# Appendix C

# 

# Site-Specific Coding Modules

# 

#  

# 

# 

**Table of Contents**

**Site-Specific Coding Modules** C-1

Lip, Upper C-3

Lip, Lower C-11

Other Lip C-19

Base of Tongue, Lingual Tonsil C-29

Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS C-37

Gum, Upper C-47

Gum, Lower and Retromolar Area Retromolar Gingiva (Trigone) C-55

Gum, NOS C-63

Floor of Mouth C-71

Hard Palate C-83

Soft Palate, Uvula C-91

Other Mouth C-101

Cheek (Buccal) Mucosa, Vestibule C-109

Parotid Gland C-119

Submandibular Gland C-127

Other and Unspecified Major Salivary Glands C-135

Tonsil, Oropharynx C-145

Anterior Surface of Epiglottis C-155

Nasopharynx C-165

Pyriform Sinus, Hypopharynx, Laryngopharynx C-173

Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites C-181

Esophagus C-193

Small Intestine C-211

Colon C-219

Rectosigmoid, Rectum C-231

Anus Anal Canal; Anus, NOS; Other Parts of Rectum C-239

Liver and Intrahepatic Bile Ducts C-249

Extrahepatic Bile Duct(s) C-261

Ampulla of Vater C-265

Other Biliary and Biliary, NOS C-269

Pancreas: Head C-275

Pancreas: Body and Tail C-281

Pancreas: Other and Unspecified C-287

Other and Ill-Defined Digestive Organs C-291

Nasal Cavity C-299

Middle Ear C-307

Maxillary Sinus C-317

Ethmoid Sinus C-325

Accessory (Paranasal) Sinuses C-333

Glottic Larynx C-343

Supraglottic Larynx C-351

Subglottic Larynx C-359

Larynx C-367

Trachea C-377

Lung C-383

Heart, Mediastinum C-395

Pleura C-399

Other and Ill-Defined Respiratory Sites and Intrathoracic Organs C-405

Bone C-411

Skin C-419

Skin of Eyelid C-425

Malignant Melanoma of Skin, Vulva, Penis, Scrotum C-431

Mycosis Fungoides and Sezary Disease of Skin, Vulva, Penis, Scrotum
C-443

Peripheral Nerves and Autonomic Nervous System; Connective,

Subcutaneous, and Other Soft Tissues C-455

Retroperitoneum and Peritoneum C-461

Breast C-469

Vulva C-487

Vagina C-491

Cervix Uteri C-497

Corpus Uteri; Uterus, Nos (Excluding Placenta C-505

Ovary C-513

Fallopian Tube C-521

Broad and Round Ligaments, Parametrium, Uterine Adnexa C-527

Other and Unspecified Female Genital Organs C-533

Placenta C-537

Penis C-545

Prostate C-551

Testis C-565

Other and Unspecified Male Genital Organs C-571

Scrotum C-575

Kidney, Renal Pelvis, and Ureter C-583

Bladder C-595

Urethra C-609

Paraurethral Gland, Overlapping Lesion of Urinary Organs,

and Unspecified Urinary Organs C-613

Conjunctiva C-619

Malignant Melanoma of Conjunctiva C-619

Cornea, Retina, Choroid, Ciliary Body

Iris, Lens, Sclera, Uveal Tract), Eyeball, Overlapping

and Other Eye \[Excluding Melanoma and Retinoblastoma\] C-627

Malignant Melanoma of Iris and Ciliary Body C-631

Malignant Melanoma of Choroid C-637

Malignant Melanoma of Other Eye C-641

Lacrimal Gland C-645

Orbit C-649

Retinoblastoma C-653

Brain \[and Other Parts of Central Nervous System\] C-661

Brain and Cerebral Meninges C-663

Other Parts of Central Nervous System C-669

Thyroid Gland C-675

Thymus, Adrenal (Suprarenal) Gland, and Other Endocrine Glands C-683

Kaposi Sarcoma of All Sites C-691

Lymph Nodes C-699

Hodgkin and Non-Hodgkin Lymphomas of All Sites (Excl. Mycosis Fungoides

and Sezary Disease) C-701

Hematopoietic, Reticuloendothelial, Immunoproliferative,

and Myeloproliferative Neoplasms C-709

# 

# Appendix C

# 

# Site-Specific Coding Modules

The site-specific coding modules are stand-alone coding manuals that
include SEER Coding Guidelines, Collaborative Staging Coding
Instructions and Surgery of Primary Site codes. In the past,
site-specific instructions were scattered throughout the SEER Program
Code Manual. Collaborative Staging and Surgery codes were in two
separate manuals. As part of the SEER commitment to continuing Quality
Improvement, this appendix brings together the site-specific
instructions needed to abstract a case, facilitating efficiency and
accuracy. General instructions in the main manual are applicable in the
absence of site-specific instructions. All modules include collaborative
staging and surgery codes. Some modules include site-specific coding
guidelines in addition to the collaborative staging and surgery codes.
The goal is to have complete stand-alone modules for every anatomic
site. SEER will continue to work toward this goal by enhancing
site-specific guidelines as modules are expanded and revised.

The site-specific coding guidelines contain instructions for various
data items other than collaborative stage and surgery of primary site.
The Guidelines are a collaborative effort between NCI/SEER and the SEER
Quality Control staff from the SEER registries. We gratefully
acknowledge the valuable input provided by the SEER QC staff.

Part II of the Collaborative Staging manual is included in this
appendix. For an introduction to Collaborative Staging, see Part I of
the Collaborative Staging Manual and Coding Instructions, version 1.0.

The surgery codes are based on the American College of Surgeons
Commission on Cancer's *Facility Oncology Registry Data System*,
American College of Surgeons, Chicago, IL, 2004 (FORDS), Appendix B:
Site-specific Surgery Codes (Revised 2004)*.* The surgery codes in this
document are identical to the FORDS manual; only formatting and
annotations may vary. The ***SEER Notes*** that appear in the Surgery
Code sections contain information or instructions not found in FORDS or
that are different from FORDS.

**Page left blank**

Collaborative Staging Codes

## Lip, Upper Lip (Vermilion or Labial Mucosa) C00.0, C00.3

C00.0 External upper lip

C00.3 Mucosa of upper lip

**Note:  ** AJCC includes labial mucosa (C00.3) with buccal mucosa
(C06.0)

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Lip, Upper**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Lip, Upper**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip)                |      |      |      |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Multiple foci                            |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
|      |                                          |      |      |      |
|      | Vermilion surface                        |      |      |      |
|      |                                          |      |      |      |
|      | Superficial extension to:                |      |      |      |
|      |                                          |      |      |      |
|      | Skin of lip                              |      |      |      |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of lip          |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature                              | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Commissure                               |      |      |      |
|      |                                          |      |      |      |
|      | Opposite (both) lip(s)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Gingiva                                  | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Maxilla                                  | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 74   | Upper lip/commissure: Nose               | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 75   | Tongue                                   | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 76   | Skin of face/neck                        | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 77   | Cortical bone (other than code 70)       | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Inferior alveolar nerve                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 50, and 51 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Lip, Upper**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Lip, Upper**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Facial                                   |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Parotid                                  |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Intraparotid                             |      |      |      |
|      |                                          |      |      |      |
|      | Periparotid                              |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
| 11,  |                                          |      |      |      |
|      | Level I node                             |      |      |      |
| co   |                                          |      |      |      |
| nt'd | 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                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Lip, Upper**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Lip, Upper**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Lip, Upper**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Lip, Upper**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Lip, Upper**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Lip, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Upper**\
**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**

## **Lip, Lower Lip (Vermilion or Labial Mucosa) **C00.1, C00.4, C00.6

C00.1 External lower lip

C00.4 Mucosa of lower lip

C00.6 Commissure of lip

**Note:  ** AJCC includes labial mucosa (C00.4) with buccal mucosa
(C06.0)

+-----------------------------------------------------------------------+
| +-------------------+-----------------------+---------------------+   |
| | 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Lip, Lower**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Lip, Lower**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip)                |      |      |      |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Multiple foci                            |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
|      |                                          |      |      |      |
|      | Vermilion surface                        |      |      |      |
|      |                                          |      |      |      |
|      | Superficial extension to:                |      |      |      |
|      |                                          |      |      |      |
|      | Skin of lip                              |      |      |      |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of lip          |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature                              | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Commissure                               |      |      |      |
|      |                                          |      |      |      |
|      | Opposite (both) lip(s)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Gingiva                                  | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Mandible                                 | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 74   | Nose                                     | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 75   | Tongue                                   | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 76   | Skin of face/neck                        | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 77   | Cortical bone (other than code 70)       | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Inferior alveolar nerve                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 50, and 51 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Lip, Lower**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Lip, Lower**\
**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.

+------+------------------------------------------+------+------+------+
| 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 I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Facial: Mandibular                       |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
| 11,  |                                          |      |      |      |
|      | Level II node                            |      |      |      |
| co   |                                          |      |      |      |
| nt'd | 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                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Lip, Lower**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Lip, Lower**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Lip, Lower**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Lip, Lower**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Lip, Lower**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Lip, Lower**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Lower**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Lower**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Lower**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Lower**\
**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                              |
+------+---------------------------------------------------------------+

**Lip, Lower**\
**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

## Other Lip Lip (Vermilion or Labial Mucosa) C00.2, C00.5, C00.8-C00.9

C00.2 External lip, NOS

C00.5 Mucosa of lip, NOS

C00.8 Overlapping lesion of lip

C00.9 Lip, NOS (excludes skin of lip C44.0)

**Note:  ** AJCC includes labial mucosa (C00.5) with buccal mucosa
(C06.0)

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Other Lip**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other Lip**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip)                |      |      |      |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Multiple foci                            |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
|      |                                          |      |      |      |
|      | Vermilion surface                        |      |      |      |
|      |                                          |      |      |      |
|      | Superficial extension to:                |      |      |      |
|      |                                          |      |      |      |
|      | Skin of lip                              |      |      |      |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of lip          |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature                              | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Commissure                               |      |      |      |
|      |                                          |      |      |      |
|      | Opposite (both) lip(s)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Gingiva                                  | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 75   | Tongue                                   | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 76   | Skin of face/neck                        | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 77   | Cortical bone                            | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Inferior alveolar nerve                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 50, and 51 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Other Lip**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Other Lip**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 11,  | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
| co   | Jugulo-omohyoid (supraomohyoid)          |      |      |      |
| nt'd |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

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

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other Lip**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Other Lip**\
**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                              |
+------+---------------------------------------------------------------+

**Other Lip**\
**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                              |
+------+---------------------------------------------------------------+

**Other Lip**\
**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                              |
+------+---------------------------------------------------------------+

**Other Lip**\
**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                              |
+------+---------------------------------------------------------------+

**Other Lip**\
**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                              |
+------+---------------------------------------------------------------+

**Other Lip**\
**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

## Oral Cavity

**Lip C000--C009**, Base of Tongue C019, Other Parts of Tongue
C020--C029,

Gum C030--C039, Floor of Mouth C040--C049, Palate C050--C059,

Other Parts of Mouth C060--C069

(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

\[***SEER Note:*** Codes 20-27 include shave and wedge resection\]

30 Wide excision, NOS

Code 30 includes:

Hemiglossectomy

Partial glossectomy

40 **Radical** **excision** of tumor, NOS

41 Radical excision of tumor ONLY

42 Combination of 41 WITH resection in continuity with mandible
(marginal, segmental, hemi‑, or total

resection)

43 Combination of 41 WITH resection in continuity with maxilla (partial,
subtotal, or total resection)

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

Codes 40--43 include:

Total glossectomy

Radical glossectomy

90 Surgery, NOS

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

Page left blank

**Collaborative Staging Codes**

## Base of Tongue, Lingual Tonsil C01.9, C02.4

C01.9 Base of tongue, NOS

C02.4 Lingual tonsil

**Note:  ** AJCC includes base of tongue (C01.9) with oropharynx
(C10.\_).

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Base of Tongue, Lingual Tonsil**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor on one side confined to   | \*   | L    | L    |
|      | posterior 1/3 of tongue:                 |      |      |      |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature, intrinsic or NOS            | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Midline tumor                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Tumor crosses midline                    | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Anterior 2/3 of tongue for base of       | \*   | RE   | RE   |
|      | tongue                                   |      |      |      |
|      |                                          |      |      |      |
|      | Base of tongue for lingual tonsil        |      |      |      |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Lower gingiva                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 53   | Sublingual gland                         | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 60   | Epiglottis, lingual (pharyngeal) surface | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Glossoepiglottic fold                    |      |      |      |
|      |                                          |      |      |      |
|      | Glossopharyngeal fold                    |      |      |      |
|      |                                          |      |      |      |
|      | Lateral pharyngeal wall                  |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngoepiglottic fold                  |      |      |      |
|      |                                          |      |      |      |
|      | Tonsillar pillars and fossae             |      |      |      |
|      |                                          |      |      |      |
|      | Tonsils                                  |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Soft palate, inferior surface or NOS     | \*   | D    | RE   |
+------+------------------------------------------+------+------+------+
| 71   | Mandible for lingual tonsil              | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 72   | Mandible for base of tongue              | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 74   | Medial pterygoid                         | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Hard palate                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Musculature, extrinsic:                  | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | Larynx                                   | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 78   | Skin                                     | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Contiguous extension to:                 | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Base of skull                            |      |      |      |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Hypopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Lateral nasopharynx                      |      |      |      |
|      |                                          |      |      |      |
|      | Lateral pterygoid muscle                 |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Uvula                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 82   | Further contiguous extension             | T4b  | 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, 20, 30, 40, 50, 53, 60, and 62 ONLY, the T
category is assigned based on the value of CS Tumor Size, as shown in
the Extension Size Table for this site.

**Base of Tongue, Lingual Tonsil**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Base of Tongue, Lingual Tonsil**\
**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.

+------+------------------------------------------+------+------+------+
| 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 I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Sublingual                               |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

**Base of Tongue, Lingual Tonsil**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Base of Tongue, Lingual Tonsil**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Base of Tongue, Lingual Tonsil**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Base of Tongue, Lingual Tonsil**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Base of Tongue, Lingual Tonsil**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Base of Tongue, Lingual Tonsil**\
**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                              |
+------+---------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**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                              |
+------+---------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**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                              |
+------+---------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**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                              |
+------+---------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**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                              |
+------+---------------------------------------------------------------+

**Base of Tongue, Lingual Tonsil**\
**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**

## Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS C02.0-C02.3, C02.8-C02.9

C02.0 Dorsal surface of tongue, NOS

C02.1 Border of tongue

C02.2 Ventral surface of tongue, NOS

C02.3 Anterior 2/3 of tongue, NOS

C02.8 Overlapping lesion of tongue

C02.9 Tongue, 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor on one side confined to:  | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature, intrinsic or NOS            | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Midline tumor                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Tumor crosses midline                    | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Base of tongue                           | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Gingiva, lower                           |      |      |      |
|      |                                          |      |      |      |
|      | Retromolar trigone                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 53   | Sublingual gland                         | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall                  | \*   | D    | RE   |
|      |                                          |      |      |      |
|      | Soft palate, inferior surface            |      |      |      |
|      |                                          |      |      |      |
|      | Tonsillar pillars and fossae             |      |      |      |
|      |                                          |      |      |      |
|      | Tonsils                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Mandible                                 | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 72   | \(60\) + (70)                            | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 74   | Maxilla                                  | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Maxillary sinus                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Musculature, extrinsic:                  | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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 codes 10, 20, 30, 40, 50, 53, and 60 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | Sublingual                               |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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 nodes cannot be assessed                       |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior 2/3 of Tongue, Tip, Border, and Tongue, NOS**\
**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

## Oral Cavity

Lip C000--C009, Base of Tongue C019, Other Parts of Tongue C020--C029,

Gum C030--C039, Floor of Mouth C040--C049, Palate C050--C059,

Other Parts of Mouth C060--C069

(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

\[***SEER Note:*** Codes 20-27 include shave and wedge resection\]

30 Wide excision, NOS

Code 30 includes:

Hemiglossectomy

Partial glossectomy

40 **Radical** **excision** of tumor, NOS

41 Radical excision of tumor ONLY

42 Combination of 41 WITH resection in continuity with mandible
(marginal, segmental, hemi‑, or total

resection)

43 Combination of 41 WITH resection in continuity with maxilla (partial,
subtotal, or total resection)

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

Codes 40--43 include:

Total glossectomy

Radical glossectomy

90 Surgery, NOS

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

**Collaborative Staging Codes**

## Gum, Upper C03.0

C03.0 Upper gum

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

##  Gum, Upper CS Tumor Size SEE STANDARD TABLE  Gum, Upper CS Extension

**Note:  ** Superficial erosion alone of bone/tooth socket by gingival
primary is not sufficient to code as bone involvement.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to lamina        | \*   | L    | L    |
|      | propria (mucoperiosteum)                 |      |      |      |
|      |                                          |      |      |      |
|      | (stroma)                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip), lip           |      |      |      |
|      |                                          |      |      |      |
|      | Tongue                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Facial muscle, NOS                       | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of face         |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall (tonsillar       | \*   | RE   | RE   |
|      | pillars and fossae, tonsils)             |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Maxilla                                  | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 72   | Deep muscle of tongue:                   | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 74   | Maxillary antrum (sinus)                 | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Nasal cavity                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Skin                                     | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 79   | Skull                                    | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Skull base                               |      |      |      |
|      |                                          |      |      |      |
|      | Encases internal 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         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For codes 10, 30, 50, 55, 60, and 65 ONLY, the T category is assigned
based on the value of CS Tumor Size, as shown in the Extension Size
Table for this site.

##  Gum, Upper CS TS/Ext-Eval SEE STANDARD TABLE  Gum, Upper 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.

+------+-----------------------------------------+------+------+------+
| Code | Description                             | TNM  | SS77 | SS   |
|      |                                         |      |      | 2000 |
+------+-----------------------------------------+------+------+------+
| 00   | None; no regional lymph node            | N0   | NONE | NONE |
|      | involvement                             |      |      |      |
+------+-----------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional    | \*   | RN   | RN   |
|      | node:                                   |      |      |      |
|      |                                         |      |      |      |
|      | Retropharyngeal, NOS                    |      |      |      |
|      |                                         |      |      |      |
|      | Regional lymph node, NOS                |      |      |      |
+------+-----------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional    | \*   | D    | D    |
|      | node:                                   |      |      |      |
| 12,  |                                         |      |      |      |
| co   | Level V node                            |      |      |      |
| nt'd |                                         |      |      |      |
|      | 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                           |      |      |      |
+------+-----------------------------------------+------+------+------+
| 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            |      |      |      |
+------+-----------------------------------------+------+------+------+
| 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, 49, 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.

**Gum, Upper**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Gum, Upper**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Gum, Upper**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Gum, Upper**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Gum, Upper**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Gum, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Upper**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Upper**\
**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**

## Gum, Lower and Retromolar Area Retromolar gingiva (trigone) C03.1, C06.2

C03.1 Lower gum

C06.2 Retromolar area

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

**Gum, Lower and Retromolar Area**\
**CS Tumor Size**\
**SEE STANDARD TABLE**

**Gum, Lower and Retromolar Area**\
**CS Extension**

Note:   Superficial erosion alone of bone/tooth socket by gingival
primary is not sufficient to code as bone involvement (code 70).

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to lamina        | \*   | L    | L    |
|      | propria (mucoperiosteum)(stroma)         |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip), lip           |      |      |      |
|      |                                          |      |      |      |
|      | Tongue                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Facial muscle, NOS                       | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of face         |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall (tonsillar       | \*   | RE   | RE   |
|      | pillars and fossae, tonsils)             |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Soft palate including uvula              | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Mandible                                 | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 72   | Deep muscle of tongue:                   | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Skin                                     | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 79   | Skull                                    | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Skull base                               |      |      |      |
|      |                                          |      |      |      |
|      | Encases internal 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         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For codes 10, 30, 50, 55, 60, and 65 ONLY, the T category is assigned
based on the value of CS Tumor Size, as shown in the Extension Size
Table for this site.

