** **by** a **gross excision**
of the lesion (does not have to be done under the same anesthesia)

31 Shave biopsy followed by a gross excision of the lesion

32 Punch biopsy followed by a gross excision of the lesion

33 Incisional biopsy followed by a gross excision of the lesion

34 Mohs surgery, NOS

35 Mohs with 1-cm margin or less

36 Mohs with more than 1-cm margin

\[***SEER Notes:*** Codes 30 to 33 include less than a wide excision,
less than 1 cm margin or margins are

unknown. If it is stated to be a **wide excision** or **reexcision**,
but the **margins are unknown**, code to 30.

Code 45 represents a wide excision in which it is known that the margins
of excision are greater than 1 cm.\]

45 **Wide excision** or **reexcision** of lesion or **minor** (local)
**amputation** with margins more than 1 cm, NOS. Margins MUST be
microscopically negative.

46 WITH margins more than 1 cm and less than or equal to 2 cm

47 WITH margins greater than 2 cm

If the excision does not have microscopically negative margins greater
than 1 cm, use the appropriate code, 20-36.

60 Major amputation

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Collaborative Staging Codes**

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**C44.0-C44.9, C51.0-C51.2, C51.8-C51.9, C60.0-C60.2, C60.8-C60.9,
C63.2**

(M-8720-8790)

C44.0 Skin of lip, NOS

C44.1 Eyelid

C44.2 External ear

C44.3 Skin of ear and unspecified parts of face

C44.4 Skin of scalp and neck

C44.5 Skin of trunk

C44.6 Skin of upper limb and shoulder

C44.7 Skin of lower limb and hip

C44.8 Overlapping lesion of skin

C44.9 Skin, NOS

C51.0 Labium majus

C51.1 Labium minus

C51.2 Clitoris

C51.8 Overlapping lesion of vulva

C51.9 Vulva, NOS

C60.0 Prepuce

C60.1 Glans penis

C60.2 Body of penis

C60.8 Overlapping lesion of penis

C60.9 Penis

C63.2 Scrotum, NOS

**Note 1:  ** Laterality must be coded for C44.1-C44.3, and C44.5-C44.7.
For codes C44.3 and C44.5, if the tumor is midline (e.g., chin), code as
9, midline, in the laterality field.

**Note 2:  ** For melanoma of sites other than those above, use the
site-specific schema for the appropriate site.

**Note 3:  ** The level of invasion, as defined by Dr. Wallace Clark, is
used when defining subcategories of T1 melanomas, but not for thicker
melanoma (i.e, T2, T3 or T4).

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -**        | tables are          |   |
| | CS TS/Ext-Eval\     | Measured Thickness  | available at the    |   |
| | CS Lymph Nodes\     | (Depth), Breslow\'s | collaborative       |   |
| | CS Reg Nodes Eval\  | Measurement\        | staging website:    |   |
| | Reg LN Pos\         | **CS Site-Specific  |                     |   |
| | Reg LN Exam\        | Factor 2 -**        | Histologies for     |   |
| | CS Mets at DX\      | Ulceration\         | Which AJCC Staging  |   |
| | CS Mets Eval        | **CS Site-Specific  | Is Not Generated\   |   |
| |                     | Factor 3 -**        | AJCC Stage\         |   |
| |                     | Clinical Status of  | Thickness and       |   |
| |                     | Lymph Node Mets\    | Ulceration\         |   |
| |                     | **CS Site-Specific  | Extension and       |   |
| |                     | Factor 4 -** LDH\   | Ulceration\         |   |
| |                     | CS Site-Specific    | CS Reg Nodes        |   |
| |                     | Factor 5\           | Positive\           |   |
| |                     | CS Site-Specific    | Clinical Status     |   |
| |                     | Factor 6            | Code for Lymph Node |   |
| |                     |                     | (N1)\               |   |
| |                     |                     | Clinical Status     |   |
| |                     |                     | Code for Lymph Node |   |
| |                     |                     | Category N (N2)\    |   |
| |                     |                     | Mets at DX and LDH  |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Tumor Size**

**Note:  ** Record the size of the tumor in the CS Tumor Size table
below, not depth or thickness. Depth or thickness is recorded in
Site-Specific Factor 1 in the Measured Thickness (Depth), Breslow\'s
Measurement table.

+-------+--------------------------------------------------------------+
| Code  | Description                                                  |
+-------+--------------------------------------------------------------+
| 000   | No mass/tumor found                                          |
+-------+--------------------------------------------------------------+
| 00    | 001 - 988 millimeters (code exact size in millimeters)       |
| 1-988 |                                                              |
+-------+--------------------------------------------------------------+
| 989   | 989 millimeters or larger                                    |
+-------+--------------------------------------------------------------+
| 990   | Microscopic focus or foci only, no size of focus given       |
+-------+--------------------------------------------------------------+
| 991   | Described as less than 1 cm                                  |
+-------+--------------------------------------------------------------+
| 992   | Described as less than 2 cm                                  |
+-------+--------------------------------------------------------------+
| 993   | Described as less than 3 cm                                  |
+-------+--------------------------------------------------------------+
| 994   | Described as less than 4 cm                                  |
+-------+--------------------------------------------------------------+
| 995   | Described as less than 5 cm                                  |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Extension**

**Note 1:  ** If there is a discrepancy between the Clark level and the
pathologic description of extent, use the higher (more extensive) code.

**Note 2:** Satellite lesions/nodules or in-transit metastasis are coded
under CS Lymph Nodes.

**Note 3:** Ulceration of melanoma is coded in Site-Specific Factor 2.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ: noninvasive; intraepidermal     | Tis  | IS   | IS   |
|      |                                          |      |      |      |
|      | Clark\'s level I                         |      |      |      |
|      |                                          |      |      |      |
|      | Basement membrane of the epidermis is    |      |      |      |
|      | intact                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Papillary dermis invaded                 | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Clark\'s level II                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Papillary-reticular dermal interface     | \*   | L    | L    |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Clark\'s level III                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Reticular dermis invaded                 | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Clark\'s level IV                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Skin/dermis, NOS                         | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Localized, NOS                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Subcutaneous tissue invaded (through     | \*   | L    | RE   |
|      | entire dermis)                           |      |      |      |
|      |                                          |      |      |      |
|      | Clark\'s level V                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | \*   | D    | D    |
|      |                                          |      |      |      |
|      | Underlying cartilage, bone, skeletal     |      |      |      |
|      | muscle                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | \*   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed (e.g.,  |      |      |      |
|      | shave biopsy or regressed melanoma)      |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For Extension codes 10 - 80, and 99 ONLY, the T category is assigned
based on the values of CS Site-Specific Factor 1, Measured Thickness and
CS Site-Specific Factor 2, Ulceration, as shown in Extra Table 1,
Thickness and Ulceration and Extra Table 2, Extension and Ulceration.

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Lymph Nodes**

**Note 1:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX.

**Note 2:** Satellite lesions/nodules or in-transit metastasis are coded
under CS Lymph Nodes.

**Note 3:** Use codes 10-12 if there is regional node involvement
without satellite nodule(s) or in-transit metastases. Use codes 13-15 if
there are satellite nodule(s) or in-transit metastases but there is
either no regional lymph node involvement, or involvement of regional
lymph nodes is not stated. Use codes 20-22 if both satellite
nodule(s)/in­transit metastases and regional lymph node(s) are present.