**Gum, Lower and Retromolar Area**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Gum, Lower and Retromolar Area**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                            |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Facial:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

**Gum, Lower and Retromolar Area**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Gum, Lower and Retromolar Area**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Gum, Lower and Retromolar Area**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Gum, Lower and Retromolar Area**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Gum, Lower and Retromolar Area**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Gum, Lower and Retromolar Area**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Lower and Retromolar Area**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Lower and Retromolar Area**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Lower and Retromolar Area**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Lower and Retromolar Area**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, Lower and Retromolar Area**\
**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**

## Gum, NOS C03.9

C03.9 Gum, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -** Size   | tables are          |   |
| | CS TS/Ext-Eval\     | of Lymph Nodes\     | available at the    |   |
| | CS Lymph Nodes\     | **CS Site-Specific  | collaborative       |   |
| | CS Reg Nodes Eval\  | Factor 2 -**        | staging website:    |   |
| | Reg LN Pos\         | Extracapsular       |                     |   |
| | Reg LN Exam\        | Extension, Lymph    | Histology Exclusion |   |
| | CS Mets at DX\      | Nodes for Head and  | Table\              |   |
| | CS Mets Eval        | Neck\               | AJCC Stage\         |   |
| |                     | **CS Site-Specific  | Extension Size      |   |
| |                     | Factor 3 -** Levels | Table\              |   |
| |                     | I-III, Lymph Nodes  | Lymph Nodes Size    |   |
| |                     | for Head and Neck\  | Table               |   |
| |                     | **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   |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Gum, NOS**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Gum, NOS**\
**CS Extension**

**Note:  ** Superficial erosion alone of bone/tooth socket by gingival
primary is not sufficient to code as bone involvement.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to lamina        | \*   | L    | L    |
|      | propria mucoperiosteum) (stroma)         |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Labial mucosa (inner lip), lip           |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Facial muscle, NOS                       | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Subcutaneous soft tissue of face         |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall (tonsillar       | \*   | RE   | RE   |
|      | pillars and                              |      |      |      |
|      |                                          |      |      |      |
|      | fossae, tonsils)                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Deep muscle of tongue:                   | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Skin                                     | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 79   | Skull                                    | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | Skull base                               |      |      |      |
|      |                                          |      |      |      |
|      | Encases internal 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         |      |      |      |
+------+------------------------------------------+------+------+------+

\*For codes 10, 30, 50, 55, 60, and 65 ONLY, the T category is assigned
based on the value of CS Tumor Size, as shown in the Extension Size
Table for this site.

**Gum, NOS**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Gum, NOS**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                            |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Facial:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 40, 49, 50 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.

**Gum, NOS**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Gum, NOS**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Gum, NOS**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Gum, NOS**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Gum, NOS**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Gum, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, NOS**\
**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                              |
+------+---------------------------------------------------------------+

**Gum, NOS**\
**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  |
+------+---------------------------------------------------------------+
| 11   | 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                              |
+------+---------------------------------------------------------------+

**Gum, NOS**\
**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**

## **Floor of Mouth** C04.0-C04.1, C04.8-C04.9

C04.0 Anterior floor of mouth

C04.1 Lateral floor of mouth

C04.8 Overlapping lesion of floor of mouth

C04.9 Floor of mouth, 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Floor of Mouth**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Floor of Mouth**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor on one side confined to:  | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor crosses midline                    | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Anterior 2/3 of tongue                   | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Base of tongue                           |      |      |      |
|      |                                          |      |      |      |
|      | Gingiva (alveolar ridge), lower          |      |      |      |
+------+------------------------------------------+------+------+------+
| 53   | Sublingual gland, including ducts        | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary) glands,     |      |      |      |
|      | including ducts                          |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 60   | Epiglottis                               | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Glossoepiglottic fold                    |      |      |      |
|      |                                          |      |      |      |
|      | Glossopharyngeal sulcus                  |      |      |      |
|      |                                          |      |      |      |
|      | Lateral pharyngeal wall                  |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngeal (lingual) surface             |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngoepiglottic fold                  |      |      |      |
|      |                                          |      |      |      |
|      | Tonsillar pillars and fossae             |      |      |      |
|      |                                          |      |      |      |
|      | Tonsils                                  |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Extension to deep extrinsic muscle of    | T4a  | L    | L    |
|      | tongue:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 63   | \(62\) + any of \[(50) or (53) or (60)\] | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 64   | Subcutaneous soft tissue of chin/neck    | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Mandible                                 | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 76   | Skin of undersurface of chin/neck        | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 77   | Further contiguous extension:            | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Maxillary sinus                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Base of skull                            |      |      |      |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**\*Note:  ** For Extension codes 10, 20, 30, 40, 50, 53, and 60 ONLY,
the T category is assigned based on the value of CS Tumor Size, as shown
in the Extension Size Table for this site.

**Floor of Mouth**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Floor of Mouth**\
**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 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.

+------+------------------------------------------+------+------+------+
| 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 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                          |      |      |      |
|      |                                          |      |      |      |
|      | Sublingual                               |      |      |      |
|      |                                          |      |      |      |
|      | 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)                                   |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 12,  | Other groups                             |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Intraparotid                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Periparotid                              |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 40, 49, 50 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.

**Floor of Mouth**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Floor of Mouth**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Floor of Mouth**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Floor of Mouth**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Floor of Mouth**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Floor of Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Floor of Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Floor of Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Floor of Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Floor of Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Floor of Mouth**\
**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

## Oral Cavity

Lip C000--C009, Base of Tongue C019, Other Parts of Tongue C020--C029,

Gum C030--C039, Floor of Mouth C040--C049, Palate C050--C059,

# Other Parts of Mouth C060--C069 {#other-parts-of-mouth-c060c069 .Style-Heading-1-+-Times-New-Roman}

(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

\[***SEER Note:*** Codes 20-27 include shave and wedge resection\]

30 Wide excision, NOS

Code 30 includes:

Hemiglossectomy

Partial glossectomy

40 **Radical** **excision** of tumor, NOS

41 Radical excision of tumor ONLY

42 Combination of 41 WITH resection in continuity with mandible
(marginal, segmental, hemi‑, ortotal

resection)

43 Combination of 41 WITH resection in continuity with maxilla (partial,
subtotal, or total resection)

\[***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\]

Codes 40--43 include:

Total glossectomy

Radical glossectomy

90 Surgery, NOS

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

**Collaborative Staging Codes**

## Hard Palate C05.0

C05.0 Hard palate

+-----------------------------------------------------------------------+
| +-------------------+-----------------------+---------------------+   |
| | 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Hard Palate**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Hard Palate**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor on one side confined to   | \*   | L    | L    |
|      | mucoperiosteum (stroma)                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor crosses midline                    | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Gingiva, upper                           |      |      |      |
|      |                                          |      |      |      |
|      | Glossopalatine arch                      |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngopalatine arch                    |      |      |      |
|      |                                          |      |      |      |
|      | Soft palate                              |      |      |      |
|      |                                          |      |      |      |
|      | Uvula                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Maxillary bone                           | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Palatine bone                            |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 74   | Deep muscle of tongue                    | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Floor of nose                            |      |      |      |
|      |                                          |      |      |      |
|      | Maxillary antrum (sinus)                 |      |      |      |
|      |                                          |      |      |      |
|      | Nasal cavity                             |      |      |      |
|      |                                          |      |      |      |
|      | Nasopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Skin of face                             |      |      |      |
|      |                                          |      |      |      |
|      | Sphenoid bone                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Pterygoid plate                          | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 30, 40, and 50 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Hard Palate**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Hard Palate**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10   |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                          |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

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

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Hard Palate**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Hard Palate**\
**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                              |
+------+---------------------------------------------------------------+

**Hard Palate**\
**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                              |
+------+---------------------------------------------------------------+

**Hard Palate**\
**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                              |
+------+---------------------------------------------------------------+

**Hard Palate**\
**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                              |
+------+---------------------------------------------------------------+

**Hard Palate**\
**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                              |
+------+---------------------------------------------------------------+

**Hard Palate**\
**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**

## **Soft Palate, Uvula** **C05.1-C05.2**

C05.1 Soft Palate, NOS

C05.2 Uvula

**Note 1:  ** AJCC includes inferior surface of the soft palate (C05.1)
and uvula (C05.2) with oropharynx (C09.\_, C10.\_).

**Note 2:  ** Soft palate excludes nasopharyngeal (superior) surface of
soft palate (C11.3).

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Soft Palate, Uvula**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Soft Palate, Uvula**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor on one side confined to:  | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature invaded                      | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Tumor crosses midline                    | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Buccal mucosa (inner cheek)              | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Gum (gingiva), upper                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall                  | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Tonsillar pillars and fossae             |      |      |      |
|      |                                          |      |      |      |
|      | Tonsils                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Hard palate                              | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Mandible                                 | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Maxilla                                  |      |      |      |
|      |                                          |      |      |      |
|      | Palatine bone (bone of hard palate)      |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Pterygoid muscle, medial or NOS          | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 72   | Tongue                                   | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Deep extrinsic muscle of tongue          |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Larynx                                   | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 74   | Maxillary antrum (sinus)                 | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Nasopharynx, lateral or NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | Nasal cavity                             | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 78   | Pterygoid muscle, lateral                | T4b  | RE   | D    |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
|      |                                          |      |      |      |
|      | **Note:** For medial pterygoid muscle or |      |      |      |
|      | pterygoid muscle, NOS, see code 71       |      |      |      |
+------+------------------------------------------+------+------+------+
| 79   | \[(77) or (78)\] with any of \[(70) to   | T4b  | D    | D    |
|      | (76)\]                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Skull base                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 40, 50, and 60 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Soft Palate, Uvula**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Soft Palate, Uvula**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Soft Palate, Uvula**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Soft Palate, Uvula**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Soft Palate, Uvula**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Soft Palate, Uvula**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Soft Palate, Uvula**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Soft Palate, Uvula**\
**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                              |
+------+---------------------------------------------------------------+

**Soft Palate, Uvula**\
**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                              |
+------+---------------------------------------------------------------+

**Soft Palate, Uvula**\
**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                              |
+------+---------------------------------------------------------------+

**Soft Palate, Uvula**\
**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                              |
+------+---------------------------------------------------------------+

**Soft Palate, Uvula**\
**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                              |
+------+---------------------------------------------------------------+

**Soft Palate, Uvula**\
**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

Oral Cavity

Lip C000--C009, Base of Tongue C019, Other Parts of Tongue C020--C029,

Gum C030--C039, Floor of Mouth C040--C049, **Palate C050--C059**,

Other Parts of Mouth C060--C069

(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

\[***SEER Note:*** Codes 20-27 include shave and wedge resection\]

30 Wide excision, NOS

Code 30 includes:

Hemiglossectomy

Partial glossectomy

40 **Radical** **excision** of tumor, NOS

41 Radical excision of tumor ONLY

42 Combination of 41 WITH resection in continuity with mandible
(marginal, segmental, hemi‑, or total

resection)

43 Combination of 41 WITH resection in continuity with maxilla (partial,
subtotal, or total resection)

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

Codes 40--43 include:

Total glossectomy

Radical glossectomy

90 Surgery, NOS

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

**Page left blank**

**Collaborative Staging Codes**

## **Other Mouth** **C05.8-C05.9, C06.8-C06.9**

C05.8 Overlapping lesion of palate

C05.9 Palate, NOS

C06.8 Overlapping lesion of other and unspecified parts of mouth

C06.9 Mouth, 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Other Mouth**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other Mouth**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature invaded                      | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Adjacent oral cavity                     | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Extension to oropharynx:                 | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Inferior surface of soft palate          |      |      |      |
|      |                                          |      |      |      |
|      | Lateral pharyngeal wall                  |      |      |      |
|      |                                          |      |      |      |
|      | Lingual surface of epiglottis            |      |      |      |
|      |                                          |      |      |      |
|      | Vallecula                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension to adjacent structures:        | T4a  | D    | D    |
|      |                                          |      |      |      |
| 70   | Mandible                                 |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Maxilla                                  |      |      |      |
|      |                                          |      |      |      |
|      | Maxillary antrum (sinus)                 |      |      |      |
|      |                                          |      |      |      |
|      | Nasal cavity                             |      |      |      |
|      |                                          |      |      |      |
|      | Skin of face/neck                        |      |      |      |
|      |                                          |      |      |      |
|      | Tongue                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Deep extrinsic muscle of tongue          | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 72   | Skull                                    | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 75   | Base of skull                            | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Encases internal carotid artery          |      |      |      |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 20, 30, 50, and 60 ONLY, the T category is
assigned based on the value of Tumor Size, as shown in the Extension
Size Table for this site.

**Other Mouth**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Other Mouth**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10   |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

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

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other Mouth**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Other Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Other Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Other Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Other Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Other Mouth**\
**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                              |
+------+---------------------------------------------------------------+

**Other Mouth**\
**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**

## **Cheek (Buccal) Mucosa, Vestibule** **C06.0-C06.1**

C06.0 Cheek mucosa

C06.1 Vestibule of mouth

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Musculature (buccinator)                 | \*   | RE   | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 50   | Lip(s) including commissure              | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 51   | Gingiva                                  | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Lateral pharyngeal wall                  | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Tonsillar pillars and fossae             |      |      |      |
|      |                                          |      |      |      |
|      | Tonsils                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Subcutaneous soft tissue of cheek        | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 66   | Skin of cheek (WITH or WITHOUT           | T4a  | RE   | D    |
|      | ulceration)                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 67   | Maxillary sinus                          | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 70   | Bone (cortical):                         | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Mandible                                 |      |      |      |
|      |                                          |      |      |      |
|      | Maxilla                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Skull                                    | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 75   | Tongue                                   | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Deep extrinsic muscle of tongue          |      |      |      |
+------+------------------------------------------+------+------+------+
| 79   | Other contiguous extension:              | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Base of skull                            |      |      |      |
|      |                                          |      |      |      |
|      | Encases internal carotid artery          |      |      |      |
|      |                                          |      |      |      |
|      | Masticator space                         |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Hard palate                              |      |      |      |
|      |                                          |      |      |      |
|      | Soft palate                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 20, 30, 50, 51, and 60 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Cheek (Buccal) Mucosa, Vestibule**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                            |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Facial:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Buccinator (buccal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Nasolabial                               |      |      |      |
|      |                                          |      |      |      |
|      | Parotid, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

**Cheek (Buccal) Mucosa, Vestibule**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Cheek (Buccal) Mucosa, Vestibule**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Cheek (Buccal) Mucosa, Vestibule**\
**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                              |
+------+---------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**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                              |
+------+---------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**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                              |
+------+---------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**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                              |
+------+---------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**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                              |
+------+---------------------------------------------------------------+

**Cheek (Buccal) Mucosa, Vestibule**\
**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

**Oral Cavity**

Lip C000--C009, Base of Tongue C019, Other Parts of Tongue C020--C029,

Gum C030--C039, Floor of Mouth C040--C049, **Palate C050--C059,**

Other Parts of Mouth C060--C069

(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

\[***SEER Note:*** Codes 20-27 include shave and wedge resection\]

30 Wide excision, NOS

Code 30 includes:

Hemiglossectomy

Partial glossectomy

40 **Radical** **excision** of tumor, NOS

41 Radical excision of tumor ONLY

42 Combination of 41 WITH resection in continuity with mandible
(marginal, segmental, hemi‑, or total

resection)

43 Combination of 41 WITH resection in continuity with maxilla (partial,
subtotal, or total resection)

\[***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\]

Codes 40--43 include:

Total glossectomy

Radical glossectomy

90 Surgery, NOS

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

**Collaborative Staging Codes**

## **Parotid Gland C07.9**

C07.9 Parotid gland

**Note:  ** Laterality must be coded for C07.9.

+-----------------------------------------------------------------------+
| +-------------------+-----------------------+---------------------+   |
| | 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Parotid Gland**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Parotid Gland**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to gland/duct of | \*   | L    | L    |
|      | origin                                   |      |      |      |
|      |                                          |      |      |      |
|      | Multiple foci confined to substance of   |      |      |      |
|      | parotid gland                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 35   | Microscopic extraparenchymal extension   | \*   | RE   | RE   |
|      | ONLY                                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Another major salivary gland             | \*   | RE   | RE   |
|      | (submaxillary, sublingual)               |      |      |      |
|      |                                          |      |      |      |
|      | Periglandular soft/connective tissue     |      |      |      |
|      | including macroscopic                    |      |      |      |
|      |                                          |      |      |      |
|      | extraparenchymal extension               |      |      |      |
|      |                                          |      |      |      |
|      | Pharyngeal mucosa                        |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscle:                         |      |      |      |
|      |                                          |      |      |      |
|      | Digastric                                |      |      |      |
|      |                                          |      |      |      |
|      | Masseter                                 |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Sternocleidomastoid                      |      |      |      |
|      |                                          |      |      |      |
|      | Stylohyoid                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | External auditory meatus                 | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Skin overlying gland                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Periosteum of mandible                   | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 50   | Auricular nerve                          | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Mandible                                 |      |      |      |
|      |                                          |      |      |      |
|      | Mastoid                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Facial (7th) nerve                       | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 72   | Spinal accessory nerve                   | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 75   | Major blood vessel(s):                   | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Facial artery or vein                    |      |      |      |
|      |                                          |      |      |      |
|      | Jugular vein                             |      |      |      |
|      |                                          |      |      |      |
|      | Maxillary artery                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | Base of skull                            | T4b  | RE   | D    |
|      |                                          |      |      |      |
|      | Skull, NOS                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | Pterygoid plates                         | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 30, 35, and 40 ONLY, the T category is
assigned based on the value of CS Tumor Size as shown in the Extension
by Size Table for this site.

**Parotid Gland**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Parotid Gland**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Parotid nodes                            |      |      |      |
|      |                                          |      |      |      |
|      | Infra-auricular                          |      |      |      |
|      |                                          |      |      |      |
|      | Intraparotid                             |      |      |      |
|      |                                          |      |      |      |
|      | Preauricular                             |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular                         |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Parotid Gland**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Parotid Gland**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Parotid Gland**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Parotid Gland**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Parotid Gland**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Parotid Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Parotid Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Parotid Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Parotid Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Parotid Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Parotid Gland**\
**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**

## **Submandibular Gland** **C08.0**

C08.0 Submandibular Gland

**Note:  ** Laterality must be coded for C08.0.

+-----------------------------------------------------------------------+
| +-------------------+-----------------------+---------------------+   |
| | 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Submandibular Gland**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Submandibular Gland**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to gland/duct of | \*   | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 35   | Microscopic extraparenchymal extension   | \*   | RE   | RE   |
|      | ONLY                                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Another major salivary gland (parotid,   | \*   | RE   | RE   |
|      | sublingual)                              |      |      |      |
|      |                                          |      |      |      |
|      | Periglandular soft/connective tissue     |      |      |      |
|      | including macroscopic                    |      |      |      |
|      |                                          |      |      |      |
|      | extraparenchymal extension               |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscle:                         |      |      |      |
|      |                                          |      |      |      |
|      | Digastric                                |      |      |      |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Stylohyoid                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Periosteum of mandible                   | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 50   | Mandible                                 | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Nerves:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Facial (7th)                             |      |      |      |
|      |                                          |      |      |      |
|      | Lingual                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | External auditory meatus                 | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 52   | Major blood vessels:                     | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Facial artery or vein                    |      |      |      |
|      |                                          |      |      |      |
|      | Maxillary artery                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Base of skull                            | T4b  | RE   | D    |
|      |                                          |      |      |      |
|      | Skull, NOS                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Spinal accessory nerve                   | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 77   | Pterygoid plates                         | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 30, 35, and 40 ONLY, the T category is
assigned based on value of CS Tumor Size as shown in the Extension Size
Table for this site.

**Submandibular Gland**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Submandibular Gland**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level I node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | 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                   |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

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

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Submandibular Gland**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Submandibular Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Submandibular Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Submandibular Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Submandibular Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Submandibular Gland**\
**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                              |
+------+---------------------------------------------------------------+

**Submandibular Gland**\
**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**

## **Other and Unspecified Major Salivary Glands** C08.1, C08.8-C08.9

C08.1 Sublingual gland

C08.8 Overlapping lesion of major salivary glands

C08.9 Major salivary gland, NOS

**Note:  ** Laterality must be coded for C08.1.

+-----------------------------------------------------------------------+
| +-------------------+-----------------------+---------------------+   |
| | 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other and Unspecified Major Salivary Glands**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to gland/duct of | \*   | L    | L    |
|      | origin                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 35   | Microscopic extraparenchymal extension   | \*   | RE   | RE   |
|      | ONLY                                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Extension to:                            | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Another major salivary gland (parotid,   |      |      |      |
|      | submandibular)                           |      |      |      |
|      |                                          |      |      |      |
|      | Periglandular soft/connective tissue     |      |      |      |
|      | including extraparenchymal               |      |      |      |
|      |                                          |      |      |      |
|      | extension                                |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscle:                         |      |      |      |
|      |                                          |      |      |      |
|      | Digastric                                |      |      |      |
|      |                                          |      |      |      |
|      | Pterygoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Stylohyoid                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Periosteum of mandible                   | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 51   | Mandible                                 | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Nerves:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Facial (7th)                             |      |      |      |
|      |                                          |      |      |      |
|      | Lingual                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Skin                                     | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 62   | External auditory meatus                 | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 65   | Blood vessel(s):                         | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Facial artery or vein                    |      |      |      |
|      |                                          |      |      |      |
|      | Maxillary artery                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Base of skull                            | T4b  | RE   | D    |
|      |                                          |      |      |      |
|      | Skull, NOS                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Spinal accessory nerve                   | T4a  | RE   | D    |
+------+------------------------------------------+------+------+------+
| 79   | Pterygoid plates                         | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 30, and 35 ONLY, the T category is assigned
based on value of CS Tumor Size as shown in the Extension Size Table for
this site.

**Other and Unspecified Major Salivary Glands**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Other and Unspecified Major Salivary Glands**\
**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.

+------+------------------------------------------+------+------+------+
| 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 I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level II node                            |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | 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                   |      |      |      |
|      |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 49, 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.

**Other and Unspecified Major Salivary Glands**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Other and Unspecified Major Salivary Glands**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Other and Unspecified Major Salivary Glands**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Other and Unspecified Major Salivary Glands**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other and Unspecified Major Salivary Glands**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Other and Unspecified Major Salivary Glands**\
**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                              |
+------+---------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**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                              |
+------+---------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**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                              |
+------+---------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**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                              |
+------+---------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**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                              |
+------+---------------------------------------------------------------+

**Other and Unspecified Major Salivary Glands**\
**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**

**Parotid and Other Unspecified Glands**

**Parotid Gland C079, Major Salivary Glands C080--C089**

(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

\[***SEER Note:*** Codes 30-80 include major salivary gland, NOS\]

30 **Less** than **total** **parotidectomy**, NOS; **less** than total
removal of major salivary gland, NOS

***\[***SEER Notes: ***Includes less than total removal of other major
salivary gland When the operative report specifies nerve monitoring, it
means that a nerve sparing surgery is being done\]***

31 Facial nerve spared

32 Facial nerve sacrificed

33 Superficial lobe ONLY

34 Facial nerve spared

35 Facial nerve sacrificed

36 Deep lobe (Total)

\[***SEER Note:*** With or without superficial lobe\]

37 Facial nerve spared

38 Facial nerve sacrificed

\[***SEER Note:*** Codes 40-80 include submandibulectomy;
submaxillectomy\]

40 Total parotidectomy, NOS; total removal of major salivary gland, NOS

41 Facial nerve spared

42 Facial nerve sacrificed

50 Radical parotidectomy, NOS; radical removal of major salivary gland,
NOS

51 WITHOUT removal of temporal bone

52 WITH removal of temporal bone

53 WITH removal of overlying skin (requires graft or flap coverage)

80 Parotidectomy, NOS

90 Surgery, NOS

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

Collaborative Staging Codes

## **Tonsil, Oropharynx** **C09.0-C09.1, C09.8-C09.9, C10.0, C10.2-C10.4, C10.8-C10.9**

C09.0 Tonsillar fossa

C09.1 Tonsillar pillar

C09.8 Overlapping lesion of tonsil

C09.9 Tonsil, NOS (excludes lingual tonsil C02.4)

C10.0 Vallecula

C10.2 Lateral wall of oropharynx

C10.3 Posterior wall of oropharynx

C10.4 Branchial cleft (site of neoplasm)

C10.8 Overlapping lesion of oropharynx

C10.9 Oropharynx, NOS

**Note 1:  ** Laterality must be coded for C09.0, C09.1, C09.8, and
C09.9.

**Note 2:  ** AJCC includes base of tongue (C01.9) with oropharynx
(C09.\_, C10.\_).

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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    | Extension Size      |   |
| |                  | I-III, Lymph Nodes for | Table\              |   |
| |                  | Head and Neck\         | Lymph Nodes Size    |   |
| |                  | **CS Site-Specific     | Table               |   |
| |                  | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Tonsil, Oropharynx**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Tonsil, Oropharynx**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to one of the    | \*   | L    | L    |
|      | following subsites:                      |      |      |      |
|      |                                          |      |      |      |
|      | Anterior wall (including vallecula and   |      |      |      |
|      | lingual (anterior) surface               |      |      |      |
|      |                                          |      |      |      |
|      | of epiglottis)                           |      |      |      |
|      |                                          |      |      |      |
|      | One lateral wall                         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior wall                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Involvement of two or more subsites:     | \*   | L    | L    |
|      |                                          |      |      |      |
|      | Posterior, anterior or lateral wall(s)   |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Soft palate, inferior surface including  | \*   | RE   | RE   |
|      | uvula, or soft palate, NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 41   | Hypopharynx NOS                          | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Pyriform sinus                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Soft palate, superior (nasopharyngeal)   | \*   | RE   | RE   |
|      | surface                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Base of tongue                           | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Buccal mucosa (inner cheek)              |      |      |      |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Gum (gingiva)                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Any extension coded in 10-50 WITH        | \*   | RE   | RE   |
|      | fixation                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Prevertebral fascia or muscle            | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Soft tissue of neck                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Nasopharynx, lateral, or NOS             | T4b  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Larynx, NOS                              | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Medial pterygoid muscle, or pterygoid    |      |      |      |
|      | muscle, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Posterior surface of epiglottis          |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Deep extrinsic muscles of tongue:        | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Hard palate                              |      |      |      |
|      |                                          |      |      |      |
|      | Mandible                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Lateral pterygoid muscle                 | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Pterygoid plates                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Bone of skull                            | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 76   | Bone                                     | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 77   | Carotid artery                           | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Anterior 2/3 of tongue                   |      |      |      |
|      |                                          |      |      |      |
|      | Parotid gland                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, 40, 41, 42, 50, 55, and 60 ONLY, the T category is
assigned based on the value of CS Tumor Size as shown in the Extension
Size Table for this site.

**Tonsil, Oropharynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Tonsil, Oropharynx**\
**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.

+------+------------------------------------------+------+------+------+
| 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 node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
| 12,  |                                          |      |      |      |
| co   | Level V node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Tonsil, Oropharynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Tonsil, Oropharynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Tonsil, Oropharynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Tonsil, Oropharynx**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Tonsil, Oropharynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Tonsil, Oropharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Tonsil, Oropharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Tonsil, Oropharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Tonsil, Oropharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Tonsil, Oropharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Tonsil, Oropharynx**\
**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**.

**Collaborative Staging Codes**

## **Anterior Surface of Epiglottis** **C10.1**

C10.1 Anterior surface of epiglottis

**Note:  ** AJCC includes lingual (anterior) surface of epiglottis
(C10.1) with larynx. SEER Extent of Disease included it with oropharynx.

+-----------------------------------------------------------------------+
| +------------------+------------------------+---------------------+   |
| | 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Anterior Surface of Epiglottis**\
**CS Extension**

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

  00      In situ; noninvasive; intraepithelial      Tis     IS      IS

  10      Invasive tumor confined to anterior        T1      L       L
          surface of epiglottis with normal vocal                    
          cord mobility                                              

  20      Mucosa of adjacent subsite(s) of           T2      L       L
          oropharynx                                                 

  30      Localized, NOS                             T1      L       L

  31      Vallecula without fixation of larynx       T2      L       L

  32      Mucosa of adjacent subsite(s) of           T2      RE      RE
          supraglottis (including posterior surface                  
          of epiglottis) without fixation of larynx                  

  33      Larynx, glottic or NOS, without fixation   T2      RE      RE
          of larynx                                                  

  34      Pyriform sinus, medial wall or NOS,        T2      RE      RE
          without fixation of larynx                                 

  35      Mucosa of base of tongue without fixation  T2      RE      RE
          of larynx                                                  

  36      Any of (10) to (35) with vocal cord        T3      RE      RE
          fixation                                                   
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+------+
| 37   | Paraglottic space                        | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Pre-epiglottic tissues                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 38   | Minor thyroid cartilage erosion (inner   | T3   | D    | D    |
|      | cortex) (see also code 67)               |      |      |      |
+------+------------------------------------------+------+------+------+
| 39   | Hypopharynx, NOS                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Pyriform sinus except medial wall (see   |      |      |      |
|      | code 34)                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 43   | \(38\) + (39)                            | T3   | D    | D    |
+------+------------------------------------------+------+------+------+
| 45   | Soft palate, inferior surface including  | T4a  | RE   | RE   |
|      | uvula, or soft palate, NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 47   | Nasopharynx, NOS                         | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Soft palate, superior (nasopharyngeal)   |      |      |      |
|      | surface                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Base of tongue, except mucosa (see code  | T4a  | RE   | RE   |
|      | 35)                                      |      |      |      |
|      |                                          |      |      |      |
|      | Buccal mucosa (inner cheek)              |      |      |      |
|      |                                          |      |      |      |
|      | Floor of mouth                           |      |      |      |
|      |                                          |      |      |      |
|      | Gum (gingiva)                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Soft tissues of neck                     | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Pterygoid muscle                         | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 66   | \[(38) or (43)\] + any of \[(45) to      | T4a  | D    | D    |
|      | (65)\]                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 67   | Invasion through thyroid cartilage (see  | T4a  | D    | D    |
|      | also code 38)                            |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid cartilage, NOS                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Trachea                                  | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 69   | Esophagus                                | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Strap muscles                            |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extrinsic muscles of tongue:             | T4a  | D    | D    |
|      |                                          |      |      |      |
|      | Genioglossus                             |      |      |      |
|      |                                          |      |      |      |
|      | Geniohyoid                               |      |      |      |
|      |                                          |      |      |      |
|      | Hyoglossus                               |      |      |      |
|      |                                          |      |      |      |
|      | Mylohyoid                                |      |      |      |
|      |                                          |      |      |      |
|      | Palatoglossus                            |      |      |      |
|      |                                          |      |      |      |
|      | Styloglossus                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Prevertebral fascia or muscle            | T4b  | RE   | RE   |
|      |                                          |      |      |      |
|      | Prevertebral space                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | \(75\) + any of \[(66) to (70)\]         | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4b  | D    | D    |
|      |                                          |      |      |      |
|      | Anterior 2/3 of tongue                   |      |      |      |
|      |                                          |      |      |      |
|      | Bone                                     |      |      |      |
|      |                                          |      |      |      |
|      | Encases carotid artery                   |      |      |      |
|      |                                          |      |      |      |
|      | Hard palate                              |      |      |      |
|      |                                          |      |      |      |
|      | Mandible                                 |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal structures                   |      |      |      |
|      |                                          |      |      |      |
|      | Parotid gland                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Anterior Surface of Epiglottis**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Anterior Surface of Epiglottis**\
**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.

+------+------------------------------------------+------+------+------+
| 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 node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Single positive ipsilateral regional     | \*   | D    | D    |
|      | node:                                    |      |      |      |
| 12,  |                                          |      |      |      |
| co   | Level V node                             |      |      |      |
| nt'd |                                          |      |      |      |
|      | 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 fossa                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Anterior Surface of Epiglottis**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Anterior Surface of Epiglottis**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Anterior Surface of Epiglottis**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Anterior Surface of Epiglottis**\
**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    |
|      | mediastinal                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (codes 08 -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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Anterior Surface of Epiglottis**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Anterior Surface of Epiglottis**\
**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) coded in the CS
Lymph Nodes field. 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                              |
+------+---------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**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                              |
+------+---------------------------------------------------------------+

**Anterior Surface of Epiglottis**\
**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**

**Collaborative Staging Codes**

## **Nasopharynx** **C11.0-C11.3, C11.8-C11.9**

C11.0 Superior wall of nasopharynx

C11.1 Posterior wall of nasopharynx

C11.2 Lateral wall of nasopharynx

C11.3 Anterior wall of nasopharynx

C11.8 Overlapping lesion of nasopharynx

C11.9 Nasopharynx, 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                   |                     |   |
| +------------------+------------------------+---------------------+   |
+-----------------------------------------------------------------------+

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

**Note:  ** Parapharyngeal involvement denotes postero-lateral
infiltration of tumor beyond the pharyngobasilar fascia. Involvement of
the masticator space denotes extension of tumor beyond the anterior
surface of the lateral pterygoid muscle, or lateral extension beyond the
postero-lateral wall of the maxillary antrum, pterygo-maxillary fissure.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to one of the    | T1   | L    | L    |
|      | following subsites:                      |      |      |      |
|      |                                          |      |      |      |
|      | Inferior wall (superior surface of soft  |      |      |      |
|      | palate)                                  |      |      |      |
|      |                                          |      |      |      |
|      | One lateral wall                         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior superior wall (vault)          |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Involvement of two or more subsites:     | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Lateral wall extending into eustachian   |      |      |      |
|      | tube/middle ear                          |      |      |      |
|      |                                          |      |      |      |
|      | Posterior, inferior, or lateral wall(s)  |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Confined to nasopharynx                  | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Localized, NOS                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Oropharynx                               | T2a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Soft palate, inferior surface            |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Nasal cavity                             | T2a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 55   | Any extension coded in 10-50 WITH        | T4   | RE   | RE   |
|      | fixation or tumor                        |      |      |      |
|      |                                          |      |      |      |
|      | Described only as FIXED                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 56   | Any extension coded in 10-50 WITH        | T2b  | RE   | RE   |
|      | parapharyngeal extension                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 57   | Hard palate                              | T4   | D    | RE   |
+------+------------------------------------------+------+------+------+
| 58   | Pterygopalatine fossa                    | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Bone, including skull                    | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 62   | Paranasal sinus                          | T3   | D    | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Orbit                                    | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 70   | Brain                                    | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Cranial nerves                           |      |      |      |
|      |                                          |      |      |      |
|      | Hypopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Infratemporal fossa                      |      |      |      |
|      |                                          |      |      |      |
|      | Orbit                                    |      |      |      |
|      |                                          |      |      |      |
|      | Intracranial extension, NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Masticator space                         | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Soft tissues of the neck                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Nasopharynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Nasopharynx**\
**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.

+------+------------------------------------------+------+------+------+
| 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 node                            |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 fossa                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 18   | Stated as N1, no other information       | N1   | 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                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 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                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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, no other information       | N2   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 70   | Stated as N3, NOS                        | N    | RN   | RN   |
|      |                                          | 3NOS |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Regional lymph nodes in the              | N3b  | D    | D    |
|      | supraclavicular fossa:                   |      |      |      |
|      |                                          |      |      |      |
|      | Inferior deep cervical (scalene)         |      |      |      |
|      |                                          |      |      |      |
|      | Spinal accessory (posterior cervical)    |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Nasopharynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Nasopharynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Nasopharynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Nasopharynx**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Nasopharynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Nasopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Nasopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Nasopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Nasopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Nasopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Nasopharynx**\
**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**

## **Pyriform Sinus, Hypopharynx, Laryngopharynx** **C12.9, C13.0-C13.2, C13.8-C13.9**

C12.9 Pyriform sinus

C13.0 Postcricoid region

C13.1 Hypopharyngeal aspect of aryepiglottic fold

C13.2 Posterior wall of hypopharynx

C13.8 Overlapping lesion of hypopharynx

C13.9 Hypopharynx, 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      | Histology Exclusion |   |
| | Reg LN Exam\      | Nodes for Head and    | Table\              |   |
| | CS Mets at DX\    | Neck\                 | AJCC Stage\         |   |
| | CS Mets Eval      | **CS Site-Specific    | Extension Size      |   |
| |                   | Factor 3 -** Levels   | Table\              |   |
| |                   | I-III, Lymph Nodes    | Lymph Nodes Size    |   |
| |                   | for Head and Neck\    | Table               |   |
| |                   | **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     |                     |   |
| +-------------------+-----------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS Extension**

**Note:  ** If fixation of hemilarynx or larynx code to 55 not 51.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to one of the    | \*   | L    | L    |
|      | following subsites:                      |      |      |      |
|      |                                          |      |      |      |
|      | Laryngopharynx                           |      |      |      |
|      |                                          |      |      |      |
|      | Postcricoid area                         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior pharyngeal wall                |      |      |      |
|      |                                          |      |      |      |
|      | Pyriform sinus                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Tumor involves adjacent subsite(s)       | \*   | L    | L    |
|      | (listed in code 10) WITHOUT fixation     |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Oropharynx                               | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 50   | Larynx                                   | \*   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 51   | Any of codes 10-40 WITH fixation of      | \*   | RE   | RE   |
|      | tumor or fixation, NOS                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Fixation of hemilarynx or larynx         | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Soft tissues of neck including           | T4a  | RE   | RE   |
|      |                                          |      |      |      |
|      | Prelaryngeal strap muscles and           |      |      |      |
|      | subcutaneous fat                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Esophagus                                | T4a  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 62   | Thyroid gland                            | T4a  | D    | RE   |
+------+------------------------------------------+------+------+------+
| 63   | Cricoid cartilage                        | T4a  | D    | RE   |
|      |                                          |      |      |      |
|      | Thyroid cartilage                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 64   | Prevertebral fascia/muscle(s)            | T4b  | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Carotid artery                           | T4b  | D    | RE   |
+------+------------------------------------------+------+------+------+
| 66   | Hyoid bone                               | T4a  | D    | D    |
+------+------------------------------------------+------+------+------+
| 70   | Mediastinal structures                   | T4b  | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4b  | 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, 20, 30, 40, 50, and 51 ONLY, the T category is
assigned based on value of CS Tumor Size as shown in the Extension Size
Table for this site.

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Single positive ipsilateral regional     | \*   | RN   | RN   |
|      | node:                                    |      |      |      |
| 10,  |                                          |      |      |      |
| co   | Level II node                            |      |      |      |
| nt'd |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Upper deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Level III node                           |      |      |      |
|      |                                          |      |      |      |
|      | Middle deep cervical                     |      |      |      |
|      |                                          |      |      |      |
|      | Mid jugular                              |      |      |      |
|      |                                          |      |      |      |
|      | Level IV node                            |      |      |      |
|      |                                          |      |      |      |
|      | Lower deep cervical                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower jugular                            |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular                               |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node, NOS                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Single positive ipsilateral regional     | \*   | D    | RN   |
|      | node:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Level I node                             |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Level VI node                            |      |      |      |
|      |                                          |      |      |      |
|      | Anterior deep cervical                   |      |      |      |
|      |                                          |      |      |      |
|      | Laterotracheal                           |      |      |      |
|      |                                          |      |      |      |
|      | Paralaryngeal                            |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Prelaryngeal                             |      |      |      |
|      |                                          |      |      |      |
|      | Pretracheal                              |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal                      |      |      |      |
|      |                                          |      |      |      |
|      | Other groups                             |      |      |      |
|      |                                          |      |      |      |
|      | Intraparotid                             |      |      |      |
|      |                                          |      |      |      |
|      | Parapharyngeal                           |      |      |      |
|      |                                          |      |      |      |
|      | Periparotid                              |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | Sub-occipital                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 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)                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 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.

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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                              |
+------+---------------------------------------------------------------+

**Pyriform Sinus, Hypopharynx, Laryngopharynx**\
**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**

## **Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites** **C14.0, C14.2, C14.8**

C14.0 Pharynx, NOS

C14.2 Waldeyer ring

C14.8 Overlapping lesion of lip, oral cavity

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

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

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS Extension**

**Note:  ** Definition of Adjacent Structures: Connective tissues large
enough to be given a specific name would be considered adjacent
structures. For example, the brachial artery has a name, as does the
broad ligament. Continuous tumor growth from one organ into an adjacent
named structure would be coded to less than 60 in the schemes for
ill-defined or non-specific sites.