+------+------------------------------------------+------+------+-----+
| Code | Description                              | TNM  | SS77 | SS2 |
|      |                                          |      |      | 000 |
+------+------------------------------------------+------+------+-----+
| 00   | None; no regional lymph node involvement | N0   | NONE | N   |
|      |                                          |      |      | ONE |
+------+------------------------------------------+------+------+-----+
| 10   | Regional lymph node(s) by primary site:  | \*   | RN   | RN  |
|      |                                          |      |      |     |
|      | (includes bilateral or contralateral     |      |      |     |
|      | nodes for head, neck, and trunk)         |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | HEAD AND NECK SITES:                     |      |      |     |
+------+------------------------------------------+------+------+-----+
|      | All subsites: Cervical, NOS              |      |      |     |
|      |                                          |      |      |     |
|      | Lip:                                     |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS:                         |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular(submaxillary)              |      |      |     |
|      |                                          |      |      |     |
|      | Eyelid/canthus:                          |      |      |     |
|      |                                          |      |      |     |
|      | Facial, NOS:                             |      |      |     |
|      |                                          |      |      |     |
|      | Buccinator (buccal)                      |      |      |     |
|      |                                          |      |      |     |
|      | Nasolabial                               |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS:                         |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Parotid, NOS:                            |      |      |     |
|      |                                          |      |      |     |
|      | Infra-auricular                          |      |      |     |
|      |                                          |      |      |     |
|      | External ear/auditory canal:             |      |      |     |
|      |                                          |      |      |     |
|      | Mastoid (post-/retro-auricular)          |      |      |     |
|      | (occipital)                              |      |      |     |
|      |                                          |      |      |     |
|      | Preauricular                             |      |      |     |
|      |                                          |      |      |     |
|      | Face, Other (cheek, chin forehead, jaw,  |      |      |     |
|      | nose and temple):                        |      |      |     |
|      |                                          |      |      |     |
|      | Facial, NOS:                             |      |      |     |
|      |                                          |      |      |     |
|      | Buccinator (buccal)                      |      |      |     |
|      |                                          |      |      |     |
|      | Nasolabial                               |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS:                         |      |      |     |
|      |                                          |      |      |     |
|      | Submandibular (submaxillary)             |      |      |     |
|      |                                          |      |      |     |
|      | Parotid, NOS:                            |      |      |     |
|      |                                          |      |      |     |
|      | Infra-auricular                          |      |      |     |
|      |                                          |      |      |     |
|      | Preauricular                             |      |      |     |
|      |                                          |      |      |     |
|      | Scalp:                                   |      |      |     |
|      |                                          |      |      |     |
|      | Mastoid (post-/retro-auricular)          |      |      |     |
|      | (occipital)                              |      |      |     |
|      |                                          |      |      |     |
|      | Parotid, NOS:                            |      |      |     |
|      |                                          |      |      |     |
|      | Infra-auricular                          |      |      |     |
|      |                                          |      |      |     |
|      | Preauricular                             |      |      |     |
|      |                                          |      |      |     |
|      | Spinal accessory (posterior cervical)    |      |      |     |
|      |                                          |      |      |     |
|      | Neck:                                    |      |      |     |
|      |                                          |      |      |     |
|      | Axillary                                 |      |      |     |
|      |                                          |      |      |     |
|      | Mandibular, NOS                          |      |      |     |
|      |                                          |      |      |     |
|      | Mastoid (post-/retro-auricular)          |      |      |     |
|      |                                          |      |      |     |
|      | Parotid, NOS:                            |      |      |     |
|      |                                          |      |      |     |
|      | Infra-auricular                          |      |      |     |
|      |                                          |      |      |     |
|      | Preauricular                             |      |      |     |
|      |                                          |      |      |     |
|      | Spinal accessory (posterior cervical)    |      |      |     |
|      |                                          |      |      |     |
|      | Supraclavicular (transverse cervical)    |      |      |     |
|      |                                          |      |      |     |
|      | UPPER TRUNK:                             |      |      |     |
|      |                                          |      |      |     |
|      | Axillary                                 |      |      |     |
|      |                                          |      |      |     |
|      | Cervical                                 |      |      |     |
|      |                                          |      |      |     |
|      | Internal mammary                         |      |      |     |
|      |                                          |      |      |     |
|      | Supraclavicular                          |      |      |     |
+------+------------------------------------------+------+------+-----+