+------+------------------------------------------+------+------+------+
| 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   | More than one region of pharynx involved | NA   | RE   | RE   |
|      | (oropharynx, nasopharynx, hypopharynx)   |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Pharynx and oral cavity involved         | NA   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 55   | Any of codes 10-50 WITH fixation         | NA   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Extension to adjacent structures (See    | NA   | RE   | RE   |
|      | note)                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS TS/Ext-Eval**

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

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

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s) bilateral and/or  | NA   | RN   | RN   |
|      | contralateral:                           |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS:                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower, NOS                               |      |      |      |
|      |                                          |      |      |      |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |      |
|      |                                          |      |      |      |
|      | Middle                                   |      |      |      |
|      |                                          |      |      |      |
|      | Upper, NOS:                              |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Mandibular, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Submandibular (submaxillary)             |      |      |      |
|      |                                          |      |      |      |
|      | Submental                                |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Recurrent laryngeal nerve chain          |      |      |      |
|      |                                          |      |      |      |
|      | Prelaryngeal                             |      |      |      |
|      |                                          |      |      |      |
|      | Delphian node                            |      |      |      |
|      |                                          |      |      |      |
|      | Retropharyngeal                          |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS Reg Nodes Eval**

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

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

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | NA   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), including:        | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Mediastinal                              |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastasis, NOS                  | NA   | D    | D    |
|      |                                          |      |      |      |
|      | Distant metastases except distant lymph  |      |      |      |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**CS Mets Eval**

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

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

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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                              |
+------+---------------------------------------------------------------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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                              |
+------+---------------------------------------------------------------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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                              |
+------+---------------------------------------------------------------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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                              |
+------+---------------------------------------------------------------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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                              |
+------+---------------------------------------------------------------+

**Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites**\
**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**

Pharynx

Tonsil C090--C099, Oropharynx C100--C109, Nasopharynx C110--C119

Pyriform Sinus C129, Hypopharynx C130--C139, Pharynx C140

(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 Pharyngectomy, NOS

31 Limited/partial pharyngectomy; tonsillectomy, bilateral tonsillectomy

32 Total pharyngectomy

40 Pharyngectomy WITH laryngectomy OR removal of contiguous bone tissue,
NOS

(does NOT include total mandibular resection)

\[***SEER Notes:*** Code 40 includes mandibulectomy (marginal,
segmental, hemi-, and/or laryngectomy) NOS Contiguous bone tissue refers
to the mandible\]

41 WITH laryngectomy (laryngopharyngectomy)

42 WITH bone \[mandibulectomy\]

43 WITH both 41 and 42

\[***SEER Notes:***

> Use code 40 when the patient had a pharyngectomy and maybe some sort
> of mandibulectomy and/or maybe a laryngectomy, but the exact
> procedures are not clear
>
> Use code 41 when the patient had pharyngectomy and laryngectomy but no
> mandibulectomy
>
> Use code 42 when the patient had pharyngectomy and mandibulectomy but
> no laryngectomy
>
> Use code 43 when it is certain that the patient had both a
> mandibulectomy and laryngectomy in addition to the pharyngectomy\]

50 **Radical** **pharyngectomy** (includes total mandibular resection),
NOS

51 WITHOUT laryngectomy

52 WITH laryngectomy

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**

ESOPHAGUS

**C150-C155, C158-C159**

Primary Site

There are two systems that divide the esophagus into three subsites. The
first system divides the esophagus into the upper third, middle third,
and lower third. The second system describes the subsites as the
cervical esophagus, the thoracic esophagus and the abdominal esophagus.
The subsites for these two different systems are not identical. Assign
the ICD-O-3 topography code that describes the primary site documented
in the medical record. See the SEER *Self Instructional Manual for Tumor
Registrars, Book 4* for illustrated descriptions of each system.

**Page left blank.**

**Collaborative Staging Codes**

**Esophagus**\
**C15.0-C15.5, C15.8-C15.9**

C15.0 Cervical esophagus

C15.1 Thoracic esophagus

C15.2 Abdominal esophagus

C15.3 Upper third of esophagus

C15.4 Middle third of esophagus

C15.5 Lower third of esophagus

C15.8 Overlapping lesion of esophagus

C15.9 Esophagus, NOS

Anatomic Limits of Esophagus:

**Cervical Esophagus (C15.0):  ** From the lower border of the cricoid
cartilage to the thoracic inlet (suprasternal notch), about 18 cm from
the incisors.

**Intrathoracic (including abdominal esophagus) (C15.1 - C15.5):  **
Upper thoracic portion (C15.3): From the thoracic inlet to the level of
the tracheal bifurcation (18-24 cm). Mid-thoracic portion (C15.4): From
the tracheal bifurcation midway to the gastroesophageal (GE) junction
(24-32 cm).

**Lower thoracic portion (C15.5:  ** From midway between the tracheal
bifurcation and the gastroesophageal junction to the GE junction,
including the abdominal esophagus (C15.2) between 32-40 cm.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Esophagus**\
**CS Tumor Size**

**Note:  ** For esophagus, this field is used for size of tumor/length
of involved esophagus.

+-------+--------------------------------------------------------------+
| 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                                  |
+-------+--------------------------------------------------------------+
| 998   | Circumferential                                              |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Esophagus**\
**CS Extension**

**Note:  ** Ignore intraluminal extension to adjacent segment(s) of
esophagus or to cardia of stomach and code depth of invasion or
extra-esophageal spread as indicated.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa, NOS   | T1   | L    | L    |
|      | (including intramucosal, NOS)            |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Invades lamina propria                   | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 12   | Invades muscularis mucosae               | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 16   | Invades submucosa                        | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria invaded               | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adventitia and/or soft tissue invaded    | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Esophagus is described as \"FIXED\"      |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Tumor invades adjacent structures        | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Cervical esophagus:                      |      |      |      |
|      |                                          |      |      |      |
|      | Blood vessel(s):                         |      |      |      |
|      |                                          |      |      |      |
|      | Carotid artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Jugular vein                             |      |      |      |
|      |                                          |      |      |      |
|      | Subclavian artery                        |      |      |      |
|      |                                          |      |      |      |
|      | Thyroid gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic, upper or mid-portion,     |      |      |      |
|      | esophagus:                               |      |      |      |
|      |                                          |      |      |      |
|      | Blood vessel(s), major:                  |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Azygos vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary artery/vein                    |      |      |      |
|      |                                          |      |      |      |
|      | Vena cava                                |      |      |      |
|      |                                          |      |      |      |
|      | Carina                                   |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm                                |      |      |      |
|      |                                          |      |      |      |
|      | Main stem bronchus                       |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic, lower portion             |      |      |      |
|      | (abdominal), esophagus:                  |      |      |      |
|      |                                          |      |      |      |
|      | Blood vessel(s):                         |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Gastric artery/vein                      |      |      |      |
|      |                                          |      |      |      |
|      | Vena cava                                |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm, not fixed, or NOS             |      |      |      |
|      |                                          |      |      |      |
|      | Stomach, cardia (via serosa)             |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Cervical esophagus:                      | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Carina                                   |      |      |      |
|      |                                          |      |      |      |
|      | Cervical vertebra(e)                     |      |      |      |
|      |                                          |      |      |      |
|      | Hypopharynx                              |      |      |      |
|      |                                          |      |      |      |
|      | Larynx                                   |      |      |      |
|      |                                          |      |      |      |
|      | Trachea                                  |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 65,  | Intrathoracic esophagus:                 |      |      |      |
|      |                                          |      |      |      |
| co   | Lung via bronchus                        |      |      |      |
| nt'd |                                          |      |      |      |
|      | Mediastinal structure(s), NOS            |      |      |      |
|      |                                          |      |      |      |
|      | Pleura                                   |      |      |      |
|      |                                          |      |      |      |
|      | Rib(s)                                   |      |      |      |
|      |                                          |      |      |      |
|      | Thoracic vertebra(e)                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | Thoracic/middle esophagus:               | T4   | RE   | D    |
|      |                                          |      |      |      |
|      | Pericardium                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Cervical/upper esophagus:                |      |      |      |
|      |                                          |      |      |      |
|      | Lung                                     |      |      |      |
|      |                                          |      |      |      |
|      | Main stem bronchus                       |      |      |      |
|      |                                          |      |      |      |
|      | Pleura                                   |      |      |      |
|      |                                          |      |      |      |
|      | Abdominal/lower esophagus:               |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm fixed                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Esophagus**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Esophagus**\
**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) (including        | N1   | RN   | RN   |
|      | contralateral or bilateral)              |      |      |      |
| 10,  |                                          |      |      |      |
| co   | For all subsites:                        |      |      |      |
| nt'd |                                          |      |      |      |
|      | Peri-/paraesophageal                     |      |      |      |
|      |                                          |      |      |      |
|      | Cervical esophagus only:                 |      |      |      |
|      |                                          |      |      |      |
|      | Cervical, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Anterior deep cervical (laterolateral)   |      |      |      |
|      | (recurrent laryngeal)                    |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS:                      |      |      |      |
|      |                                          |      |      |      |
|      | Upper, NOS:                              |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic esophagus, upper or        |      |      |      |
|      | middle, only:                            |      |      |      |
|      |                                          |      |      |      |
|      | Internal jugular, NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Deep cervical, NOS:                      |      |      |      |
|      |                                          |      |      |      |
|      | Lower, NOS:                              |      |      |      |
|      |                                          |      |      |      |
|      | Jugulo-omohyoid (supraomohyoid)          |      |      |      |
|      |                                          |      |      |      |
|      | Middle                                   |      |      |      |
|      |                                          |      |      |      |
|      | Upper cervical, NOS:                     |      |      |      |
|      |                                          |      |      |      |
|      | Jugulodigastric (subdigastric)           |      |      |      |
|      |                                          |      |      |      |
|      | Intrabronchial:                          |      |      |      |
|      |                                          |      |      |      |
|      | Carinal (tracheobronchial) (tracheal     |      |      |      |
|      | bifurcation)                             |      |      |      |
|      |                                          |      |      |      |
|      | Hilar (bronchopulmonary) (proximal       |      |      |      |
|      | lobar) (pulmonary root)                  |      |      |      |
|      |                                          |      |      |      |
|      | Peritracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Left gastric (superior gastric):         |      |      |      |
|      |                                          |      |      |      |
|      | Cardiac (cardial)                        |      |      |      |
|      |                                          |      |      |      |
|      | Lesser curvature                         |      |      |      |
|      |                                          |      |      |      |
|      | Perigastric, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior mediastinal                    |      |      |      |
|      | (tracheoesophageal)                      |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic esophagus, lower           |      |      |      |
|      | (abdominal) only:                        |      |      |      |
|      |                                          |      |      |      |
|      | Left gastric (superior gastric):         |      |      |      |
|      |                                          |      |      |      |
|      | Cardiac (cardial)                        |      |      |      |
|      |                                          |      |      |      |
|      | Lesser curvature                         |      |      |      |
|      |                                          |      |      |      |
|      | Perigastric, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior mediastinal                    |      |      |      |
|      | (tracheoesophageal)                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Cervical Esophagus only:                 | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Scalene (inferior deep cervical)         |      |      |      |
|      |                                          |      |      |      |
|      | Supraclavicular (transverse cervical)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 22   | Intrathoracic, upper thoracic or middle, | N1   | D    | RN   |
|      | only:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Superior mediastinal                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | All esophagus subsites:                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Anterior mediastinal                     |      |      |      |
|      |                                          |      |      |      |
|      | Mediastinal, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Cervical esophagus only:                 |      |      |      |
|      |                                          |      |      |      |
|      | Aortopulmonary                           |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Posterior mediastinal                    |      |      |      |
|      |                                          |      |      |      |
|      | Superior mediastinal                     |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic esophagus,upper or middle, |      |      |      |
|      | only:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Aortopulmonary                           |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic esophagus, lower           |      |      |      |
|      | (abdominal) only:                        |      |      |      |
|      |                                          |      |      |      |
|      | Common hepatic                           |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragmatic                            |      |      |      |
|      |                                          |      |      |      |
|      | Paratracheal                             |      |      |      |
|      |                                          |      |      |      |
|      | Splenic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Superior mediastinal                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph node(s), NOS              | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Esophagus**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Esophagus**\
**Reg LN Pos**\
**SEE STANDARD TABLE**

**Esophagus**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Esophagus**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | M    | D    | D    |
|      |                                          | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Upper thoracic esophagus only:           | M1a  | D    | D    |
|      |                                          |      |      |      |
|      | Cervical lymph node(s)                   |      |      |      |
|      |                                          |      |      |      |
|      | Lower thoracic (abdominal) esophagus     |      |      |      |
|      | only:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Celiac lymph node(s)                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Specified distant lymph node(s), other   | M    | D    | D    |
|      | than code 11, including:                 | 1NOS |      |      |
|      |                                          |      |      |      |
|      | Cervical esophagus only:                 |      |      |      |
|      |                                          |      |      |      |
|      | Common hepatic                           |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragmatic                            |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
|      |                                          |      |      |      |
|      | Splenic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Intrathoracic esophagus, upper or        |      |      |      |
|      | middle, only:                            |      |      |      |
|      |                                          |      |      |      |
|      | Common hepatic                           |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragmatic                            |      |      |      |
|      |                                          |      |      |      |
|      | Splenic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lower thoracic (abdominal) esophagus     |      |      |      |
|      | only:                                    |      |      |      |
|      |                                          |      |      |      |
|      | Aortopulmonary                           |      |      |      |
|      |                                          |      |      |      |
|      | Pulmonary ligament                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1b  | D    | D    |
|      | node(s) (codes 10 - 12)                  |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(40\) + any of \[(10) to (12)\]         | M1b  | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Esophagus**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Site-Specific Surgery Codes**

**Esophagus**

**C150--C159**

(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 Partial esophagectomy

40 Total esophagectomy, NOS

50 Esophagectomy, NOS WITH laryngectomy and/or gastrectomy, NOS

\[***SEER Note:*** Esophagectomy WITH other procedures may be partial,
total, or NOS\]

51 WITH laryngectomy

52 WITH gastrectomy, NOS

53 Partial gastrectomy

54 Total gastrectomy

55 Combination of 51 WITH any of 52--54

80 Esophagectomy, NOS

90 Surgery, NOS

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

**Page left blank.**

**Collaborative Staging Codes**

**Stomach**\
**C16.0-C16.6, C16.8-C16.9**

C16.0 Cardia, NOS

C16.1 Fundus of stomach

C16.2 Body of stomach

C16.3 Gastric antrum

C16.4 Pylorus

C16.5 Lesser curvature of stomach, NOS

C16.6 Greater curvature of stomach, NOS

C16.8 Overlapping lesion of stomach

C16.9 Stomach, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           | Lymph Nodes Number  |   |
| |                     | CS Site-Specific    | Positive Table      |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Stomach**\
**CS Tumor Size**

+-------+--------------------------------------------------------------+
| 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                                  |
+-------+--------------------------------------------------------------+
| 998   | Diffuse; widespread; 3/4\'s or more: linitis plastica        |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Stomach**\
**CS Extension**

**Note 1:  ** INTRALUMINAL or INTRAMURAL extension to esophagus and
duodenum is classified by the depth of greatest invasion in any of these
sites, including stomach. (For extension to esophagus or duodenum via
serosa, see code 60.)

**Note 2:  ** If the diagnosis states \"linitis plastica\" and no other
information regarding extension is available, use code 35.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 05   | (Adeno)carcinoma in a polyp, noninvasive | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa, NOS   | T1   | L    | L    |
|      | (including intramucosal, NOS)            |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Invades lamina propria                   | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 12   | Invades muscularis mucosae               | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 13   | Confined to head of polyp                | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Extension to stalk                       |      |      |      |
+------+------------------------------------------+------+------+------+
| 14   | Confined to stalk of polyp               | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 15   | Tumor in polyp, NOS                      | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 16   | Invades submucosa (superficial invasion) | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 20   | Invades into but not through muscularis  | T2a  | L    | L    |
|      | propria                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Implants inside stomach                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Linitis plastica (see Note 2) and no     | T2a  | RE   | L    |
|      | other information regarding extension is |      |      |      |
|      | available.                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Invasion through muscularis propria or   | T2b  | L    | L    |
|      | muscularis, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Extension through wall, NOS              |      |      |      |
|      |                                          |      |      |      |
|      | Perimuscular tissue invaded              |      |      |      |
|      |                                          |      |      |      |
|      | Subserosal tissue/(sub)serosal fat       |      |      |      |
|      | invaded                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 45   | Extension to adjacent (connective)       | T2b  | RE   | RE   |
|      | tissue                                   |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT perforation of visceral          |      |      |      |
|      | peritoneum:                              |      |      |      |
|      |                                          |      |      |      |
|      | Gastric artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Ligaments:                               |      |      |      |
|      |                                          |      |      |      |
|      | Gastrocolic                              |      |      |      |
|      |                                          |      |      |      |
|      | Gastrohepatic                            |      |      |      |
|      |                                          |      |      |      |
|      | Gastrosplenic                            |      |      |      |
|      |                                          |      |      |      |
|      | Omentum, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Greater                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lesser                                   |      |      |      |
|      |                                          |      |      |      |
|      | Perigastric fat                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through serosa (mesothelium) | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | (tunica serosa) (visceral peritoneum),   |      |      |      |
|      | including perforation of                 |      |      |      |
|      |                                          |      |      |      |
|      | visceral peritoneum covering the gastric |      |      |      |
|      | ligaments or the omentum                 |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT invasion of adjacent structures  |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | \(45\) + (50)                            | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Diaphragm                                | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Duodenum via serosa or NOS               |      |      |      |
|      |                                          |      |      |      |
|      | Esophagus via serosa                     |      |      |      |
|      |                                          |      |      |      |
|      | Ileum                                    |      |      |      |
|      |                                          |      |      |      |
|      | Jejunum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Liver                                    |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Small intestine, NOS                     |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon (including flexures)    |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Abdominal wall                           | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Adrenal gland                            |      |      |      |
|      |                                          |      |      |      |
|      | Kidney                                   |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Stomach**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Stomach**\
**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):                  | \*   | RN   | RN   |
|      |                                          |      |      |      |
| 10,  | Left gastric (superior gastric), NOS:    |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Cardial                                  |      |      |      |
|      |                                          |      |      |      |
|      | Cardioesophageal                         |      |      |      |
|      |                                          |      |      |      |
|      | Gastric, left                            |      |      |      |
|      |                                          |      |      |      |
|      | Gastropancreatic, left                   |      |      |      |
|      |                                          |      |      |      |
|      | Lesser curvature                         |      |      |      |
|      |                                          |      |      |      |
|      | Lesser omental                           |      |      |      |
|      |                                          |      |      |      |
|      | Paracardial                              |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticosplenic (pancreaticolienal)   |      |      |      |
|      |                                          |      |      |      |
|      | Pancreatoduodenal                        |      |      |      |
|      |                                          |      |      |      |
|      | Perigastric, NOS                         |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic                           |      |      |      |
|      |                                          |      |      |      |
|      | Right gastric (inferior gastric), NOS:   |      |      |      |
|      |                                          |      |      |      |
|      | Gastrocolic                              |      |      |      |
|      |                                          |      |      |      |
|      | Gastroduodenal                           |      |      |      |
|      |                                          |      |      |      |
|      | Gastroepiploic (gastro-omental), right   |      |      |      |
|      | or NOS                                   |      |      |      |
|      |                                          |      |      |      |
|      | Gastrohepatic                            |      |      |      |
|      |                                          |      |      |      |
|      | Greater curvature                        |      |      |      |
|      |                                          |      |      |      |
|      | Greater omental                          |      |      |      |
|      |                                          |      |      |      |
|      | Pyloric, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
|      |                                          |      |      |      |
|      | Suprapyloric                             |      |      |      |
|      |                                          |      |      |      |
|      | Splenic (lienal), NOS:                   |      |      |      |
|      |                                          |      |      |      |
|      | Gastroepiploic (gastro-omental), left    |      |      |      |
|      |                                          |      |      |      |
|      | Splenic hilar                            |      |      |      |
|      |                                          |      |      |      |
|      | Nodule(s) in perigastric fat             |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Celiac                                   | \*   | D    | RN   |
|      |                                          |      |      |      |
|      | Hepatic (excluding gastrohepatic, \[see  |      |      |      |
|      | code 10\]                                |      |      |      |
|      |                                          |      |      |      |
|      | and hepatoduodenal \[see code 42\])      |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | For lesser curvature only:               | \*   | D    | D    |
|      |                                          |      |      |      |
|      | Hepatoduodenal                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Regional lymph node(s), NOS              | \*   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 80   | Lymph node(s), NOS                       | \*   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 99   | Unknown; not stated                      | NX   | U    | U    |
|      |                                          |      |      |      |
|      | Regional lymph node(s) cannot be         |      |      |      |
|      | assessed                                 |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

\* For codes 10-80 ONLY, the N category is assigned based on the value
of the Reg LN Pos using the Lymph Nodes Number Positive table for this
site.

**Stomach**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

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

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s):                   | M1   | D    | D    |
|      |                                          |      |      |      |
|      | For all subsites:                        |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Porta hepatis (portal) (hilar) (in hilus |      |      |      |
|      | of liver)                                |      |      |      |
|      |                                          |      |      |      |
|      | Retropancreatic                          |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric or mesenteric, NOS   |      |      |      |
|      |                                          |      |      |      |
|      | For all subsites EXCEPT lesser curvature |      |      |      |
|      |                                          |      |      |      |
|      | Hepatoduodenal                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Site-Specific Surgery Codes**

Stomach

C160--C169

(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 **Gastrectomy**, NOS (**partial**, subtotal, hemi‑)

31 Antrectomy, lower (distal‑less than 40% of stomach)\*\*\*

32 Lower (distal) gastrectomy (partial, subtotal, hemi‑)

33 Upper (proximal) gastrectomy (partial, subtotal, hemi‑)

Code 30 includes:

Partial gastrectomy, including a sleeve resection of the stomach

Billroth I: anastomosis to duodenum (duodenostomy)

Billroth II: anastomosis to jejunum (jejunostomy)

40 Near‑total or total gastrectomy, NOS

41 Near‑total gastrectomy

42 Total gastrectomy

A total gastrectomy may follow a previous partial resection of the
stomach

50 **Gastrectomy**, NOS WITH removal of a portion of **esophagus**

51 Partial or subtotal gastrectomy

52 Near total or total gastrectomy

Codes 50--52 are used for gastrectomy resection when only portions of
esophagus are included in procedure

60 **Gastrectomy** with a resection in continuity with the resection of
**other** **organs**, NOS\*\*\*

61 Partial or subtotal gastrectomy, in continuity with the resection of
other organs\*\*\*

62 Near total or total gastrectomy, in continuity with the resection of
other organs\*\*\*

63 Radical gastrectomy, in continuity with the resection of other
organs\*\*\*

Codes 60--63 are used for gastrectomy resection with organs other than
esophagus. Portions of esophagus

may or may not be included in the resection.

\[***SEER Notes:*** A portion of the duodenum may be removed during this
procedure; assign codes 60-63

unless the entire duodenum was removed and a gastrojejunostomy was
performed. Codes 60-63 may include

omentectomy among the organs/tissues removed. 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\]

80 Gastrectomy, NOS

90 Surgery, NOS

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

\_\_\_\_\_\_\_\_\_\_

\*\*\* Incidental splenectomy NOT included

**Collaborative Staging Codes**

## **Small Intestine** **C17.0-C17.3, C17.8-C17.9**

C17.0 Duodenum

C17.1 Jejunum

C17.2 Ileum (excludes ileocecal valve C18.0)

C17.3 Meckel diverticulum (site of neoplasm)

C17.8 Overlapping lesion of small intestine

C17.9 Small intestine, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Small Intestine**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Small Intestine**\
**CS Extension**

**Note 1:  ** Ignore intraluminal or lateral extension to adjacent
segment(s) of small intestine and code depth of invasion or spread
outside the small intestine as indicated.

**Note 2:  ** The nonperitonealized perimuscular tissue is, for jejunum
and ileum, part of the mesentery and, for duodenum in areas where serosa
is lacking, part of the retroperitoneum.

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

  00      In situ; non-invasive; intraepithelial     Tis     IS      IS

  05      (Adeno)carcinoma in a polyp, noninvasive   Tis     IS      IS

  10      Invasive tumor confined to mucosa, NOS,    T1      L       L
          including intramucosal, NOS                                

  11      Invasion of lamina propria                 T1      L       L

  12      Invasion of muscularis mucosae             T1      L       L

  13      Confined to head of polyp                  T1      L       L

  14      Confined to stalk of polyp                 T1      L       L

  15      Invasion of polyp, NOS                     T1      L       L

  16      Invasion of submucosa (superficial         T1      L       L
          invasion)                                                  

  20      Muscularis propria invaded                 T2      L       L
  ------- ------------------------------------------ ------- ------- --------

+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Intraluminal spread to other segments of |      |      |      |
|      | small intestine or cecum                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Invasion through muscularis propria or   | T3   | L    | L    |
|      | muscularis, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Extension through wall, NOS              |      |      |      |
|      |                                          |      |      |      |
|      | Subserosal tissue/(sub) serosal fat      |      |      |      |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Transmural, NOS                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Fat, NOS                                 | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 45   | Adjacent connective tissue               | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Mesentery, including mesenteric fat,     |      |      |      |
|      | invaded less than or equal to 2 cm in    |      |      |      |
|      | depth or NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Nonperitonealized perimuscular tissue    |      |      |      |
|      | invaded less than or equal to 2 cm in    |      |      |      |
|      | depth or NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum invaded less than or     |      |      |      |
|      | equal to 2 cm in depth or NOS            |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through                      | T4   | L    | RE   |
|      | serosa(mesothelium)(tunica serosa)       |      |      |      |
|      | (visceral peritoneum)                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | \(50\) + \[(42) or (45)\]                | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | For duodenum primary only:               | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Ampulla of Vater                         |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm                                |      |      |      |
|      |                                          |      |      |      |
|      | Extrahepatic bile ducts                  |      |      |      |
|      |                                          |      |      |      |
|      | Gallbladder                              |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Pancreatic duct                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | For duodenum primary only:               | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Blood vessel(s), major:                  |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Gastroduodenal artery                    |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Renal vein                               |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric artery or vein       |      |      |      |
|      |                                          |      |      |      |
|      | Vena cava                                |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic flexure                          |      |      |      |
|      |                                          |      |      |      |
|      | Kidney, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Kidney, right                            |      |      |      |
|      |                                          |      |      |      |
|      | Liver, NOS                               |      |      |      |
|      |                                          |      |      |      |
|      | Liver, quadrate lobe                     |      |      |      |
|      |                                          |      |      |      |
|      | Liver, right lobe                        |      |      |      |
|      |                                          |      |      |      |
|      | Omentum, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon                         |      |      |      |
|      |                                          |      |      |      |
|      | Ureter, right                            |      |      |      |
|      |                                          |      |      |      |
|      | For jejunum or ileum primary only:       |      |      |      |
|      |                                          |      |      |      |
|      | Colon, including appendix                |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | For duodenum primary only:               | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 67   | For all small intestine sites:           | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Abdominal wall                           |      |      |      |
|      |                                          |      |      |      |
|      | Mesentery invaded greater than 2 cm in   |      |      |      |
|      | depth                                    |      |      |      |
|      |                                          |      |      |      |
|      | Non-peritonealized perimuscular tissue   |      |      |      |
|      | invaded greater than 2                   |      |      |      |
|      |                                          |      |      |      |
|      | cm in depth                              |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum invaded greater than 2   |      |      |      |
|      | cm in depth                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | For all small intestine sites:           | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Other segments of the small intestine    |      |      |      |
|      | via serosa                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | For jejunum or ileum primary only:       | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Bladder                                  |      |      |      |
|      |                                          |      |      |      |
|      | Fallopian tube                           |      |      |      |
|      |                                          |      |      |      |
|      | Ovary                                    |      |      |      |
|      |                                          |      |      |      |
|      | Uterus                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Small Intestine**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Small Intestine**\
**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   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | For duodenum primaries only:             |      |      |      |
|      |                                          |      |      |      |
|      | Duodenal                                 |      |      |      |
|      |                                          |      |      |      |
|      | Gastroduodenal                           |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal                      |      |      |      |
|      |                                          |      |      |      |
|      | Pyloric                                  |      |      |      |
|      |                                          |      |      |      |
|      | For jejunum or ileum primaries only:     |      |      |      |
|      |                                          |      |      |      |
|      | Ileocolic for terminal ileum primary     |      |      |      |
|      |                                          |      |      |      |
|      | Mesenteric, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Posterior cecal (retrocecal) for         |      |      |      |
|      | terminal ileum primary                   |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s) for duodenum      | N1   | D    | RN   |
|      | primaries only:                          |      |      |      |
|      |                                          |      |      |      |
|      | Pericholodochal (common bile duct)       |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | (See code 11 in CS Mets at DX for other  |      |      |      |
|      | lymph nodes of of small intestine)       |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph node(s), NOS              | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

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

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), other than those  | M1   | D    | D    |
|      | listed                                   |      |      |      |
|      |                                          |      |      |      |
|      | in code 11 including celiac lymph        |      |      |      |
|      | node(s)                                  |      |      |      |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | For jejunum and ileum primaries only:    | M1   | D    | RN   |
|      |                                          |      |      |      |
|      | Pericholodochal                          |      |      |      |
|      |                                          |      |      |      |
|      | (For duodenal primary, see Lymph Nodes   |      |      |      |
|      | field)                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(40\) + any of \[(10) or (11)\]         | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Small Intestine**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Small Intestine**\
**CS Site-Specific Factor 1**

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

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

**Small Intestine**\
**CS Site-Specific Factor 2**

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

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

**Small Intestine**\
**CS Site-Specific Factor 3**

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

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

**Small Intestine**\
**CS Site-Specific Factor 4**

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

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

**Small Intestine**\
**CS Site-Specific Factor 5**

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

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

**Small Intestine**\
**CS Site-Specific Factor 6**

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

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

**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**

**SEER Site-Specific Coding Guidelines**

## COLON

C180--C189

# Grade

Colon cancer is often graded using a two-grade system; Low Grade (2) or
High Grade (4). If the grade is listed as 1/2 or as low grade, convert
to a grade 2. If the grade is listed as 2/2 or as high grade, convert to
a code 4.

Code the highest grade given.

  -----------------------------------------------------------------------
  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                                         
  -----------------------------------------------------------------------

# Familial Polyposis

Familial polyposis is an inherited, benign disease. The patients have
hundreds of adenomatous polyps throughout their large intestines, and at
times, throughout the digestive system. These polyps, if left untreated,
invariably develop cancer.

Patients develop polyps as early as ten years of age, but more commonly
at puberty. Approximately half of all patients with familial polyposis
develop polyps by age 14 and 90% have detectable polyps by age 25.

These patients are usually treated with a colectomy. The pathology
report will frequently identify carcinoma insitu in many of the polyps
and may also identify invasive carcinomas. Prepare one abstract and code
the primary site to colon, NOS (C189). Code the stage of disease using
the most invasive of the cancers.

**Synonyms** for familial polyposis:

Adenomatosis of the colon and rectum (ACR)

Familial adenomatous colon polyposis

Familial adenomatous polyposis (FAP)

Familial colonic polyposis

Multiple familial polyposis

Polyposis coli

**Page left blank**

**Collaborative Staging Codes**

**Colon\
C18.0-C18.9**

C18.0 Cecum

C18.1 Appendix

C18.2 Ascending colon

C18.3 Hepatic flexure of colon

C18.4 Transverse colon

C18.5 Splenic flexure of colon

C18.6 Descending colon

C18.7 Sigmoid colon

C18.8 Overlapping lesion of colon

C18.9 Colon, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -**        | tables are          |   |
| | CS TS/Ext-Eval\     | Carcinoembryonic    | available at the    |   |
| | CS Lymph Nodes\     | Antigen (CEA)\      | 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\           | Lymph Nodes Number  |   |
| |                     | CS Site-Specific    | Positive Table      |   |
| |                     | Factor 5\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Colon**\
**CS Tumor Size**

+-------+--------------------------------------------------------------+
| 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                                  |
+-------+--------------------------------------------------------------+
| 998   | Familial/multiple polyposis (M-8220/8221)                    |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Colon**\
**CS Extension**

**Note 1:  ** Ignore intraluminal extension to adjacent segment(s) of
colon/rectum or to the ileum from the cecum; code depth of invasion or
extracolonic spread as indicated.

**Note 2:  ** A tumor nodule in the pericolic adipose tissue of a
primary carcinoma without histologic evidence of residual lymph node in
the nodule is classified as a regional lymph node metastasis if the
nodule has the form and smooth contour of a lymph node, or if the
contour is not described. If the nodule has an irregular contour, it
should be coded in CS Extension as code 45.

**Note 3:  ** Codes 60-80 are used for contiguous extension from the
site of origin. Discontinuous involvement is coded in CS Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 05   | (Adeno)carcinoma in a polyp or adenoma,  | Tis  | IS   | IS   |
|      | noninvasive                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa, NOS   | Tis  | L    | L    |
|      | (including intramucosal, NOS)            |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Lamina propria, including lamina propria | T1   | L    | L    |
|      | in the stalk of a polyp                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Muscularis mucosae, including muscularis | T1   | L    | L    |
|      | mucosae in the stalk of a polyp          |      |      |      |
+------+------------------------------------------+------+------+------+
| 13   | Confined to head of polyp, NOS           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 14   | Confined to stalk of polyp, NOS          | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 15   | Invasive tumor in polyp, NOS             | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 16   | Invades submucosa (superficial           | T1   | L    | L    |
|      | invasion), including submucosa in the    |      |      |      |
|      | stalk of a polyp                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria invaded               | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Confined to colon, NOS                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Extension through wall, NOS              | T3   | L    | L    |
|      |                                          |      |      |      |
|      | Invasion through muscularis propria or   |      |      |      |
|      | muscularis, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Non-peritonealized pericolic tissues     |      |      |      |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Perimuscular tissue invaded              |      |      |      |
|      |                                          |      |      |      |
|      | Subserosal tissue/(sub)serosal fat       |      |      |      |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Transmural, NOS                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Fat, NOS                                 | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 45   | Extension to:                            | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | All colon sites:                         |      |      |      |
|      |                                          |      |      |      |
|      | Adjacent tissue(s), NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Connective tissue                        |      |      |      |
|      |                                          |      |      |      |
|      | Mesenteric fat                           |      |      |      |
|      |                                          |      |      |      |
|      | Mesentery                                |      |      |      |
|      |                                          |      |      |      |
|      | Mesocolon                                |      |      |      |
|      |                                          |      |      |      |
|      | Pericolic fat                            |      |      |      |
|      |                                          |      |      |      |
|      | Ascending and descending colon           |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal fat                      |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon/flexures                |      |      |      |
|      |                                          |      |      |      |
|      | Gastrocolic ligament                     |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 46   | Adherent to other organs or structures,  | T3   | RE   | RE   |
|      | but no microscopic tumor found in        |      |      |      |
|      | adhesion(s)                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through serosa (mesothelium) | T4   | RE   | RE   |
|      | (visceral peritoneum)                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Any of \[(42) to (45)\] + (50)           | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 57   | Adherent to other organs or structures,  | T4   | RE   | RE   |
|      | NOS                                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | All colon sites:                         | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Small intestine                          |      |      |      |
|      |                                          |      |      |      |
|      | Cecum and appendix:                      |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Ascending colon:                         |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Liver, right lobe                        |      |      |      |
|      |                                          |      |      |      |
|      | Tranverse colon and flexures:            |      |      |      |
|      |                                          |      |      |      |
|      | Gallbladder/bile ducts                   |      |      |      |
|      |                                          |      |      |      |
|      | Kidney                                   |      |      |      |
|      |                                          |      |      |      |
|      | Liver                                    |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
|      |                                          |      |      |      |
|      | Descending colon:                        |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic wall                              |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoid colon:                           |      |      |      |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic wall                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | All colon sites:                         | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Abdominal wall                           |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum (excluding fat)          |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Ascending colon:                         | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Right kidney                             |      |      |      |
|      |                                          |      |      |      |
|      | Right ureter                             |      |      |      |
|      |                                          |      |      |      |
|      | Descending colon:                        |      |      |      |
|      |                                          |      |      |      |
|      | Left kidney                              |      |      |      |
|      |                                          |      |      |      |
|      | Left ureter                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Cecum, appendix, ascending, descending   | T4   | D    | D    |
|      | and sigmoid colon:                       |      |      |      |
|      |                                          |      |      |      |
|      | Fallopian tube                           |      |      |      |
|      |                                          |      |      |      |
|      | Ovary                                    |      |      |      |
|      |                                          |      |      |      |
|      | Uterus                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | All colon sites unless otherwise stated  | T4   | D    | D    |
|      | above:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Adrenal (suprarenal) gland               |      |      |      |
|      |                                          |      |      |      |
|      | Bladder                                  |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm                                |      |      |      |
|      |                                          |      |      |      |
|      | Fistula to skin                          |      |      |      |
|      |                                          |      |      |      |
|      | Gallbladder                              |      |      |      |
|      |                                          |      |      |      |
|      | Other segment(s) of colon via serosa     |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Cecum and appendix:                      |      |      |      |
|      |                                          |      |      |      |
|      | Kidney                                   |      |      |      |
|      |                                          |      |      |      |
|      | Liver                                    |      |      |      |
|      |                                          |      |      |      |
|      | Ureter                                   |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon and flexures:           |      |      |      |
|      |                                          |      |      |      |
|      | Ureter                                   |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoid colon:                           |      |      |      |
|      |                                          |      |      |      |
|      | Cul de sac (rectouterine pouch)          |      |      |      |
|      |                                          |      |      |      |
|      | Ureter                                   |      |      |      |
|      |                                          |      |      |      |
|      | Other contiguous extension               |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Colon**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Colon**\
**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:  ** A tumor nodule in the pericolic adipose tissue of a
primary carcinoma without histologic evidence of residual lymph node in
the nodule is classified as a regional lymph node metastasis if the
nodule has the form and smooth contour of a lymph node, or if the
contour is not described. If the nodule has an irregular contour, it
should be coded in CS Extension as code 45.

**Note 3:  ** Inferior mesenteric nodes are coded in CS Mets at DX for
cecum, appendix, ascending colon, transverse colon, and hepatic flexure.
Superior mesenteric nodes are coded in CS Mets at DX for all colon
sites.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s) for all colon     | \*   | RN   | RN   |
|      | sites:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Colic (NOS)                              |      |      |      |
|      |                                          |      |      |      |
|      | Epicolic (adjacent to bowel wall)        |      |      |      |
|      |                                          |      |      |      |
|      | Mesocolic (NOS)                          |      |      |      |
|      |                                          |      |      |      |
|      | Paracolic/pericolic                      |      |      |      |
|      |                                          |      |      |      |
|      | Nodule(s) or foci in pericolic           |      |      |      |
|      | fat/adjacent mesentery/                  |      |      |      |
|      |                                          |      |      |      |
|      | mesocolic fat                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s), for specific     | \*   | RN   | RN   |
|      | subsites:                                |      |      |      |
| 20,  |                                          |      |      |      |
| co   | Cecum and appendix:                      |      |      |      |
| nt'd |                                          |      |      |      |
|      | Cecal: anterior (prececal), posterior    |      |      |      |
|      | (retrocecal); NOS                        |      |      |      |
|      |                                          |      |      |      |
|      | Ileocolic                                |      |      |      |
|      |                                          |      |      |      |
|      | Right colic                              |      |      |      |
|      |                                          |      |      |      |
|      | Ascending colon:                         |      |      |      |
|      |                                          |      |      |      |
|      | Ileocolic                                |      |      |      |
|      |                                          |      |      |      |
|      | Middle colic                             |      |      |      |
|      |                                          |      |      |      |
|      | Right colic                              |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon and flexures:           |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric for splenic flexure  |      |      |      |
|      | only                                     |      |      |      |
|      |                                          |      |      |      |
|      | Left colic for splenic flexure only      |      |      |      |
|      |                                          |      |      |      |
|      | Middle colic                             |      |      |      |
|      |                                          |      |      |      |
|      | Right colic for hepatic flexure only     |      |      |      |
|      |                                          |      |      |      |
|      | Descending colon:                        |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Left colic                               |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoid                                  |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoid colon:                           |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoidal (sigmoid mesenteric)           |      |      |      |
|      |                                          |      |      |      |
|      | Superior hemorrhoidal                    |      |      |      |
|      |                                          |      |      |      |
|      | Superior rectal                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph node(s) for all colon     | \*   | RN   | RN   |
|      | sites:                                   |      |      |      |
|      |                                          |      |      |      |
|      | Mesenteric, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 10-80 ONLY, the N category is assigned based on the value
of Reg LN Pos, using the Lymph Nodes Number Positive Table for this
site.