+------+------------------------------------------+----+------+-------+
| 10,  | LOWER TRUNK:                             |    |      |       |
+------+------------------------------------------+----+------+-------+
| co   | Superficial inguinal (femoral)           |    |      |       |
| nt'd |                                          |    |      |       |
|      | ARM/SHOULDER:                            |    |      |       |
|      |                                          |    |      |       |
|      | Axillary                                 |    |      |       |
|      |                                          |    |      |       |
|      | Epitrochlear for hand/forearm            |    |      |       |
|      |                                          |    |      |       |
|      | Spinal accessory (posterior cervical)    |    |      |       |
|      | for shoulder                             |    |      |       |
|      |                                          |    |      |       |
|      | LEG/HIP:                                 |    |      |       |
|      |                                          |    |      |       |
|      | Popliteal for heel and calf              |    |      |       |
|      |                                          |    |      |       |
|      | Superficial inguinal (femoral)           |    |      |       |
|      |                                          |    |      |       |
|      | VULVA/PENIS/SCROTUM:                     |    |      |       |
|      |                                          |    |      |       |
|      | Deep inguinal: Rosenmuller or Cloquet    |    |      |       |
|      | node                                     |    |      |       |
|      |                                          |    |      |       |
|      | Superficial inguinal (femoral)           |    |      |       |
|      |                                          |    |      |       |
|      | ALL SITES:                               |    |      |       |
|      |                                          |    |      |       |
|      | Regional lymph node(s), NOS              |    |      |       |
+------+------------------------------------------+----+------+-------+
| 12   | Regional lymph node(s) by primary site:  | \* | D    | RN    |
+------+------------------------------------------+----+------+-------+
|      | HEAD AND NECK SITES:                     |    |      |       |
+------+------------------------------------------+----+------+-------+
|      | Lip:                                     |    |      |       |
|      |                                          |    |      |       |
|      | Facial, NOS                              |    |      |       |
|      |                                          |    |      |       |
|      | Buccinator (buccal)                      |    |      |       |
|      |                                          |    |      |       |
|      | Nasolabial                               |    |      |       |
|      |                                          |    |      |       |
|      | Mandibular, NOS                          |    |      |       |
|      |                                          |    |      |       |
|      | Submental                                |    |      |       |
|      |                                          |    |      |       |
|      | Parotid, NOS                             |    |      |       |
|      |                                          |    |      |       |
|      | Infra-auricular                          |    |      |       |
|      |                                          |    |      |       |
|      | Preauricular                             |    |      |       |
|      |                                          |    |      |       |
|      | Eyelid/canthus:                          |    |      |       |
|      |                                          |    |      |       |
|      | Facial, NOS:                             |    |      |       |
|      |                                          |    |      |       |
|      | Mandibular, NOS                          |    |      |       |
|      |                                          |    |      |       |
|      | Submental                                |    |      |       |
|      |                                          |    |      |       |
|      | Face, Other (cheek, chin, forehead, jaw, |    |      |       |
|      | nose, and temple)                        |    |      |       |
|      |                                          |    |      |       |
|      | Mandibular, NOS                          |    |      |       |
|      |                                          |    |      |       |
|      | Submental                                |    |      |       |
|      |                                          |    |      |       |
|      | Neck:                                    |    |      |       |
|      |                                          |    |      |       |
|      | Mandibular, NOS                          |    |      |       |
|      |                                          |    |      |       |
|      | Submental                                |    |      |       |
+------+------------------------------------------+----+------+-------+
| 13   | Satellite nodule(s) or in-transit        | N  | RE   | RE    |
|      | metastases, NOS (distance from           | 2c |      |       |
|      |                                          |    |      |       |
|      | primary tumor not stated) WITHOUT        |    |      |       |
|      | regional lymph node                      |    |      |       |
|      |                                          |    |      |       |
|      | involvement or involvement of regional   |    |      |       |
|      | nodes not stated.                        |    |      |       |
+------+------------------------------------------+----+------+-------+
| 14   | Satellite nodule(s) or in-transit        | N  | RE   | RE    |
|      | metastases less than or equal to 2 cm    | 2c |      |       |
|      |                                          |    |      |       |
|      | from primary tumor WITHOUT regional      |    |      |       |
|      | lymph node involvement                   |    |      |       |
|      |                                          |    |      |       |
|      | or involvement of regional nodes not     |    |      |       |
|      | stated.                                  |    |      |       |
+------+------------------------------------------+----+------+-------+
| 15   | Satellite nodule(s) or in-transit        | N  | RE   | RN    |
|      | metastases greater than 2 cm from        | 2c |      |       |
|      |                                          |    |      |       |
|      | primary tumor WITHOUT regional lymph     |    |      |       |
|      | node involvement or                      |    |      |       |
+------+------------------------------------------+----+------+-------+
|      | involvement of regional nodes not        |    |      |       |
|      | stated.                                  |    |      |       |
+------+------------------------------------------+----+------+-------+
| 17   | Matted nodes in code 10                  | N3 | RN   | RN    |
+------+------------------------------------------+----+------+-------+
| 18   | Matted nodes in code 12                  | N3 | D    | RN    |
+------+------------------------------------------+----+------+-------+
| 20   | Satellite nodule(s) or in-transit        | N3 | RE + | RE +  |
|      | metastases WITH regional lymph           |    | RN   | RN    |
|      |                                          |    |      |       |
|      | nodes listed in code 10.                 |    |      |       |
+------+------------------------------------------+----+------+-------+
| 22   | Satellite nodule(s) or in-transit        | N3 | D    | RE +  |
|      | metastases WITH regional lymph           |    |      | RN    |
|      |                                          |    |      |       |
|      | nodes listed in code 12.                 |    |      |       |
+------+------------------------------------------+----+------+-------+
| 80   | Lymph nodes, NOS                         | \* | RN   | RN    |
+------+------------------------------------------+----+------+-------+

+------+------------------------------------------+------+------+-----+
| 99   | Unknown; not stated                      | NX   | U    | U   |
|      |                                          |      |      |     |
|      | Regional lymph node(s) cannot be         |      |      |     |
|      | assessed                                 |      |      |     |
|      |                                          |      |      |     |
|      | Not documented in patient record         |      |      |     |
+------+------------------------------------------+------+------+-----+

\*Mapping of N depends on the values in Reg LN Pos and the Site-Specific
Factor 3 Table, Clinical Status of Lymph Node Mets.

Malignan Melanoma of Skin, Vulva, Penis, Scrotum

CS Reg Nodes Eval

**Note:** This item reflects the validity of the classification of the
item CS Lymph Nodes only according to diagnostic methods employed.

+----+-----------------------------------------------------------+-----+
| Co | Description                                               | S   |
| de |                                                           | tag |
|    |                                                           | ing |
|    |                                                           |     |
|    |                                                           | Ba  |
|    |                                                           | sis |
+----+-----------------------------------------------------------+-----+
|    | No regional lymph nodes, satellite nodule(s) or           | c   |
|    | in-transit metastases (nodules) removed for examination.  |     |
|    | Evidence based on physical examination, imaging           |     |
|    | examination, or other non­ invasive clinical evidence. No  |     |
|    | autopsy evidence used.                                    |     |
+----+-----------------------------------------------------------+-----+
| 1  | No regional lymph nodes, satellite nodule(s) or           | p   |
|    | in-transit metastases (nodules) removed for examination.  |     |
|    | Evidence based on endoscopic examination, diagnostic      |     |
|    | biopsy including fine needle aspiration of lymph node(s)  |     |
|    | or other invasive techniques, including surgical          |     |
|    | observation without biopsy. No autopsy evidence used.     |     |
+----+-----------------------------------------------------------+-----+
| 2  | No regional lymph nodes, satellite nodule(s) or           | p   |
|    | in-transit metastases (nodules) removed forexamination,   |     |
|    | but evidence derived from autopsy (tumor was suspected or |     |
|    | diagnosed prior to autopsy).                              |     |
+----+-----------------------------------------------------------+-----+
| 3  | Regional lymph nodes, satellite nodules(s) or in-transit  | p   |
|    | metastases (nodules) removed for examination (removal of  |     |
|    | at least 1 lymph node, satellite nodule(s) or in-transit  |     |
|    | metastasis) WITHOUT pre-surgical systemic treatment or    |     |
|    | radiation OR lymph nodes, satellite nodule(s) or          |     |
|    | in-transit metastases (nodules) removed for examination,  |     |
|    | unknown if pre­surgical systemic treatment or radiation    |     |
|    | performed.                                                |     |
+----+-----------------------------------------------------------+-----+
| 5  | Regional lymph nodes, satellite nodule(s) or in-transit   | c   |
|    | metastases (nodules) removed for examination WITH         |     |
|    | pre-surgical systemic treatment or radiation, BUT lymph   |     |
|    | node, satellite nodule(s) or in-transit metastases        |     |
|    | (nodules) evaluation based on clinical evidence.          |     |
+----+-----------------------------------------------------------+-----+
| 6  | Regional lymph nodes, satellite nodule(s) or in-transit   | y   |
|    | metastases (nodules) removed for examination WITH         |     |
|    | pre-surgical systemic treatment or radiation, and lymph   |     |
|    | node(s), satellite nodule(s) or in-transit metastases     |     |
|    | (nodules) evaluation based on pathologic evidence.        |     |
+----+-----------------------------------------------------------+-----+
| 8  | Evidence from autopsy; tumor was unsuspected or           | a   |
|    | undiagnosed prior to autopsy.                             |     |
+----+-----------------------------------------------------------+-----+
| 9  | Unknown if lymph nodes, satellite nodule(s) or in-transit | c   |
|    | metastases (nodules) removed for examination              |     |
|    |                                                           |     |
|    | Not assessed; cannot be assessed                          |     |
|    |                                                           |     |
|    | Unknown if assessed                                       |     |
|    |                                                           |     |
|    | Not documented in patient record                          |     |
+----+-----------------------------------------------------------+-----+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**Reg LN Pos**

**Note 1:  ** Record this field even if there has been preoperative
treatment.

**Note 2:  ** Although satellite nodules and in-transit metastasis are
coded under CS Lymph Nodes, DO NOT count as Reg LN Pos in this field.