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

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 08   | Cecum, appendix, ascending, hepatic      | M1   | RN   | D    |
|      | flexure and transverse colon:            |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric lymph node(s)        |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s) other than code 08 | M1   | D    | D    |
|      |                                          |      |      |      |
|      | For all colon sites:                     |      |      |      |
|      |                                          |      |      |      |
|      | Common iliac                             |      |      |      |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
|      |                                          |      |      |      |
|      | External iliac                           |      |      |      |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | For cecum, appendix, ascending colon,    |      |      |      |
|      | transverse colon, and hepatic flexure:   |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | For splenic flexure, descending colon,   |      |      |      |
|      | and sigmoid colon:                       |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (codes 08-10)                    |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(40\) + \[(08) or (10)\]                | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Colon**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Colon**\
**CS Site-Specific Factor 1 Carcinoembryonic Antigen (CEA)**

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | Test not done                                                 |
+------+---------------------------------------------------------------+
| 010  | Positive/elevated                                             |
+------+---------------------------------------------------------------+
| 020  | Negative/normal; within normal limits                         |
+------+---------------------------------------------------------------+
| 030  | Borderline; undetermined whether positive or negative         |
+------+---------------------------------------------------------------+
| 080  | Ordered, but results not in chart                             |
+------+---------------------------------------------------------------+
| 999  | Unknown or no information                                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Page left blank.**

**Site-Specific Surgery Codes**

**Colon**

**C180--C189**

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

**Code** removal/surgical ablation of single or multiple liver
metastases under the data item *Surgical Procedure/Other Site* (NAACCR
Item #1294)

###### 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

27 Excisional biopsy

26 Polypectomy, NOS

28 Polypectomy‑endoscopic

29 Polypectomy‑surgical excision

Any **combination** of **20** or **26--29** 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,
27 Excisional biopsy,

26 Polypectomy, NOS, 28 Polypectomy-endoscopic or
29 Polypectomy-surgical excision WITH 21 PDT,

22 Electrocautery, 23 Cryosurgery, 24 Laser ablation, or 25 Laser
excision\]

**Specimen** sent to **pathology** from surgical events 20--29

30 **Partial** **colectomy**, \[but less than hemicolectomy\]
**segmental** resection

32 Plus resection of contiguous organ; example: small bowel, bladder

\[***SEER Note:*** Codes 30 and 32 include but are not limited to:
Appendectomy (for an appendix primary

only), enterocolectomy, ileocolectomy, partial colectomy, NOS, partial
resection of transverse colon and

flexures, and segmental resection, such as cecectomy or sigmoidectomy.
Removal of a short portion of the

distal ileum is not coded as removal of a contiguous organ.\]

40 **Subtotal** **colectomy/hemicolectomy** (total right or left colon
and a portion of transverse colon)

41 Plus resection of contiguous organ; example: small bowel, bladder

\[***SEER Notes:*** Code 40 includes extended (but less than total)
right or left colectomy

Removal of a short portion of the distal ileum is not coded as removal
of a contiguous organ\]

50 **Total** **colectomy** (removal of colon from cecum to the
rectosigmoid junction; may include a portion of the

rectum)

51 Plus resection of contiguous organ; example: small bowel, bladder

\[***SEER Note:*** Removal of a short portion of the distal ileum is not
coded as removal of a contiguous organ\]

60 Total proctocolectomy (removal of colon from cecum to the
rectosigmoid junction, including the entire

rectum)

\[***SEER Note:*** Commonly used for familial polyposis or polyposis
coli\]

61 Plus resection of contiguous organ; example: small bowel, bladder

\[***SEER Note:*** Removal of a short portion of the distal ileum is not
coded as removal of a contiguous organ\]

70 Colectomy or coloproctotectomy with resection of contiguous organ(s),
NOS (where there is not enough

information to code 32, 41, 51, or 61)

Code 70 includes: Any colectomy (partial, hemicolectomy, or total) WITH
a resection of any other organs in

continuity with the primary site. Other organs may be partially or
totally removed. Other organs may include,

but are not limited to, oophorectomy, partial proctectomy, rectal
mucosectomy, or pelvic exenteration.

\[***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\]

80 Colectomy, NOS

90 Surgery, NOS

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

**Collaborative Staging Codes**

## **Rectosigmoid, Rectum** **C19.9, C20.9**

C19.9 Rectosigmoid junction

C20.9 Rectum, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -**        | tables are          |   |
| | CS TS/Ext-Eval\     | Carcinoembryonic    | available at the    |   |
| | CS Lymph Nodes\     | Antigen (CEA)\      | 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\           | Lymph Nodes Number  |   |
| |                     | CS Site-Specific    | Positive Table      |   |
| |                     | Factor 5\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Rectosigmoid, Rectum**\
**CS Tumor Size**

+-------+--------------------------------------------------------------+
| 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 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                                  |
+-------+--------------------------------------------------------------+
| 998   | Familial/multiple polyposis (M-8220/8221)                    |
+-------+--------------------------------------------------------------+
| 999   | Unknown; size not stated                                     |
|       |                                                              |
|       | Not documented in patient record                             |
+-------+--------------------------------------------------------------+

**Rectosigmoid, Rectum**\
**CS Extension**

**Note 1:  ** Ignore intraluminal extension to adjacent segment(s) of
colon/rectum and code depth of invasion or extracolonic spread as
indicated.

**Note 2:  ** A tumor nodule in the pericolic adipose tissue of a
primary carcinoma without histologic evidence of residual lymph node in
the nodule is classified as a regional lymph node metastasis if the
nodule has the form and smooth contour of a lymph node, or if the
contour is not described. If the nodule has an irregular contour, it
should be coded in CS Extension as code 45.

**Note 3:  ** Codes 60-80 are used for contiguous extension from the
site of origin. Discontinuous involvement is coded in CS Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 05   | (Adeno)carcinoma in a polyp or adenoma,  | Tis  | IS   | IS   |
|      | noninvasive                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa, NOS,  | Tis  | L    | L    |
|      | including intramucosal, NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Lamina propria, including lamina propria | Tis  | L    | L    |
|      | in the stalk of a polyp                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Muscularis mucosae, including muscularis | T1   | L    | L    |
|      | mucosae in the stalk of a polyp          |      |      |      |
+------+------------------------------------------+------+------+------+
| 13   | Confined to head of polyp, NOS           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 14   | Confined to stalk of polyp, NOS          | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 15   | Invasive tumor in polyp, NOS             | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 16   | Submucosa (superficial invasion),        | T1   | L    | L    |
|      | including submucosa in the stalk of a    |      |      |      |
|      | polyp                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria invaded               | T2   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | TX   | L    | L    |
|      |                                          |      |      |      |
|      | Confined to rectum, NOS                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Extension through wall, NOS              | T3   | L    | L    |
|      |                                          |      |      |      |
|      | Invasion through muscularis propria or   |      |      |      |
|      | muscularis, NOS                          |      |      |      |
|      |                                          |      |      |      |
|      | Perimuscular tissue invaded              |      |      |      |
|      |                                          |      |      |      |
|      | Subserosal tissue/(sub)serosal fat       |      |      |      |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Non-peritonealized pericolic tissues     |      |      |      |
|      | invaded                                  |      |      |      |
|      |                                          |      |      |      |
|      | Transmural, NOS                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 42   | Fat, NOS                                 | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 45   | Adjacent (connective) tissue:            | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | For all sites:                           |      |      |      |
|      |                                          |      |      |      |
|      | Perirectal fat                           |      |      |      |
|      |                                          |      |      |      |
|      | For rectosigmoid:                        |      |      |      |
|      |                                          |      |      |      |
|      | Mesentery (including mesenteric fat,     |      |      |      |
|      | mesocolon)                               |      |      |      |
|      |                                          |      |      |      |
|      | Pericolic fat                            |      |      |      |
|      |                                          |      |      |      |
|      | For rectum:                              |      |      |      |
|      |                                          |      |      |      |
|      | Extension to anus                        |      |      |      |
|      |                                          |      |      |      |
|      | Rectovaginal septum                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 46   | Adherent to other organs or structures   | T3   | RE   | RE   |
|      | but no tumor found in adhesion(s)        |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through serosa (mesothelium) | T4   | RE   | RE   |
|      | ( visceral peritoneum)                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | \(50\) with \[(42) or (45)\]             | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 57   | Adherent to other organs or structures,  | T4   | RE   | RE   |
|      | NOS                                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Rectosigmoid:                            | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Cul de sac (rectouterine pouch)          |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic wall                              |      |      |      |
|      |                                          |      |      |      |
|      | Small intestine                          |      |      |      |
|      |                                          |      |      |      |
|      | Rectum:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Bladder for males only                   |      |      |      |
|      |                                          |      |      |      |
|      | Cul de sac (rectouterine pouch)          |      |      |      |
|      |                                          |      |      |      |
|      | Ductus deferens                          |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic wall                              |      |      |      |
|      |                                          |      |      |      |
|      | Prostate                                 |      |      |      |
|      |                                          |      |      |      |
|      | Rectovesical fascia for male only        |      |      |      |
|      |                                          |      |      |      |
|      | Seminal vesicle(s)                       |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscle of pelvic floor          |      |      |      |
|      |                                          |      |      |      |
|      | Vagina                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Rectosigmoid:                            | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Bladder                                  |      |      |      |
|      |                                          |      |      |      |
|      | Colon via serosa                         |      |      |      |
|      |                                          |      |      |      |
|      | Fallopian tube(s)                        |      |      |      |
|      |                                          |      |      |      |
|      | Ovary(ies)                               |      |      |      |
|      |                                          |      |      |      |
|      | Prostate                                 |      |      |      |
|      |                                          |      |      |      |
|      | Ureter(s)                                |      |      |      |
|      |                                          |      |      |      |
|      | Uterus                                   |      |      |      |
|      |                                          |      |      |      |
|      | Rectum:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Bladder for female only                  |      |      |      |
|      |                                          |      |      |      |
|      | Bone(s) of pelvis                        |      |      |      |
|      |                                          |      |      |      |
|      | Urethra                                  |      |      |      |
|      |                                          |      |      |      |
|      | Uterus                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Rectosigmoid, Rectum**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Rectosigmoid, Rectum**\
**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:  ** A tumor nodule in the perirectal adipose tissue of a
primary carcinoma without histologic evidence of residual lymph node in
the nodule is classified as a regional lymph node metastasis if the
nodule has the form and smooth contour of a lymph node, or if the
contour is not described. If the nodule has an irregular contour, it
should be coded in CS Extension as code 45.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | \*   | RN   | RN   |
|      |                                          |      |      |      |
|      | Rectosigmoid:                            |      |      |      |
|      |                                          |      |      |      |
|      | Paracolic/pericolic                      |      |      |      |
|      |                                          |      |      |      |
|      | Perirectal                               |      |      |      |
|      |                                          |      |      |      |
|      | Rectal                                   |      |      |      |
|      |                                          |      |      |      |
|      | Nodule(s) or foci in pericolic           |      |      |      |
|      | fat/adjacent                             |      |      |      |
|      |                                          |      |      |      |
|      | mesentery/mesocolic fat                  |      |      |      |
|      |                                          |      |      |      |
|      | Rectum:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Perirectal                               |      |      |      |
|      |                                          |      |      |      |
|      | Rectal, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Nodule(s) or foci in perirectal fat      |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s):                  | \*   | RN   | RN   |
|      |                                          |      |      |      |
|      | Rectosigmoid:                            |      |      |      |
|      |                                          |      |      |      |
|      | Colic, NOS                               |      |      |      |
|      |                                          |      |      |      |
|      | Left colic                               |      |      |      |
|      |                                          |      |      |      |
|      | Hemorrhoidal, superior or middle         |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Middle rectal                            |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoidal (sigmoid mesenteric)           |      |      |      |
|      |                                          |      |      |      |
|      | Superior rectal                          |      |      |      |
|      |                                          |      |      |      |
|      | Rectum:                                  |      |      |      |
|      |                                          |      |      |      |
|      | Hemorrhoidal, superior, middle or        |      |      |      |
|      | inferior                                 |      |      |      |
|      |                                          |      |      |      |
|      | Inferior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
|      |                                          |      |      |      |
|      | Rectal, superior, middle, or inferior    |      |      |      |
|      |                                          |      |      |      |
|      | Sacral, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Lateral (laterosacral)                   |      |      |      |
|      |                                          |      |      |      |
|      | Middle (promontorial) (Gerota\'s node)   |      |      |      |
|      |                                          |      |      |      |
|      | Presacral                                |      |      |      |
|      |                                          |      |      |      |
|      | Sacral promotory                         |      |      |      |
|      |                                          |      |      |      |
|      | Sigmoidal (sigmoid mesenteric)           |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Mesenteric, NOS                          | \*   | RN   | RN   |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 Lymph Nodes codes 10-80 ONLY, the N category is assigned based on
the value of Reg LN Pos, using the Lymph Nodes Number Positive Table for
this site:

**Rectosigmoid, Rectum**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Rectosigmoid, Rectum**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Rectosigmoid, Rectum**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Rectosigmoid, Rectum**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | M1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 11   | Rectosigmoid:                            | M1   | RN   | D    |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Other distant lymph node(s), including   | M1   | D    | D    |
|      |                                          |      |      |      |
|      | external iliac or common iliac           |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) codes 10-12                      |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(40\) + any of \[(10) to (12)\]         | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Rectosigmoid, Rectum**\
**CS Mets Eval**\
**SEE STANDARD TABLE**

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 1 Carcinoembryonic Antigen (CEA)**

**Note:  ** The Site-Specific Factors section includes factors that are
needed to derive TNM or AJCC stage and also includes items that are
considered important but are not needed for AJCC. This includes
prognostic and predictive factors and tumor markers. There are many
sites for which there are no Site-Specific Factors required at this
time.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | Test none done                                                |
+------+---------------------------------------------------------------+
| 010  | Positive/elevated                                             |
+------+---------------------------------------------------------------+
| 020  | Negative/normal; within normal limits                         |
+------+---------------------------------------------------------------+
| 030  | Borderline; undetermined whether positive or negative         |
+------+---------------------------------------------------------------+
| 080  | Ordered, but results not in chart                             |
+------+---------------------------------------------------------------+
| 999  | Unknown or no information                                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 2**

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

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

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 3**

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

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

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 4**

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

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

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 5**

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

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

**Rectosigmoid, Rectum**\
**CS Site-Specific Factor 6**

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

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

**Page left blank**

**Collaborative Staging Codes**

## **Anus** **Anal Canal; Anus, NOS; Other Parts of Rectum C21.0-C21.2, C21.8**

C21.0 Anus, NOS (excludes skin of anus and perianal skin C44.5)

C21.1 Anal canal

C21.2 Cloacogenic zone

C21.8 Overlapping lesion of rectum, anus and anal canal

**Note:  ** Skin of anus is coded separately (C44.5).

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

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

**Note:  ** Codes 60-80 are used for contiguous extension from the site
of origin. Discontinuous involvement is coded in CS Mets at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; noninvasive; intraepithelial    | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to mucosa, NOS   | \*   | L    | L    |
|      | (including intramucosal, NOS)            |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Invades lamina propria                   | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 12   | Invades muscularis mucosae               | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 16   | Invades submucosa (superficial invasion) | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 20   | Invades muscularis propria (internal     | \*   | L    | L    |
|      | sphincter)                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Ischiorectal fat/tissue                  | \*   | RE   | RE   |
|      |                                          |      |      |      |
|      | Perianal skin                            |      |      |      |
|      |                                          |      |      |      |
|      | Perirectal skin                          |      |      |      |
|      |                                          |      |      |      |
|      | Rectal mucosa or submucosa               |      |      |      |
|      |                                          |      |      |      |
|      | Rectal wall                              |      |      |      |
|      |                                          |      |      |      |
|      | Skeletal muscles:                        |      |      |      |
|      |                                          |      |      |      |
|      | Anal sphincter (external)                |      |      |      |
|      |                                          |      |      |      |
|      | Levator ani                              |      |      |      |
|      |                                          |      |      |      |
|      | Subcutaneous perianal tissue             |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Perineum                                 | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Vulva                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Bladder                                  | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Pelvic peritoneum                        |      |      |      |
|      |                                          |      |      |      |
|      | Urethra                                  |      |      |      |
|      |                                          |      |      |      |
|      | Vagina                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Broad ligament(s)                        | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Cervix uteri                             |      |      |      |
|      |                                          |      |      |      |
|      | Corpus uteri                             |      |      |      |
|      |                                          |      |      |      |
|      | Prostate                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 codes 10-40 ONLY, the T category is assigned based on the value
of CS Tumor Size, as shown in the Extension Size Table for this site.

**Anus**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Anus**\
**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   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Unilateral and bilateral:                | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | For all subsites:                        |      |      |      |
|      |                                          |      |      |      |
|      | Anorectal                                |      |      |      |
|      |                                          |      |      |      |
|      | Inferior hemorrhoidal                    |      |      |      |
|      |                                          |      |      |      |
|      | Lateral sacral (laterosacral)            |      |      |      |
|      |                                          |      |      |      |
|      | Perirectal                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Unilateral:                              | N2   | RN   | RN   |
|      |                                          |      |      |      |
|      | For anal canal:                          |      |      |      |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 21   | Unilateral:                              | N2   | D    | RN   |
|      |                                          |      |      |      |
|      | For anus:                                |      |      |      |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Unilateral:                              | N2   | RN   | RN   |
|      |                                          |      |      |      |
|      | For anal canal:                          |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
+------+------------------------------------------+------+------+------+
| 31   | Unilateral:                              | N2   | D    | RN   |
|      |                                          |      |      |      |
|      | For anus:                                |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | \(20\) + (30)                            | N2   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 41   | \(10\) + (30)                            | N3   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 42   | \(10\) + (31)                            | N3   | D    | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Bilateral:                               | N3   | RN   | RN   |
|      |                                          |      |      |      |
|      | For anal canal:                          |      |      |      |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | Bilateral:                               | N3   | D    | RN   |
|      |                                          |      |      |      |
|      | For anus:                                |      |      |      |
|      |                                          |      |      |      |
|      | Internal iliac (hypogastric)             |      |      |      |
|      |                                          |      |      |      |
|      | Obturator                                |      |      |      |
|      |                                          |      |      |      |
|      | Superficial inguinal (femoral)           |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Regional lymph node(s), NOS              | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Site-Specific Surgery Codes**

Rectosigmoid

C199

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

**Code** removal/surgical ablation of single or multiple liver
metastases under the data item *Surgical Procedure/Other Site* (NAACCR
Item #1294)

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

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 Wedge or segmental resection; partial proctosigmoidectomy, NOS

31 Plus resection of contiguous organs; example: small bowel, bladder

Procedures coded 30 include, but are not limited to:

Anterior resection

Hartmann operation

Low anterior resection (LAR)

Partial colectomy, NOS

Rectosigmoidectomy, NOS

Sigmoidectomy

40 Pull through WITH sphincter preservation (colo‑anal anastomosis)

\[***SEER Note:*** Procedures coded 40 include but are not limited to:
Altemeier's operation, Duhamel's operation, Soave's submucosal
resection, Swenson's operation, Turnbull's operation\]

50 Total proctectomy

\[***SEER Note:*** Procedures coded 50 include but are not limited to:
Abdominoperineal resection (A & P resection), anterior/posterior
resection (A/P resection)/Miles' operation, Rankin's operation\]

51 Total colectomy

\[***SEER Note:*** Removal of the colon from cecum to rectosigmoid or
portion of rectum\]

55 Total colectomy WITH ileostomy, NOS

56 Ileorectal reconstruction

57 Total colectomy WITH other pouch; example: Koch pouch

60 **Total proctocolectomy**, NOS \[combination of 50 and 51\]

65 Total proctocolectomy WITH ileostomy, NOS

66 Total proctocolectomy WITH ileostomy and pouch

\[***SEER Note:*** Removal of the colon from cecum to the rectosigmoid
junction including the entire rectum.\]

70 Colectomy or proctocolectomy resection in continuity with other
organs; pelvic exenteration

> \[***SEER Notes:*** Procedures that may be part of an en bloc
> resection include, but are not limited to: an oophorectomy and a
> rectal mucosectomy. Code 70 includes any colectomy (partial,
> hemicolectomy or total) with an en bloc resection of any other organs.
> There may be partial or total removal of other organs in continuity
> with the primary. In continuity with or "en bloc" means that all of
> the tissues were removed during the same procedure, but not
> necessarily in a single specimen\]

80 Colectomy, NOS; Proctectomy, NOS

90 Surgery, NOS

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

**Site-Specific Surgery Codes**

## Rectum

**C209**

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

**Code** removal/surgical ablation of single or multiple liver
metastases under the data item *Surgical Procedure/Other Site* (NAACCR
Item #1294)

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

27 Excisional biopsy

26 Polypectomy

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

21 Photodynamic therapy (PDT)

22 Electrocautery

23 Cryosurgery

24 Laser ablation

25 Laser excision

28 Curette and fulguration

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

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

30 **Wedge or segmental resection**; partial proctectomy, NOS

Procedures coded 30 include, but are not limited to:

Anterior resection

Hartmann's operation

Low anterior resection (LAR)

Transsacral rectosigmoidectomy

40 Pull through WITH sphincter preservation (colo-anal anastomosis)

> \[***SEER Note:*** Procedures coded 40 include but are not limited to:
> Altemeier's operation, Duhamel's operation, Soave's submucosal
> resection, Swenson's operation, Turnbull's operation\]

50 Total proctectomy

Procedure coded 50 includes, but is not limited to: Abdominoperineal
resection (Miles Procedure)

\[***SEER Note:*** Also called A & P resection, anterior/posterior (A/P)
resection/Miles' operation, Rankin's

operation\]

60 Total proctocolectomy, NOS

70 Proctectomy or proctocolectomy with resection in continuity with
other organs; pelvic exenteration

\[***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\]

80 Proctectomy, NOS

90 Surgery, NOS

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

Site-Specific Surgery Codes

Anus

C210--C218

(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 Thermal ablation

**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

\[***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

\[***SEER Note:*** Margins of resection may have microscopic
involvement\]

60 **Abdominal perineal resection**, NOS (APR; Miles procedure)

61 APR and sentinel node excision

62 APR and unilateral inguinal lymph node dissection

63 APR and bilateral inguinal lymph node dissection

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

90 Surgery, NOS

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

**Page left blank**

**Collaborative Staging Codes**

## **Liver and Intrahepatic Bile Ducts** **C22.0-C22.1**

C22.0 Liver

C22.1 Intrahepatic bile duct

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | CS Tumor Size\      | **CS Site-Specific  | The following       |   |
| | CS Extension\       | Factor 1 -** Alpha  | tables are          |   |
| | CS TS/Ext-Eval\     | Fetoprotein (AFP)\  | available at the    |   |
| | CS Lymph Nodes\     | **CS Site-Specific  | collaborative       |   |
| | CS Reg Nodes Eval\  | Factor 2 -**        | staging website:    |   |
| | Reg LN Pos\         | Fibrosis Score\     |                     |   |
| | 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\           | Extension Size      |   |
| |                     | CS Site-Specific    | Table               |   |
| |                     | Factor 5\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Liver and Intrahepatic Bile Ducts**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Liver and Intrahepatic Bile Ducts**\
**CS Extension**

**Note 1:  ** In codes 30, 40, and 65, \"multiple (satellite)
nodules/tumors\" includes satellitosis, multifocal tumors, and
intrahepatic metastases.

**Note 2:  ** Major vascular invasion (code 63) is defined as invasion
of the branches of the main portal vein (right or left portal vein, not
including sectoral or segmental branches) or as invasion of one or more
of the three hepatic veins (right, middle, or left). Invasion of hepatic
artery or vein is coded to 66.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 10   | Single lesion (one lobe)                 | T1   | L    | L    |
|      |                                          |      |      |      |
|      | WITHOUT intrahepatic vascular invasion,  |      |      |      |
|      | including vascular invasion not stated   |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Single lesion (one lobe) WITH            | T2   | L    | L    |
|      | intrahepatic vascular invasion           |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Multiple (satellite) nodules/tumors (one | \*   | L    | L    |
|      | lobe)                                    |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT intrahepatic vascular invasion,  |      |      |      |
|      | including vascular invasion not stated   |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Multiple (satellite) nodules/tumors (one | \*   | L    | L    |
|      | lobe)                                    |      |      |      |
|      |                                          |      |      |      |
|      | WITH intrahepatic vascular invasion      |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Confined to liver, NOS                   | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Localized, NOS                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 51   | More than one lobe involved by           | T1   | RE   | RE   |
|      | contiguous growth (single lesion)        |      |      |      |
|      |                                          |      |      |      |
|      | WITHOUT vascular invasion, including     |      |      |      |
|      | vascular invasion not stated             |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | More than one lobe involved by           | T2   | RE   | RE   |
|      | contiguous growth (single lesion)        |      |      |      |
|      |                                          |      |      |      |
|      | WITH vascular invasion                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 53   | Extension to gallbladder, extent within  | T1   | RE   | RE   |
|      | liver not stated                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 54   | Single lesion with extension to          | T1   | RE   | RE   |
|      | gallbladder + \[(10) or (51)\]           |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Single lesion with extension to          | T2   | RE   | RE   |
|      | gallbladder + \[(20) or (52)\]           |      |      |      |
+------+------------------------------------------+------+------+------+
| 56   | Extension to gallbladder + \[(30) or     | \*   | RE   | RE   |
|      | (40)\]                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 58   | Extrahepatic bile ducts                  | T2   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 63   | Major vascular invasion: major           | T3   | RE   | RE   |
|      | branch(es) of portal or hepatic vein(s)  |      |      |      |
|      | (see Note 2)                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 64   | Direct extension/perforation of visceral | T4   | RE   | RE   |
|      | peritoneum                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Multiple (satellite) nodules/tumors in   | \*   | D    | RE   |
|      | more than one lobe of liver or on        |      |      |      |
|      | surface of parenchyma                    |      |      |      |
|      |                                          |      |      |      |
|      | Satellite nodules, NOS                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Extension to hepatic artery or vena cava | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | Diaphragm                                | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 75   | Lesser omentum                           | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Ligament(s):                             |      |      |      |
|      |                                          |      |      |      |
|      | Coronary                                 |      |      |      |
|      |                                          |      |      |      |
|      | Falciform                                |      |      |      |
|      |                                          |      |      |      |
|      | Round \[of liver\]                       |      |      |      |
|      |                                          |      |      |      |
|      | Hepatoduodenal                           |      |      |      |
|      |                                          |      |      |      |
|      | Hepatogastric                            |      |      |      |
|      |                                          |      |      |      |
|      | Triangular                               |      |      |      |
|      |                                          |      |      |      |
|      | Parietal peritoneum                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 76   | \(65\) + any of \[(64) or (66) or (70)   | T4   | D    | RE   |
|      | or (75)\]                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension:            | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Pleura                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
|      |                                          |      |      |      |
|      | Other contiguous extension               |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 30, 40, 56, and 65 ONLY, the T category is
assigned based on the value of CS Tumor Size, as shown in the Extension
Size Table for this site.

**Liver and Intrahepatic Bile Ducts**\
**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 radiation 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                       |      |
+------+--------------------------------------------------------+------+

**Liver and Intrahepatic Bile Ducts**\
**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   |
|      |                                          |      |      |      |
|      | Hepatic NOS:                             |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic pedicle                          |      |      |      |
|      |                                          |      |      |      |
|      | Inferior vena cava                       |      |      |      |
|      |                                          |      |      |      |
|      | Porta hepatis (hilar) \[in hilus of      |      |      |      |
|      | liver\]                                  |      |      |      |
|      |                                          |      |      |      |
|      | Hepatoduodenal ligament                  |      |      |      |
|      |                                          |      |      |      |
|      | Periportal                               |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Liver and Intrahepatic Bile Ducts**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Liver and Intrahepatic Bile Ducts**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Liver and Intrahepatic Bile Ducts**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Liver and Intrahepatic Bile Ducts**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s), NOS               | M1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 11   | Distant lymph node(s):                   | M1   | RN   | D    |
|      |                                          |      |      |      |
|      | Cardiac                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lateral (aortic) (lumbar)                |      |      |      |
|      |                                          |      |      |      |
|      | Pericardial (pericardiac)                |      |      |      |
|      |                                          |      |      |      |
|      | Posterior mediastinal                    |      |      |      |
|      | (tracheoesophageal) including            |      |      |      |
|      | juxtaphrenic                             |      |      |      |
|      |                                          |      |      |      |
|      | nodes                                    |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal, NOS                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 12   | Distant lymph node(s):                   | M1   | RN   | D    |
|      |                                          |      |      |      |
|      | Coronary artery                          |      |      |      |
|      |                                          |      |      |      |
|      | Renal artery                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 13   | Distant lymph node(s):                   | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Aortic (para-, peri-)                    |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragmatic, NOS                       |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (near head of pancreas    |      |      |      |
|      | only)                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 15   | Distant lymph node(s) other than codes   | M1   | D    | D    |
|      | 10-13, including inferior phrenic nodes  |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastasis except distant lymph  | M1   | D    | D    |
|      | node(s) (codes 10-15)                    |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS                  |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | \(40\) + any of \[(10) or (11) or (15)\] | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 52   | \(40\) + \[(12) or (13)\]                | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s) plus other distant |      |      |      |
|      | metastases                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 99   | Unknown if distant metastasis            | MX   | U    | U    |
|      |                                          |      |      |      |
|      | Primary tumor cannot be assessed         |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Liver and Intrahepatic Bile Ducts**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 1 Alpha Fetoprotein (AFP)**

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | Test not done                                                 |
+------+---------------------------------------------------------------+
| 010  | Positive/elevated                                             |
+------+---------------------------------------------------------------+
| 020  | Negative/normal; within normal limits                         |
+------+---------------------------------------------------------------+
| 030  | Borderline; undetermined whether positive or negative         |
+------+---------------------------------------------------------------+
| 080  | Ordered, but results not in chart                             |
+------+---------------------------------------------------------------+
| 999  | Unknown or no information                                     |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 2 Fibrosis Score**

**Note:  ** AJCC classifies fibrosis scores 0-4 (none to moderate
fibrosis) as F0, and fibrosis scores 5-6 (severe fibrosis or cirrhosis)
as F1. Fibrosis score is also called Ishak score.

+------+---------------------------------------------------------------+
| Code | Description                                                   |
+------+---------------------------------------------------------------+
| 000  | F0: Fibrosis score 0-4 (none to moderate fibrosis)            |
+------+---------------------------------------------------------------+
| 001  | F1: Fibrosis score 5-6 (severe fibrosis or cirrhosis)         |
+------+---------------------------------------------------------------+
| 999  | Fibrosis score not recorded                                   |
|      |                                                               |
|      | Insufficient information                                      |
|      |                                                               |
|      | Not documented in patient record                              |
+------+---------------------------------------------------------------+

**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 3**

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

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

**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 4**

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

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

**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 5**

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

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

**Liver and Intrahepatic Bile Ducts**\
**CS Site-Specific Factor 6**

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

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

**Site-Specific Surgery Codes**

**Liver and Intrahepatic Bile Ducts**

**C220--C221**

(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 Alcohol (Percutaneous Ethanol Injection‑PEI)

16 Heat‑Radio‑frequency ablation (RFA)

17 Other (ultrasound, acetic acid)

**No** specimen sent to **pathology** from surgical events 10--17

\[***SEER Note:*** Code 15 Alcohol (Percutaneous Ethanol Injection-PEI)
can also be described as an

"intratumoral injection of alcohol" or "alcohol ablation"\]

20 Wedge or segmental resection, NOS

21 Wedge resection

22 Segmental resection, NOS

23 One

24 Two

25 Three

26 Segmental resection AND local tumor destruction

**Specimen** sent to **pathology** from surgical events 20--26

30 Lobectomy, NOS

36 Right lobectomy

37 Left lobectomy

38 Lobectomy AND local tumor destruction

\[***SEER Note:*** Code 30 also referred to as simple lobectomy\]

50 **Extended** **lobectomy**, NOS (extended: resection of a single lobe
plus a segment of another lobe)

51 Right lobectomy

52 Left lobectomy

59 Extended lobectomy AND local tumor destruction

[]{.mark}

60 Hepatectomy, NOS

61 Total hepatectomy and **transplant**

[]{.mark}

65 **Excision** of a **bile** **duct** (for an intrahepatic bile duct
primary only)

66 Excision of a bile duct PLUS partial hepatectomy

75 Bile duct and hepatectomy WITH transplant

90 Surgery, NOS

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

**Page left blank**

**Collaborative Staging Codes**

**Gallbladder**\
**C23.9**

C23.9 Gallbladder

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

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

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | T1a  | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Mucosa, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria                       | T1b  | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T    | L    | L    |
|      |                                          | 1NOS |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Perimuscular connective tissue           | T2   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through serosa (visceral     | T3   | L    | RE   |
|      | peritoneum)                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | \(40\) + (50)                            | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Extension into liver, NOS                | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 61   | Extension into liver less than or equal  | T3   | RE   | RE   |
|      | to 2 cm                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Extension to ONE of the following:       | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Ampulla of Vater                         |      |      |      |
|      |                                          |      |      |      |
|      | Duodenum                                 |      |      |      |
|      |                                          |      |      |      |
|      | Extrahepatic bile duct(s)                |      |      |      |
|      |                                          |      |      |      |
|      | Omentum, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Greater                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lesser                                   |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Small intestine, NOS                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Extension to ONE of the following        | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | WITHOUT extension to any structure in    |      |      |      |
|      | (62):                                    |      |      |      |
|      |                                          |      |      |      |
|      | Colon                                    |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Extension to cystic artery/vein          | T3   | RE   | D    |
|      |                                          |      |      |      |
|      | WITHOUT extension to any structure in    |      |      |      |
|      | \[(62) to (65)\]                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 67   | \[(60) or (61)\] PLUS extension to ONE   | T3   | RE   | RE   |
|      | structure in codes \[(62) to (65)\]      |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | \(66\) + \[(60) or (61)\]                | T3   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 71   | Extension into liver greater than 2 cm   | T3   | D    | D    |
|      |                                          |      |      |      |
|      | WITHOUT extension to any structure in    |      |      |      |
|      | codes \[(62) to (66)\]                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 72   | Extension into liver greater than 2 cm   | T3   | D    | D    |
|      |                                          |      |      |      |
|      | PLUS extension to ONE structure in codes |      |      |      |
|      | \[(62) to (66)\]                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Extension to two or more structures in   | T4   | D    | D    |
|      | codes \[(62) to (66)\],                  |      |      |      |
|      |                                          |      |      |      |
|      | WITH or WITHOUT extension into liver of  |      |      |      |
|      | any depth                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Extension to:                            | T4   | RE   | D    |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | \(75\) + any of \[(60) to (73)\]         | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension, including: | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Abdominal wall                           |      |      |      |
|      |                                          |      |      |      |
|      | Diaphragm                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

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

**Note:  ** Code only regional nodes and nodes, NOS, in this field.
Distant nodes are coded in the field Mets at DX. Also note that celiac
and superior mesenteric nodes are listed in this field rather than Mets
at DX, because AJCC classifies them as N1 and not M1.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | None; no regional lymph node involvement | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
| 10   | Cystic duct (Calot\'s node)              |      |      |      |
| co   |                                          |      |      |      |
| nt'd | Node of foramen of Winslow (omental)     |      |      |      |
|      | (epiploic)                               |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (common bile duct)       |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Regional lymph node(s):                  | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Porta hepatis (portal) (periportal)      |      |      |      |
|      | (hilar) (in hilus of liver)              |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 21   | Regional lymph node(s):                  | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Periduodenal                             |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (near head of pancreas    |      |      |      |
|      | only)                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 25   | \(11\) + (20)                            | N1   | D    | RN   |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph node(s), NOS              | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Celiac lymph node(s)                     | N1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 60   | Superior mesenteric lymph node(s)        | N1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Gallbladder**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Gallbladder**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Gallbladder**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Gallbladder**\
**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    |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (along body and tail of   |      |      |      |
|      | pancreas only)                           |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**Collaborative Staging Codes**

## **Extrahepatic Bile Duct(s)** **C24.0**

C24.0 Extrahepatic bile duct

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Extrahepatic Bile Duct(s)**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor of extrahepatic bile      | T1   | L    | L    |
|      | duct(s) (choledochal, common, cystic,    |      |      |      |
|      | and hepatic) confined to:                |      |      |      |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Mucosa, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria                       | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Beyond wall of bile duct                 | T2   | RE   | RE   |
|      |                                          |      |      |      |
|      | Periductal/fibromuscular connective      |      |      |      |
|      | tissue                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Gallbladder                              | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Liver, porta hepatis                     |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Unilateral branches of hepatic artery    | T3   | RE   | RE   |
|      | (right or left)                          |      |      |      |
|      |                                          |      |      |      |
|      | Unilateral branches of portal vein       |      |      |      |
|      | (right or left)                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Colon, NOS                               | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Transverse including flexure             |      |      |      |
|      |                                          |      |      |      |
|      | Duodenum, NOS                            |      |      |      |
|      |                                          |      |      |      |
|      | Omentum, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Lesser                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stomach, distal                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Common hepatic artery                    | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Hepatic artery, NOS                      |      |      |      |
|      |                                          |      |      |      |
|      | Main main portal vein or its branches    |      |      |      |
|      | bilaterally                              |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein, NOS                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Other parts of colon                     | T4   | D    | RE   |
|      |                                          |      |      |      |
|      | Greater omentum                          |      |      |      |
|      |                                          |      |      |      |
|      | Stomach, proximal                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Abdominal wall                           | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Extrahepatic Bile Duct(s)**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**CS Lymph Nodes**

**Note:  ** Code only regional nodes and nodes, NOS, in this field.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 15   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Cystic duct (node of the neck of the     |      |      |      |
|      | gallbladder) (Calot\'s node)             |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Hilar (in the hepatoduodenal ligament)   |      |      |      |
|      |                                          |      |      |      |
|      | Node of the foramen of Winslow (omental) |      |      |      |
|      | (epiploic)                               |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal                      |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (node around common bile |      |      |      |
|      | duct)                                    |      |      |      |
|      |                                          |      |      |      |
|      | Periduodenal                             |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (near head of pancreas    |      |      |      |
|      | only)                                    |      |      |      |
|      |                                          |      |      |      |
|      | Periportal                               |      |      |      |
|      |                                          |      |      |      |
|      | Porta hepatis (portal) (hilar) (in hilus |      |      |      |
|      | of liver)                                |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 35   | Regional lymph node(s):                  | N1   | D    | D    |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Extrahepatic Bile Duct(s)**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**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    |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (along body and tail of   |      |      |      |
|      | pancreas only)                           |      |      |      |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastases, 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 patientrecord          |      |      |      |
+------+------------------------------------------+------+------+------+

**Extrahepatic Bile Duct(s)**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 1**

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

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

**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 2**

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

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

**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 3**

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

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

**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 4**

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

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

**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 5**

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

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

**Extrahepatic Bile Duct(s)**\
**CS Site-Specific Factor 6**

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

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

Collaborative Staging Codes

## **Ampulla of Vater C24.1**

C24.1 Ampulla of Vater

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Ampulla of Vater**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined/limited to       | T1   | L    | L    |
|      | ampulla of Vater or extending to         |      |      |      |
|      | sphincter of Oddi                        |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 42   | Duodenal wall                            | T2   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 52   | Pancreas                                 | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 62   | Common bile duct                         | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 65   | Extrahepatic bile ducts other than       | T4   | RE   | RE   |
|      | common bile duct or sphincter of Oddi    |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension to other adjacent organs or    | T4   | RE   | RE   |
|      | tissues:                                 |      |      |      |
|      |                                          |      |      |      |
|      | Blood vessels(major):                    |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Gallbladder                              |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic flexure                          |      |      |      |
|      |                                          |      |      |      |
|      | Lesser omentum                           |      |      |      |
|      |                                          |      |      |      |
|      | Liver including porta hepatis            |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic soft tissues              |      |      |      |
|      |                                          |      |      |      |
|      | Stomach, NOS:                            |      |      |      |
|      |                                          |      |      |      |
|      | Distal                                   |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Stomach, proximal                        | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 80   | Further contiguous extension             | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Other adjacent organs                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Ampulla of Vater**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**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:  ** Splenic lymph nodes and those located at the tail of the
pancreas are not considered regional and should be coded under Mets at
DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Node of the foramen of Winslow           |      |      |      |
|      | (epiploic) (omental)                     |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal                      |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (except at tail of        |      |      |      |
|      | pancreas, see CS Mets at DX)             |      |      |      |
|      |                                          |      |      |      |
|      | Periportal                               |      |      |      |
|      |                                          |      |      |      |
|      | Lymph node(s):                           |      |      |      |
|      |                                          |      |      |      |
|      | Anterior to the ampulla of Vater         |      |      |      |
|      |                                          |      |      |      |
|      | Inferior to the ampulla of Vater         |      |      |      |
|      |                                          |      |      |      |
|      | Posterior to the ampulla of Vater        |      |      |      |
|      |                                          |      |      |      |
|      | Superior to the ampulla of Vater         |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Regional lymph node(s):                  | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
|      |                                          |      |      |      |
|      | Lateral aortic (lumbar)                  |      |      |      |
|      |                                          |      |      |      |
|      | Proximal mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Ampulla of Vater**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Node(s) at the tail of the pancreas      |      |      |      |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
|      |                                          |      |      |      |
|      | Splenic lymph node(s)                    |      |      |      |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Carcinomatosis                           |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS (Includes        |      |      |      |
|      | seeding of peritoneum, even if limited   |      |      |      |
|      | to the lesser sac region; positive       |      |      |      |
|      | peritoneal cytology)                     |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 patientrecord          |      |      |      |
+------+------------------------------------------+------+------+------+