  ------- ---------------------------------------------------------------
  Code    Description

  00      All nodes examined negative.
  ------- ---------------------------------------------------------------

+------+---------------------------------------------------------------+
| 0    | 01 - 89 nodes positive (code exact number of nodes positive)  |
| 1-89 |                                                               |
+------+---------------------------------------------------------------+
| 90   | 90 or more nodes positive                                     |
+------+---------------------------------------------------------------+
| 95   | Positive aspiration of lymph node(s)                          |
+------+---------------------------------------------------------------+
| 97   | Positive nodes - number unspecified                           |
+------+---------------------------------------------------------------+
| 98   | No nodes examined                                             |
+------+---------------------------------------------------------------+
| 99   | Unknown if nodes are positive; not applicable                 |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**Reg LN Exam**

**Note:  ** Although satellite nodules and in-transit metastasis are
coded under CS Lymph Nodes, DO NOT count as Reg LN Exam in this field.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 00   | No nodes examined                                             |
+------+---------------------------------------------------------------+
| 0    | 01 - 89 nodes examined (code exact number of regional lymph   |
| 1-89 | nodes examined)                                               |
+------+---------------------------------------------------------------+
| 90   | 90 or more nodes examined                                     |
+------+---------------------------------------------------------------+
| 95   | No regional nodes removed, but aspiration of regional nodes   |
|      | performed                                                     |
+------+---------------------------------------------------------------+
| 96   | Regional lymph node removal documented as sampling and number |
|      | of nodes unknown/not stated                                   |
+------+---------------------------------------------------------------+
| 97   | Regional lymph node removal documented as dissection and      |
|      | number of nodes unknown/not stated                            |
+------+---------------------------------------------------------------+
| 98   | Regional lymph nodes surgically removed but number of lymph   |
|      | nodes unknown/not stated and not documented as sampling or    |
|      | dissection; nodes examined, but number unknown                |
+------+---------------------------------------------------------------+
| 99   | Unknown if nodes were examined; not applicable or negative    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Mets at DX**

+-----+-------------------------------------------+-----+-----+-----+
| C   | Description                               | TNM | S   | SS2 |
| ode |                                           |     | S77 | 000 |
+-----+-------------------------------------------+-----+-----+-----+
| 00  | No; none                                  | M0  | N   | N   |
|     |                                           |     | ONE | ONE |
+-----+-------------------------------------------+-----+-----+-----+
| 05  | Underlying cartilage, bone, skeletal      | \*  | D   | D   |
|     | muscle                                    |     |     |     |
+-----+-------------------------------------------+-----+-----+-----+
| 10  | Distant lymph node(s)                     | \*  | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 40  | Distant metastasis, NOS                   | \*  | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 42  | Metastatases to skin or subcutaneous      | \*  | D   | D   |
|     | tissue beyond regional lymph nodes        |     |     |     |
+-----+-------------------------------------------+-----+-----+-----+
| 43  | Lung                                      | \*  | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 44  | Other distant metastases                  | M1c | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 52  | \(10\) + (42)                             | \*  | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 53  | \(10\) + (43)                             | \*  | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 54  | \(10\) + (44)                             | M1c | D   | D   |
+-----+-------------------------------------------+-----+-----+-----+
| 99  | Unknown                                   | MX  | U   | U   |
|     |                                           |     |     |     |
|     | Distant metastasis cannot be assessed     |     |     |     |
|     |                                           |     |     |     |
|     | Not documented in patient record          |     |     |     |
+-----+-------------------------------------------+-----+-----+-----+

\*For codes 05, 10, 40, 42, 43, 52 and 53 ONLY, the M category is
assigned based on the status of serum LDH as coded in Site-Specific
Factor 4 LDH table and shown in the Special Mets at DX and LDH table.

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 1 Measured Thickness (Depth), Breslow\'s
Measurement**

**Note:  ** Code MEASURED THICKNESS (Depth) of tumor (Breslow\'s
measurement), not size. Record actual thickness measurement in hundreths
of millimeters from the pathology report.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No mass/tumor found                                           |
+------+---------------------------------------------------------------+
| 001  | 0.01 - 9.88 millimeters                                       |
| -988 |                                                               |
|      | Code exact measurement in HUNDREDTHS of millimeters.          |
|      |                                                               |
|      | Examples:                                                     |
|      |                                                               |
|      | Code Measured thickness                                       |
|      |                                                               |
|      | 001 0.01 millimeter                                           |
|      |                                                               |
|      | 002 0.02 millimeters                                          |
|      |                                                               |
|      | 010 0.1 millimeter                                            |
|      |                                                               |
|      | 074 0.74 millimeters                                          |
|      |                                                               |
|      | 100 1 millimeters                                             |
|      |                                                               |
|      | 105 1.05 millimeters                                          |
|      |                                                               |
|      | 988 9.88 millimeters                                          |
+------+---------------------------------------------------------------+
| 989  | 9.89 millimeters or larger                                    |
+------+---------------------------------------------------------------+
| 990  | OBSOLETE See Code 999                                         |
+------+---------------------------------------------------------------+
| 999  | Microinvasion; microscopic focus or foci only; no size given  |
+------+---------------------------------------------------------------+
|      | Not documented in patient record                              |
|      |                                                               |
|      | Unknown; measured thickness not stated                        |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 2 Ulceration**

**Note 1:  ** Melanoma ulceration is the absence of an intact epidermis
overlying the primary melanoma based upon histopathological examination.

**NOte 2:  ** If the pathology report does not mention ulceration in
diagnosis, No Ulceration Present, code 000.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No ulceration present                                         |
+------+---------------------------------------------------------------+
| 001  | Ulceration present                                            |
+------+---------------------------------------------------------------+
| 999  | Unknown                                                       |
|      |                                                               |
|      | Not stated                                                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 3 Clinical Status of Lymph Node Mets**

**Note:** Use code 000, No lymph node metastases, if either: A) there is
no lymph node involvement, i.e., CS Lymph Nodes is coded 00, or B) there
are satellite nodules or in-transit metastases, but no regional lymph
node metastases, i.e., CS Lymph Nodes is coded 13-15.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No lymph node metastases                                      |
+------+---------------------------------------------------------------+
| 001  | Clinically occult (microscopic) lymph node metastases only    |
+------+---------------------------------------------------------------+
| 002  | Clinically apparent (macroscopic) lymph node metastases       |
+------+---------------------------------------------------------------+
| 999  | Unknown                                                       |
|      |                                                               |
|      | Not stated                                                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 4 LDH**

**Note:  ** Per AJCC, \"An elevated serum LDH should be used only when
there are 2 or more determinations obtained more than 24 hours apart,
because an elevated serum LDH on a single determination can be falsely
positive as a result of hemolysis or other factors unrelated to melanoma
metastases.\"

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | Test not done, test was not ordered and was not performed     |
+------+---------------------------------------------------------------+
| 002  | Within normal limits                                          |
+------+---------------------------------------------------------------+
| 004  | Range 1 less than 1.5 x upper limit of normal for LDH assay   |
|      |                                                               |
|      | Stated as elevated, NOS                                       |
+------+---------------------------------------------------------------+
| 005  | Range 2 1.5 - 10 x upper limit of normal for LDH assay        |
+------+---------------------------------------------------------------+
| 006  | Range 3 more than 10 x upper limit of normal for LDH assay    |
+------+---------------------------------------------------------------+
| 008  | Ordered, but results not in chart                             |
+------+---------------------------------------------------------------+
| 999  | Unknown                                                       |
|      |                                                               |
|      | Not stated                                                    |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Malignant Melanoma of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**Skin**

**C440--C449**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser ablation

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 Local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

\[***SEER Notes:*** Code UVB phototherapy for mycosis fungoides
primaries under Surgery of Primary Site for

skin. Assign code 11 if there is no pathology specimen. Assign code 21
if there is a pathology specimen.

Codes 20-27 include shave and wedge resection\]

30 **Biopsy** of primary tumor **followed** **by** a **gross excision**
of the lesion (does not have to be done under the same anesthesia)

31 Shave biopsy followed by a gross excision of the lesion

32 Punch biopsy followed by a gross excision of the lesion

33 Incisional biopsy followed by a gross excision of the lesion

34 Mohs surgery, NOS

35 Mohs with 1-cm margin or less

36 Mohs with more than 1-cm margin

\[***SEER Notes:*** Codes 30 to 33 include less than a wide excision,
less than 1 cm margin or margins are

unknown. If it is stated to be a **wide excision** or **reexcision**,
but the **margins are unknown**, code to 30. Code 45 represents a wide
excision in which it is known that the margins of excision are greater
than 1 cm.\]

45 **Wide excision** or **reexcision** of lesion or **minor** (local)
**amputation** with margins more than 1 cm, NOS. Margins MUST be
microscopically negative.

46 WITH margins more than 1 cm and less than or equal to 2 cm

47 WITH margins greater than 2 cm

If the excision does not have microscopically negative margins greater
than 1 cm, use the appropriate code, 20-36.

60 Major amputation

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
C310--C319, C339, C379, C380--C388, C390--C399, C480--C488, C510--C519,
C529, C570--C579, C589, **C600--C609, C630--C639,** C680--C689,
C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor excision,
26 Polypectomy or

27 Excisional biopsy with 21 PDT, 22 Electrocautery, 23 Cryosurgery,
24 Laser ablation, or

25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**Collaborative Staging Codes**

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**(M-9700-9701)**\
**C44.0-C44.9, C51.0-C51.2, C51.8-C51.9, C60.0-C60.2, C60.8-C60.9,
C63.2**

C44.0 Skin of lip, NOS

C44.1 Eyelid

C44.2 External ear

C44.3 Skin of ear and unspecified parts of face

C44.4 Skin of scalp and neck

C44.5 Skin of trunk

C44.6 Skin of upper limb and shoulder

C44.7 Skin of lower limb and hip

C44.8 Overlapping lesion of skin

C44.9 Skin, NOS

C51.0 Labium majus

C51.1 Labium minus

C51.2 Clitoris

C51.8 Overlapping lesion of vulva

C51.9 Vulva, NOS

C60.0 Prepuce

C60.1 Glans penis

C60.2 Body of penis

C60.8 Overlapping lesion of penis

C60.9 Penis

C63.2 Scrotum, NOS

**Note 1:  ** Laterality must be coded for C44.1-C44.3 and C44.5-C44.7.
For codes C44.3 and C44.5, if the tumor is midline (e.g., chin), code as
9 (midline) in the laterality field.

**Note 2:  ** Source: Developed by the Mycosis Fungoides Cooperative
Group (MFCG)

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -**        | tables are          |   |
| | CS TS/Ext-Eval\     | Peripheral Blood    | available at the    |   |
| | CS Lymph Nodes\     | Involvement\        | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 2\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 3\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage          |   |
| |                     | Factor 4\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 5\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Extension**

**Note 1:  ** In approximating body surface, the palmar surface of the
hand, including digits, is about 1%.

**Note 2:  ** Use code 25 when skin involvement is present but only a
general location/site is mentioned (i.e., face, legs, torso, arms). Use
code 30 when there is skin involvement but there is no mention of
location/site.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Plaques, papules, or erythematous        | T1   | L    | L    |
|      | patches plaque stage\"):                 |      |      |      |
|      |                                          |      |      |      |
|      | Less than 10% of skin surface, no tumors |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 10,  | Limited plaques/patches                  |      |      |      |
|      |                                          |      |      |      |
| Co   | MFCG Stage I                             |      |      |      |
| nt'd |                                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Plaques, papules, or erythematous        | T2   | L    | L    |
|      | patches (\"plaque stage\"):              |      |      |      |
|      |                                          |      |      |      |
|      | Greater than or equal to 10% of skin     |      |      |      |
|      | surface, no tumors                       |      |      |      |
|      |                                          |      |      |      |
|      | Generalized plaques/patches              |      |      |      |
|      |                                          |      |      |      |
|      | MFCG Stage II                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 25   | Plaques, papules, or erythematous        | T2   | L    | L    |
|      | patches (\"plaque stage\"):              |      |      |      |
|      |                                          |      |      |      |
|      | \% or body surface not stated, no tumors |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Skin involvement, NOS:                   | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Extent not stated, no tumors             |      |      |      |
|      |                                          |      |      |      |
|      | Localized, NOS                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | One or more tumors (tumor stage)         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Cutaneous tumors                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Generalized erythroderma (greater than   | T4   | RE   | RE   |
|      | 50% of body involved with diffuse        |      |      |      |
|      | redness)                                 |      |      |      |
|      |                                          |      |      |      |
|      | Sezary syndrome/Sezary disease           |      |      |      |
|      |                                          |      |      |      |
|      | MFGC Stage III                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Lymph Nodes**

**Note:  ** For this site, code ALL lymph node (regional and distant)
involvement in this field.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Clinically enlarged palpable lymph       | N1   | RN   | RN   |
|      | node(s) (adenopathy), and either         |      |      |      |
|      | pathologically negative nodes or no      |      |      |      |
|      | pathological statement                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | No clinically enlarged palpable lymph    | N2   | RN   | RN   |
|      | node(s) (adenopathy); pathologically     |      |      |      |
|      | positive lymph node(s)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Both clinically enlarged palpable lymph  | N3   | RN   | RN   |
|      | node(s) (adenopathy) and pathologically  |      |      |      |
|      | positive lymph node(s)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Mets at DX**

**Note:  ** For this site, code ALL lymph node (regional and distant)
involvement in the CS Lymph Nodes field.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 40   | Visceral (non-cutaneous, extra nodal)    | M1   | D    | D    |
|      | involvement:                             |      |      |      |
|      |                                          |      |      |      |
|      | MFCG Stage IV                            |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | MX   | U    | U    |
|      |                                          |      |      |      |
|      | Distant metastasis cannot be assessed    |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 1 Peripheral Blood Involvement**

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | No peripheral blood involvement                               |
|      |                                                               |
|      | Less than 1000 Sezary cells                                   |
+------+---------------------------------------------------------------+
| 001  | Atypical circulating cells in peripheral blood:               |
|      |                                                               |
|      | Less than 5%                                                  |
|      |                                                               |
|      | Greater than or equal to 1000 Sezary cells                    |
+------+---------------------------------------------------------------+
| 002  | Atypical circulating cells in peripheral blood:               |
|      |                                                               |
|      | Greater than 5%                                               |
+------+---------------------------------------------------------------+
| 003  | \% not stated                                                 |
+------+---------------------------------------------------------------+
| 999  | Insufficient information                                      |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Site-Specific Surgery Codes**

**Skin**

**C440--C449**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser ablation

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 Local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

> \[***SEER Notes:*** Code UVB phototherapy for mycosis fungoides
> primaries under Surgery of Primary Site for skin. Assign code 11 if
> there is no pathology specimen. Assign code 21 if there is a pathology
> specimen.
>
> Codes 20-27 include shave and wedge resection\]

30 **Biopsy** of primary tumor **followed** **by** a **gross excision**
of the lesion (does not have to be done under the same anesthesia)

31 Shave biopsy followed by a gross excision of the lesion

32 Punch biopsy followed by a gross excision of the lesion

33 Incisional biopsy followed by a gross excision of the lesion

34 Mohs surgery, NOS

35 Mohs with 1-cm margin or less

36 Mohs with more than 1-cm margin

> \[***SEER Notes:*** Codes 30 to 33 include less than a wide excision,
> less than 1 cm margin or margins are unknown. If it is stated to be a
> **wide excision** or **reexcision**, but the **margins are unknown**,
> code to 30. Code 45 represents a wide excision in which it is known
> that the margins of excision are greater than 1 cm.\]

45 **Wide excision** or **reexcision** of lesion or **minor** (local)
**amputation** with margins more than 1 cm, NOS. Margins MUST be
microscopically negative.

46 WITH margins more than 1 cm and less than or equal to 2 cm

47 WITH margins greater than 2 cm

If the excision does not have microscopically negative margins greater
than 1 cm, use the appropriate code, 20-36.

60 Major amputation

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
C310--C319, C339, C379, C380--C388, C390--C399, C480--C488,
**C510--C519**, C529, C570--C579, C589, **C600--C609**, **C630--C639**,
C680--C689, C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

\[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor excision,
26 Polypectomy or 27 Excisional biopsy with 21 PDT, 22 Electrocautery,
23 Cryosurgery, 24 Laser ablation, or 25 Laser excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

**Page left blank**

**SEER Site-Specific Coding Guidelines**

**BONES, JOINTS, AND ARTICULAR CARTILAGE C400--C419**

**PERIPHERAL NERVES AND AUTONOMIC NERVOUS SYSTEM C470--C479**

**CONNECTIVE, SUBCUTANEOUS, AND OTHER SOFT TISSUES C490--C499**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Three Grade System (Nuclear Grade)

There are several sites for which a three-grade system is used. The
patterns of cell growth are measured on a scale of 1, 2, and 3 (also
referred to as low, medium, and high grade). This system measures the
proportion of cancer cells that are growing and making new cells and how
closely they resemble the cells of the host tissue. Thus, it is similar
to a four-grade system, but simply divides the spectrum into three
rather than four categories (see comparison table below). The expected
outcome is more favorable for lower grades. Soft tissue sarcomas are
evaluated using a three-grade system.

If a grade is written as 2/3 that means this is a grade 2 of a
three-grade system. Do not simply code the numerator. Use the following
table to convert the grade to SEER codes.

  -----------------------------------------------------------------------
  Term            Grade                            SEER Code
  --------------- -------------------------------- ----------------------
  1/3, 1/2        Low grade                        2

  2/3             Intermediate grade               3

  3/3, 2/2        High grade                       4
  -----------------------------------------------------------------------

#  

# Page left blank 

# Sarcoma

Sarcomas are graded low, intermediate or high grade by the pathologist.
Use the following table to convert these terms to a histologic grade.

  -----------------------------------------------------------------------
  Term                                            Grade    SEER Code
  ----------------------------------------------- -------- --------------
  Well differentiated                             I        1

                                                           

  Fairly well differentiated                      II       2

  Low grade                                       I-II     2

  Mid differentiated                              II       2

  Moderately differentiated                       II       2

  Partially differentiated                        II       2

  Partially well differentiated                   I-II     2

  Partially well differentiated                   II       2

  Relatively or generally well differentiated     II       2

                                                           

  Medium grade, intermediate grade                II-III   3

  Moderately poorly differentiated                III      3

  Moderately undifferentiated                     III      3

  Pleomorphic                                     III      3

  Poorly differentiated                           III      3

  Relatively poorly differentiated                III      3

  Relatively undifferentiated                     III      3

  Slightly differentiated                         III      3

                                                           

  High grade                                      III-IV   4

  Undifferentiated, anaplastic, not               IV       4
  differentiated                                           
  -----------------------------------------------------------------------

**Page left blank**

**Collaborative Staging Codes**

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**C47.0-C47.6, C47.8-C47.9, C49.0-C49.6, C49.8-C49.9**

C47.0 Peripheral nerves and autonomic nervous system of head, face and
neck

C47.1 Peripheral nerves and autonomic nervous system of upper limb and
shoulder

C47.2 Peripheral nerves and autonomic nervous system of lower limb and
hip

C47.3 Peripheral nerves and autonomic nervous system of thorax

C47.4 Peripheral nerves and autonomic nervous system of abdomen

C47.5 Peripheral nerves and autonomic nervous system of pelvis

C47.6 Peripheral nerves and autonomic nervous system of trunk, NOS

C47.8 Overlapping lesion of peripheral nerves and autonomic nervous
system

C47.9 Autonomic nervous system, NOS

C49.0 Connective, subcutaneous and other soft tissues of head, face, and
neck

C49.1 Connective, subcutaneous and other soft tissues of upper limb and
shoulder

C49.2 Connective, subcutaneous and other soft tissues of lower limb and
hip

C49.3 Connective, subcutaneous and other soft tissues of thorax

C49.4 Connective, subcutaneous and other soft tissues of abdomen

C49.5 Connective, subcutaneous and other soft tissues of pelvis

C49.6 Connective, subcutaneous and other soft tissues of trunk

C49.8 Overlapping lesion of connective, subcutaneous and other soft
tissues

C49.9 Connective, subcutaneous and other soft tissues, NOS

**Note 1:  ** Laterality must be coded for C47.1-C47.2 and C49.1-C49.2.

**Note 2:  ** Soft tissue sarcomas of the heart and mediastinum
(C38.0-C38.3 and C38.9) use the Heart, Mediastinum schema.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage\         |   |
| |                     | Factor 5\           | Special Extension   |   |
| |                     | CS Site-Specific    | Size Table 1\       |   |
| |                     | Factor 6            | Special Extension   |   |
| |                     |                     | Size Table 2\       |   |
| |                     |                     | Special Extension   |   |
| |                     |                     | Size Table 3        |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Extension**

**Note 1:  ** Connective tissue includes adipose tissue; aponeuroses;
arteries; blood vessels; bursa; connective tissue, NOS; fascia; fatty
tissue; fibrous tissue; ligaments; lymphatic channels (not nodes);
muscle; skeletal muscle; subcutaneous tissue; synovia; tendons; tendon
sheaths; veins; and vessels, NOS. Peripheral nerves and autonomic
nervous system includes: ganglia, nerve, parasympathetic nervous system,
peripheral nerves, spinal nerves, sympathetic nervous system.

**Note 2:  ** If a vessel has a name, for example, brachial artery or
recurrent laryngeal nerve, consider it a structure (code 60).

**Note 3:  ** For tumors of the extremities and trunk ONLY, superficial
lesions are defined as those not involving the superficial muscular
fascia. Deep lesions are those that involve or are beneath the
superficial fascia.

**Note 4:  ** According to AJCC, \"All intraperitoneal visceral lesions,
retroperitoneal lesions, and intrathoracic lesions, and the majority of
head and neck tumors are considered deep.\" For coding extension of soft
tissue tumors in these sites (C47.0, C47.3-5, C49.0, C49.3-5), use only
codes 12, 32, 42, 62, 80, 95, or 99.

**Note 5:  ** Definition of Adjacent Connective Tissue: Some of the
schemes for ill-defined or non-specific sites in this manual contain a
code 40, adjacent connective tissue, which is defined here as the
unnamed tissues that immediately surround an organ or structure
containing a primary cancer. Use this code when a tumor has invaded past
the outer border (capsule, serosa, or other edge) of the primary organ
into the organ\'s surrounding supportive structures but has not invaded
into larger structures or adjacent organs. In general, these tissues do
not have specific names. These tissues form the framework of many
organs, provide support to hold organs in place, bind tissues and organs
together, and serve as storage sites for nutrients. Blood, cartilage and
bone are sometimes considered connective tissues, but in this manual
they are listed separately.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to site/tissue   | \*   | L    | L    |
|      | of origin, NOS                           | \*\* |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Superficial invasive tumor confined to   | \*   | L    | L    |
|      | site/tissue of origin (lesion does not   |      |      |      |
|      | involve superficial fascia)              |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Deep tumor confined to site/tissue of    | \*\* | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
|      |                                          | \*\* |      |      |
+------+------------------------------------------+------+------+------+
| 31   | Superficial: localized tumor, NOS        | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 32   | Deep: localized tumor, NOS               | \*\* | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue (see Note 5)  | \*   | RE   | RE   |
|      |                                          | \*\* |      |      |
+------+------------------------------------------+------+------+------+
| 41   | Superficial tumor involving adjacent     | \*   | RE   | RE   |
|      | connective tissue                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Deep tumor involving adjacent connective | \*\* | RE   | RE   |
|      | tissue                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures including     | \*   | RE   | RE   |
|      | bone/cartilage (including major vessel   | \*\* |      |      |
|      | invasion) (see Note 5)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Superficial tumor involving adjacent     | \*   | RE   | RE   |
|      | organs/structures including              |      |      |      |
|      | bone/cartilage (including major vessel   |      |      |      |
|      | invasion) (see Note 5)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Deep tumor involving adjacent            | \*\* | RE   | RE   |
|      | organs/structures including              |      |      |      |
|      | bone/cartilage (including major vessel   |      |      |      |
|      | invasion) (see Note 5)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | \*\* | D    | D    |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For Extension codes 11, 31, 41, and 61 ONLY, the T category is
assigned based on the value of CS Tumor Size as shown in the Special
Extension Size Table 1 for this site.

\*\* For Extension codes 12, 32, 42, 62 and 80 ONLY, the T category is
assigned based on the value of CS Tumor Size as shown in the Special
Extension Size Table 2 for this site.

\*\*\* For Extension codes 10, 30, 40, and 60 ONLY, the T category is
assigned based on the value of CS Tumor Size as shown in the Special
Extension Size Table 3 for this site.

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Lymph Nodes**

**Note 1:  ** Regional lymph nodes are defined as those in the vicinity
of the primary tumor.

**Note 2:  ** Regional lymph node involvement is rare. For this schema,
if there is no mention of lymph node involvement clinically, assume that
lymph nodes are negative (code 00). Use code 99 (Unknown) only when
there is no available information on the extent of the patient\'s
disease, for example, when a lab-only case is abstracted from a biopsy
report and no clinical history is available.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s) by primary site   | N1   | RN   | RN   |
|      | (bilateral or contralateral for head,    |      |      |      |
|      | neck, trunk)                             |      |      |      |
|      |                                          |      |      |      |
|      | Head and Neck:                           |      |      |      |
|      |                                          |      |      |      |
|      | All subsites: Cervical, NOS              |      |      |      |
|      |                                          |      |      |      |
|      | Lip:                                     |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Eyelid/canthus:                          |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | External ear and auditory canal:         |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (posterior, retro-auricular)     |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Face, Other (cheek, chin, forehead, jaw, |      |      |      |
|      | nose and temple):                        |      |      |      |
|      |                                          |      |      |      |
|      | Facial, NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Scalp:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (posterior, retro-auricular)     |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory (posterior cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Neck:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid (posterior, retro-auricular)     |      |      |      |
|      | (occipital)                              |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS:                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 10,  | Parotid, NOS:                            |      |      |      |
|      |                                          |      |      |      |
| co   | Infra-auricular                          |      |      |      |
| nt'd |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory (posterior cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Arm/shoulder:                            |      |      |      |
|      |                                          |      |      |      |
|      | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory for shoulder            |      |      |      |
|      |                                          |      |      |      |
|      | Epitrochlear for hand/forearm            |      |      |      |
|      |                                          |      |      |      |
|      | Leg/hip:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Femoral (superficial inguinal)           |      |      |      |
|      |                                          |      |      |      |
|      | Popliteal for heel and calf              |      |      |      |
|      |                                          |      |      |      |
|      | Thorax:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Hilar (bronchopulmonary) (proximal       |      |      |      |
|      | lobar)                                   |      |      |      |
|      |                                          |      |      |      |
|      | (pulmonary root)                         |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal                              |      |      |      |
|      |                                          |      |      |      |
|      | Abdomen:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Iliac                                    |      |      |      |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Pelvis:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Deep inguinal, NOS:                      |      |      |      |
|      |                                          |      |      |      |
|      | Rosenmuller or Cloquet node              |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper trunk:                             |      |      |      |
|      |                                          |      |      |      |
|      | Axillary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Cervical                                 |      |      |      |
|      |                                          |      |      |      |
|      | Internal mammary                         |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Lower trunk:                             |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
|      |                                          |      |      |      |
|      | All sites:                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Submental nodes for neck primary only    | N1   | D    | RN   |
|      | (bilateral or contralateral)             |      |      |      |
+------+------------------------------------------+------+------+------+
| 15   | Neck primary only: (10) + (12)           | N1   | D    | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown (see Note 2)                     | NX   | U    | U    |
+------+------------------------------------------+------+------+------+

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**

**CS Reg Nodes Eval**

**SEE STANDARD TABLE**

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Mets at DX**\
**SEE STANDARD TABLE**\
\
**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Peripheral Nerves and Autonomic Nervous System; Connective,
Subcutaneous, and Other Soft Tissues**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Collaborative Staging Codes**

**Retroperitoneum and Peritoneum**\
**C48.0-C48.2, C48.8**

C48.0 Retroperitoneum

C48.1 Specified parts of peritoneum (including omentum and mesentery)

C48.2 Peritoneum, NOS

C48.8 Overlapping lesion of retroperitoneum and peritoneum

**Note:  ** AJCC includes these sites with soft tissue sarcomas
(C47.0-C48.9)

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | CS Site-Specific    | The following       |   |
| | CS Extension\       | Factor 1\           | tables are          |   |
| | CS TS/Ext-Eval\     | CS Site-Specific    | available at the    |   |
| | CS Lymph Nodes\     | Factor 2\           | collaborative       |   |
| | CS Reg Nodes Eval\  | CS Site-Specific    | staging website:    |   |
| | Reg LN Pos\         | Factor 3\           |                     |   |
| | Reg LN Exam\        | CS Site-Specific    | Histology Exclusion |   |
| | CS Mets at DX\      | Factor 4\           | Table\              |   |
| | CS Mets Eval        | CS Site-Specific    | AJCC Stage\         |   |
| |                     | Factor 5\           | Extension Size      |   |
| |                     | CS Site-Specific    | Table               |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Retroperitoneum and Peritoneum**\
**CS Tumor Size**\
**SEE STANDARD TABLE**

**Retroperitoneum and Peritoneum**\
**CS Extension**

**Note:  ** For AJCC TNM staging, all retroperitoneal lesions are
considered deep lesions.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Tumor confined to site of origin         | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue see           | \*   | RE   | RE   |
|      | definition of adjacent connective tissue |      |      |      |
|      | in General Instructions.                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures including     | \*   | RE   | RE   |
|      | bone/cartilage                           |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum:                         |      |      |      |
|      |                                          |      |      |      |
|      | Adrenal(s) (suprarenal gland(s))         |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Ascending colon                          |      |      |      |
|      |                                          |      |      |      |
|      | Descending colon                         |      |      |      |
|      |                                          |      |      |      |
|      | Kidney(s)                                |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Vena cava                                |      |      |      |
|      |                                          |      |      |      |
|      | Vertebra                                 |      |      |      |
|      |                                          |      |      |      |
|      | Peritoneum:                              |      |      |      |
|      |                                          |      |      |      |
|      | Colon (except ascending and descending   |      |      |      |
|      | colon)                                   |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus                                |      |      |      |
|      |                                          |      |      |      |
|      | Gallbladder                              |      |      |      |
|      |                                          |      |      |      |
|      | Liver                                    |      |      |      |
|      |                                          |      |      |      |
|      | Small intestine                          |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | \*   | D    | D    |
|      |                                          |      |      |      |
|      | For retroperitoneum: extension to colon  |      |      |      |
|      | other than ascending or                  |      |      |      |
|      |                                          |      |      |      |
|      | descending                               |      |      |      |
|      |                                          |      |      |      |
|      | For peritoneum: extension to ascending   |      |      |      |
|      | or descending colon                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 95   | No evidence of primary tumor             | T0   | U    | U    |
+------+------------------------------------------+------+------+------+
| 99   | Unknown extension                        | TX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For codes 10-80 ONLY, the T category is assigned based on value of CS
Tumor Size, as shown in the Extension Size Table for this site.

**Retroperitoneum and Peritoneum**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Retroperitoneum and Peritoneum**\
**CS Lymph Nodes**

**Note 1:  ** Regional lymph nodes are defined as those in the vicinity
of the primary tumor.

**Note 2:  ** Regional lymph node involvement is rare. For this schema,
if there is no mention of lymph node involvement clinically, assume that
lymph nodes are negative (code 00). Use code 99 (Unknown) only when
there is no available information on the extent of the patient\'s
disease, for example, when a lab-only case is abstracted from a biopsy
report and no clinical history is available.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Intra-abdominal                          |      |      |      |
|      |                                          |      |      |      |
|      | Paracaval                                |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic                                   |      |      |      |
|      |                                          |      |      |      |
|      | Subdiaphragmatic                         |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Lymph nodes, NOS                         | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown (see Note 2)                     | NX   | U    | U    |
+------+------------------------------------------+------+------+------+

**Retroperitoneum and Peritoneum**\
**CS Reg Nodes Eval**

**SEE STANDARD TABLE**

**Retroperitoneum and Peritoneum**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Retroperitoneum and Peritoneum**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Retroperitoneum and Peritoneum**\
**CS Mets at DX**\
**SEE STANDARD TABLE**\
\
**Retroperitoneum and Peritoneum**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 1**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 2**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 3**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 4**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 5**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

**Retroperitoneum and Peritoneum**\
**CS Site-Specific Factor 6**

  ------- ---------------------------------------------------------------
  Code    Description

  888     Not applicable for this site
  ------- ---------------------------------------------------------------

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**Site-Specific Surgery Codes**

**BONES, JOINTS, AND ARTICULAR CARTILAGE C400--C419**

**PERIPHERAL NERVES AND AUTONOMIC NERVOUS SYSTEM C470--C479**

**CONNECTIVE, SUBCUTANEOUS, AND OTHER SOFT TISSUES C490--C499**

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

19 Local tumor destruction or excision, NOS

**Unknown** whether a specimen was sent to **pathology** for surgical
events coded 19 (Principally

for cases diagnosed prior to January 1, 2003)

15 Local tumor destruction

**No** specimen sent to **pathology** from surgical event 15

25 Local excision

[]{.mark}

26 Partial resection

**Specimen** sent to **pathology** from surgical events 25--26

30 **Radical** **excision** or **resection** of lesion WITH limb salvage

40 Amputation of limb

41 Partial amputation of limb

42 Total amputation of limb

50 Major amputation, NOS

51 Forequarter, including scapula

52 Hindquarter, including ilium/hip bone

53 Hemipelvectomy, NOS

54 Internal hemipelvectomy

90 Surgery, NOS

99 **Unknown** if surgery performed; **death certificate** ONLY

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**Site-Specific Surgery Codes**

**All Other Sites**

C142--C148, C170--C179, C239, C240--C249, C260--C269, C300--C301,
C310--C319, C339, C379, C380--C388, C390--C399, **C480--C488,**
C510--C519, C529, C570--C579, C589, C600--C609, C630--C639, C680--C689,
C690--C699, C740--C749, C750--C759

(Except for M-9750, 9760-9764, 9800-9820, 9826, 9831-9920, 9931-9964,
9980-9989)

Codes

00 None; **no** **surgery** of primary site; **autopsy** ONLY

10 Local tumor destruction, NOS

11 Photodynamic therapy (PDT)

12 Electrocautery; fulguration (includes use of hot forceps for tumor
destruction)

13 Cryosurgery

14 Laser

**No** specimen sent to **pathology** from surgical events 10--14

20 **Local** tumor **excision**, NOS

26 Polypectomy

27 Excisional biopsy

Any **combination** of **20** or **26--27** WITH

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

> \[***SEER Note:*** Codes 21 to 25 above combine 20 local tumor
> excision, 26 Polypectomy or 27 Excisional biopsy with 21 PDT,
> 22 Electrocautery, 23 Cryosurgery, 24 Laser ablation, or 25 Laser
> excision\]

**Specimen** sent to **pathology** from surgical events 20--27

30 Simple/partial surgical removal of primary site

40 **Total surgical removal** of primary site; enucleation

41 Total enucleation (for eye surgery only)

50 Surgery stated to be "**debulking**"

60 Radical surgery

Partial or total removal of the primary site WITH a resection in
continuity (partial or total removal) with other organs

\[***SEER Note:*** In continuity with or "en bloc" means that all of the
tissues were removed during the same procedure, but not necessarily in a
single specimen\]

90 Surgery, NOS

99 **Unknown** if surgery performed; **death** **certificate** ONLY

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