**Ampulla of Vater**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Ampulla of Vater**\
**CS Site-Specific Factor 1**

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

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

**Ampulla of Vater**\
**CS Site-Specific Factor 2**

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

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

**Ampulla of Vater**\
**CS Site-Specific Factor 3**

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

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

**Ampulla of Vater**\
**CS Site-Specific Factor 4**

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

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

**Ampulla of Vater**\
**CS Site-Specific Factor 5**

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

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

**Ampulla of Vater**\
**CS Site-Specific Factor 6**

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

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

**Collaborative Staging Codes**

## **Other Biliary and Biliary, NOS** **C24.8-C24.9**

C24.8 Overlapping lesion of biliary tract (neoplasms involving both
intrahepatic and extrahepatic bile ducts)

C24.9 Biliary tract, NOS

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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\           |                     |   |
| |                     | CS Site-Specific    |                     |   |
| |                     | Factor 6            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Other Biliary and Biliary, NOS**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**CS Extension**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | Tis  | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasive tumor confined to:              | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Lamina propria                           |      |      |      |
|      |                                          |      |      |      |
|      | Mucosa, NOS                              |      |      |      |
|      |                                          |      |      |      |
|      | Submucosa (superficial invasion)         |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Muscularis propria                       | T1   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | T1   | L    | L    |
|      |                                          |      |      |      |
|      | Tumor confined to bile duct              |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Perimuscular connective tissue           | T2   | RE   | RE   |
|      |                                          |      |      |      |
|      | Tumor invades beyond the wall of the     |      |      |      |
|      | bile duct                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Invasion of/through serosa               | T2   | L    | RE   |
+------+------------------------------------------+------+------+------+
| 55   | \(40\) + (50)                            | T2   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Extension into liver, NOS                | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 61   | Extension into liver less than or equal  | T3   | RE   | RE   |
|      | to 2 cm                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Extension to ONE of the following:       | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Ampulla of Vater                         |      |      |      |
|      |                                          |      |      |      |
|      | Omentum, NOS                             |      |      |      |
|      |                                          |      |      |      |
|      | Greater                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lesser                                   |      |      |      |
|      |                                          |      |      |      |
|      | Pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Small intestine, NOS                     |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 63   | Gallbladder                              | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Unilateral branches of the right or left |      |      |      |
|      | portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Unilateral branches of the right or left |      |      |      |
|      | hepatic artery                           |      |      |      |
+------+------------------------------------------+------+------+------+
| 65   | Extension to ONE of the following:       | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Colon                                    |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 66   | Abdominal wall                           | T4   | RE   | RE   |
|      |                                          |      |      |      |
|      | Duodenum                                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 70   | Extension into liver greater than 2 cm   | T3   | D    | D    |
|      |                                          |      |      |      |
|      | Extension to two or more adjacent organs |      |      |      |
|      | listed in codes \[(60) to (63)\]         |      |      |      |
+------+------------------------------------------+------+------+------+
| 71   | Extension to two or more adjacent organs | T4   | D    | D    |
|      | any of which are in codes \[(65) to      |      |      |      |
|      | (66)\]                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | Common hepatic artery                    | T4   | RE   | D    |
|      |                                          |      |      |      |
|      | Cystic artery/vein                       |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic artery, NOS                      |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein or its branches bilaterally  |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein, NOS                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other Biliary and Biliary, NOS**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**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   |
|      |                                          |      |      |      |
|      | Cystic duct (Calot\'s node)              |      |      |      |
|      |                                          |      |      |      |
|      | Node of foramen of Winslow (epiploic)    |      |      |      |
|      | (omental)                                |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (common bile duct)       |      |      |      |
+------+------------------------------------------+------+------+------+
| 11   | Regional lymph node(s):                  | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Porta hepatis (portal) (hilar) \[in      |      |      |      |
|      | hilus of liver\]                         |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal                      |      |      |      |
|      |                                          |      |      |      |
|      | Periportal                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 21   | Regional lymph node(s):                  | N1   | D    | RN   |
|      |                                          |      |      |      |
|      | Periduodenal                             |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic (near head of pancreas    |      |      |      |
|      | only)                                    |      |      |      |
+------+------------------------------------------+------+------+------+
| 30   | Regional lymph node(s), NOS              | N1   | RN   | RN   |
+------+------------------------------------------+------+------+------+
| 50   | Celiac                                   | N1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 60   | Superior mesenteric                      | N1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other Biliary and Biliary, NOS**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**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    |
|      |                                          |      |      |      |
|      | Para-aortic                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastases, 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other Biliary and Biliary, NOS**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Other Biliary and Biliary, NOS**\
**CS Site-Specific Factor 1**

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

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

**Other Biliary and Biliary, NOS**\
**CS Site-Specific Factor 2**

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

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

**Other Biliary and Biliary, NOS**\
**CS Site-Specific Factor 3**

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

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

**Other Biliary and Biliary, NOS**\
**CS Site-Specific Factor 4**

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

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

**Other Biliary and Biliary, NOS**\
**CS Site-Specific Factor 5**

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

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

**Other Biliary and Biliary, NOS**\
**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**

**Collaborative Staging Codes**

## **Pancreas: Head** **C25.0**

C25.0 Head of pancreas

**Note:  ** For tumors of the islet cells, determine which subsite of
the pancreas is involved and use that primary site code and the
corresponding Collaborative Stage scheme. If the subsite cannot be
determined, use the general code for Islets of Langerhans, C25.4, and
use the Collaborative Stage scheme for Pancreas, Other and Unspecified.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Pancreas: Head**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pancreas: Head**\
**CS Extension**

**Note 1:  ** Islets of Langerhans are distributed throughout the
pancreas, and therefore any extension code can be used.

**Note 2:  ** Codes 40-80 are used for contiguous extension of tumor
from the site of origin. Discontinuous involvement is coded in CS Mets
at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive                    | Tis  | IS   | IS   |
|      |                                          |      |      |      |
|      | PanIn III                                |      |      |      |
|      |                                          |      |      |      |
|      | Pancreatic Intraepithelial Neoplasia III |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Confined to pancreas                     | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Extension to peripancreatic tissue, NOS  | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Fixation to adjacent structures, NOS     |      |      |      |
+------+------------------------------------------+------+------+------+
| 44   | Ampulla of Vater                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Duodenum                                 |      |      |      |
|      |                                          |      |      |      |
|      | Extrahepatic bile duct(s)                |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Adjacent stomach                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Stomach, NOS                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 54   | Blood vessel(s) (major):                 | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Gastroduodenal artery                    |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticoduodenal artery               |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric artery               |      |      |      |
|      |                                          |      |      |      |
|      | Transverse colon, including hepatic      |      |      |      |
|      | flexure                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 55   | Mesenteric fat                           | T3   | RE   | D    |
|      |                                          |      |      |      |
|      | Mesentery                                |      |      |      |
|      |                                          |      |      |      |
|      | Mesocolon                                |      |      |      |
|      |                                          |      |      |      |
|      | Peritoneum                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 57   | Gallbladder                              | T3   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 58   | Body of stomach                          | T3   | D    | RE   |
+------+------------------------------------------+------+------+------+
| 59   | \(58\) + \[(55) or (57)\]                | T3   | D    | D    |
+------+------------------------------------------+------+------+------+
| 60   | Tumor is inseparable from the superior   | T4   | RE   | RE   |
|      | mesenteric artery                        |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric artery               |      |      |      |
+------+------------------------------------------+------+------+------+
| 61   | Omentum                                  | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 63   | Liver (including porta hepatis)          | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 65   | \(60\) + \[(55) or (57)\]                | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 66   | \(60\) + (58)                            | T4   | D    | RE   |
+------+------------------------------------------+------+------+------+
| 67   | (60 + 59)                                | T4   | D    | D    |
|      |                                          |      |      |      |
|      | OR any of \[(61 to 65)\] + \[(58) or     |      |      |      |
|      | (59)\]                                   |      |      |      |
|      |                                          |      |      |      |
|      | OR (66) + any of \[(55) or (57) or (59)  |      |      |      |
|      | or (61) or (63) or (65)\]                |      |      |      |
+------+------------------------------------------+------+------+------+
| 68   | Tumor is inseparable from the celiac     | T4   | D    | D    |
|      | axis                                     |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Celiac artery                            |      |      |      |
+------+------------------------------------------+------+------+------+
| 69   | Colon (other than transverse colon       | T4   | D    | D    |
|      | including hepatic flexure)               |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 78   | Adrenal (suprarenal) gland               | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Ileum                                    |      |      |      |
|      |                                          |      |      |      |
|      | Jejunum                                  |      |      |      |
|      |                                          |      |      |      |
|      | Kidney                                   |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneum                          |      |      |      |
|      |                                          |      |      |      |
|      | Ureter                                   |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 and 30 ONLY, the T category is assigned based
on the value of CS Tumor Size, as shown in the Extension Size Table for
this site.

**Pancreas: Head**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Pancreas: Head**\
**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   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Gastroepiploic (gastro-omental), left    |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
|      |                                          |      |      |      |
|      | Lateral aortic (lumbar)                  |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic, NOS:                     |      |      |      |
|      |                                          |      |      |      |
|      | Anterior, NOS:                           |      |      |      |
|      |                                          |      |      |      |
|      | Anterior pancreaticoduodenal             |      |      |      |
|      |                                          |      |      |      |
|      | Anterior proximal mesenteric             |      |      |      |
|      |                                          |      |      |      |
|      | Pyloric                                  |      |      |      |
|      |                                          |      |      |      |
|      | Inferior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior, NOS:                          |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (common bile duct)       |      |      |      |
|      |                                          |      |      |      |
|      | Posterior pancreaticoduodenal            |      |      |      |
|      |                                          |      |      |      |
|      | Posterior proximal mesentery             |      |      |      |
|      |                                          |      |      |      |
|      | Superior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Pancreaticosplenic (pancreaticolienal)   | N1   | D    | D    |
|      |                                          |      |      |      |
|      | Splenic (lienal), NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Superior hilum                           |      |      |      |
|      |                                          |      |      |      |
|      | Suprapancreatic                          |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Head**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Head**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pancreas: Head**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Pancreas: Head**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS (includes        |      |      |      |
|      | seeding of peritoneum, even if limited   |      |      |      |
|      | to the lesser sac region; positive       |      |      |      |
|      | peritoneal cytology)                     |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Head**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Head**\
**CS Site-Specific Factor 1**

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

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

**Pancreas: Head**\
**CS Site-Specific Factor 2**

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

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

**Pancreas: Head**\
**CS Site-Specific Factor 3**

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

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

**Pancreas: Head**\
**CS Site-Specific Factor 4**

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

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

**Pancreas: Head**\
**CS Site-Specific Factor 5**

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

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

**Pancreas: Head**\
**CS Site-Specific Factor 6**

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

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

**Page left blank**

**Collaborative Staging Codes**

## **Pancreas: Body and Tail** **C25.1-C25.2**

C25.1 Body of pancreas

C25.2 Tail of pancreas

**Note:  ** For tumors of the islet cells, determine which subsite of
the pancreas is involved and use that primary site code and
corresponding the Collaborative Stage scheme. If the subsite cannot be
determined, use the general code for Islets of Langerhans, C25.4, and
use the Collaborative Stage scheme for Pancreas, Other and Unspecified.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Pancreas: Body and Tail**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pancreas: Body and Tail**\
**CS Extension**

**Note 1:  ** Islets of Langerhans are distributed throughout the
pancreas, and therefore any extension code can be used.

**Note 2:  ** Codes 40-80 are used for contiguous extension of tumor
from the site of origin. Discontinuous involvement is coded in CS Mets
at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive                    | Tis  | IS   | IS   |
|      |                                          |      |      |      |
|      | PanIn III                                |      |      |      |
|      |                                          |      |      |      |
|      | Pancreatic Intraepithelial Neoplasia III |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Confined to pancreas                     | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Extension to peripancreatic tissue, NOS  | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Fixation to adjacent structures, NOS     |      |      |      |
+------+------------------------------------------+------+------+------+
| 44   | Duodenum                                 | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 48   | Ampulla of Vater                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Extrahepatic bile duct(s)                |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Spleen                                   | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 56   | Blood vessel(s):                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Hepatic artery                           |      |      |      |
|      |                                          |      |      |      |
|      | Portal vein                              |      |      |      |
|      |                                          |      |      |      |
|      | Splenic artery/vein                      |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric vein                 |      |      |      |
|      |                                          |      |      |      |
|      | Splenic flexure of colon                 |      |      |      |
+------+------------------------------------------+------+------+------+
| 57   | Kidney, NOS                              | T3   | RE   | D    |
|      |                                          |      |      |      |
|      | Left adrenal (suprarenal) gland          |      |      |      |
|      |                                          |      |      |      |
|      | Left kidney                              |      |      |      |
|      |                                          |      |      |      |
|      | Left ureter                              |      |      |      |
+------+------------------------------------------+------+------+------+
| 58   | Mesenteric fat                           | T3   | RE   | D    |
|      |                                          |      |      |      |
|      | Mesentery                                |      |      |      |
|      |                                          |      |      |      |
|      | Mesocolon                                |      |      |      |
|      |                                          |      |      |      |
|      | Peritoneum                               |      |      |      |
+------+------------------------------------------+------+------+------+
| 59   | Retroperitoneal soft tissue              | T3   | D    | D    |
|      | (retroperitoneal space)                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 60   | Tumor is inseparable from the celiac     | T4   | RE   | RE   |
|      | axis or superior mesenteric artery       |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Celiac artery                            |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric artery               |      |      |      |
+------+------------------------------------------+------+------+------+
| 62   | Stomach                                  | T4   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 70   | \[(60) or (62)\] + \[(57) or (58)\]      | T4   | RE   | D    |
+------+------------------------------------------+------+------+------+
| 71   | Ileum                                    | T4   | RE   | D    |
|      |                                          |      |      |      |
|      | Jejunum                                  |      |      |      |
+------+------------------------------------------+------+------+------+
| 73   | Gallbladder                              | T4   | RE   | D    |
|      |                                          |      |      |      |
|      | Liver (including porta hepatis)          |      |      |      |
+------+------------------------------------------+------+------+------+
| 75   | \(59\) + any of \[(60) or (62) or (71)   | T4   | D    | D    |
|      | or (73)\]                                |      |      |      |
+------+------------------------------------------+------+------+------+
| 77   | Colon (other than splenic flexure)       | T4   | D    | D    |
+------+------------------------------------------+------+------+------+
| 78   | Diaphragm                                | T4   | D    | D    |
|      |                                          |      |      |      |
|      | Right adrenal (suprarenal) gland         |      |      |      |
|      |                                          |      |      |      |
|      | Right kidney                             |      |      |      |
|      |                                          |      |      |      |
|      | Right ureter                             |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 and 30 ONLY, the T category is assigned based
on the value of CS Tumor Size, as shown in the Extension Size Table for
this site.

**Pancreas: Body and Tail**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**

**Pancreas: Body and Tail**\
**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   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Lateral aortic (lumbar)                  |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticosplenic (pancreaticolienal)   |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic, NOS:                     |      |      |      |
|      |                                          |      |      |      |
|      | Anterior, NOS:                           |      |      |      |
|      |                                          |      |      |      |
|      | Anterior pancreaticoduodenal             |      |      |      |
|      |                                          |      |      |      |
|      | Anterior proximal mesenteric             |      |      |      |
|      |                                          |      |      |      |
|      | Pyloric                                  |      |      |      |
|      |                                          |      |      |      |
|      | Inferior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior, NOS:                          |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (common bile duct)       |      |      |      |
|      |                                          |      |      |      |
|      | Posterior pancreaticoduodenal            |      |      |      |
|      |                                          |      |      |      |
|      | Posterior proximal mesentery             |      |      |      |
|      |                                          |      |      |      |
|      | Superior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | Splenic (lienal)                         |      |      |      |
|      |                                          |      |      |      |
|      | Gastroepiploic                           |      |      |      |
|      |                                          |      |      |      |
|      | Splenic hilum                            |      |      |      |
|      |                                          |      |      |      |
|      | Suprapancreatic                          |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | Regional lymph node(s), NOS              |      |      |      |
+------+------------------------------------------+------+------+------+
| 20   | Regional lymph node(s):                  | N1   | D    | D    |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
+------+------------------------------------------+------+------+------+
| 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Body and Tail**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Body and Tail**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pancreas: Body and Tail**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Pancreas: Body and Tail**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS (includes        |      |      |      |
|      | seeding of peritoneum, even if limited   |      |      |      |
|      | to the lesser sac region; positive       |      |      |      |
|      | peritoneal cytology)                     |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Body and Tail**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Body and Tail**\
**CS Site-Specific Factor 1**

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

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

**Pancreas: Body and Tail**\
**CS Site-Specific Factor 2**

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

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

**Pancreas: Body and Tail**\
**CS Site-Specific Factor 3**

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

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

**Pancreas: Body and Tail**\
**CS Site-Specific Factor 4**

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

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

**Pancreas: Body and Tail**\
**CS Site-Specific Factor 5**

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

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

**Pancreas: Body and Tail**\
**CS Site-Specific Factor 6**

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

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

**Page left blank**

**Collaborative Staging Codes**

**Pancreas: Other and Unspecified**\
C25.3-C25.4, C25.7-C25.9

C25.3 Pancreatic duct

C25.4 Islets of Langerhans

C25.7 Other specified parts of pancreas

C25.8 Overlapping lesion of pancreas

C25.9 Pancreas, NOS

**Note:  ** For tumors of the islet cells, determine which subsite of
the pancreas is involved and use that primary site code and the
corresponding Collaborative Stage scheme. If the subsite cannot be
determined, use the general code for Islets of Langerhans, C25.4, and
use the Collaborative Stage scheme for Pancreas, Other and Unspecified.

+-----------------------------------------------------------------------+
| +---------------------+---------------------+---------------------+   |
| | 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            |                     |   |
| +---------------------+---------------------+---------------------+   |
+-----------------------------------------------------------------------+

**Pancreas: Other and Unspecified**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Pancreas: Other and Unspecified**\
**CS Extension**

**Note 1:  ** Islets of Langerhans are distributed throughout the
pancreas, and, therefore, any extension code can be used.

**Note 2:  ** Codes 40-80 are used for contiguous extension of tumor
from the site of origin. Discontinuous involvement is coded in CS Mets
at DX.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive                    | Tis  | IS   | IS   |
|      |                                          |      |      |      |
|      | PanIn III                                |      |      |      |
|      |                                          |      |      |      |
|      | Pancreatic intraepithelial neoplasia III |      |      |      |
+------+------------------------------------------+------+------+------+
| 10   | Confined to pancreas                     | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | \*   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Peripancreatic tissue                    | T3   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 45   | Ampulla of Vater                         | T3   | RE   | RE   |
|      |                                          |      |      |      |
|      | Duodenum                                 |      |      |      |
|      |                                          |      |      |      |
|      | Extra hepatic bile duct(s)               |      |      |      |
+------+------------------------------------------+------+------+------+
| 50   | Adjacent large vessel(s) (except as      | T3   | RE   | RE   |
|      | listed in code 60)                       |      |      |      |
|      |                                          |      |      |      |
|      | Colon                                    |      |      |      |
|      |                                          |      |      |      |
|      | Spleen                                   |      |      |      |
|      |                                          |      |      |      |
|      | Stomach                                  |      |      |      |
+------+------------------------------------------+------+------+------+

+------+------------------------------------------+------+------+------+
| 60   | Tumor is inseparable from the celiac     | T4   | RE   | RE   |
|      | axis or superior mesenteric artery       |      |      |      |
|      |                                          |      |      |      |
|      | Aorta                                    |      |      |      |
|      |                                          |      |      |      |
|      | Celiac artery                            |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric artery               |      |      |      |
+------+------------------------------------------+------+------+------+
| 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 and 30 ONLY, the T category is assigned based
on the value of CS Tumor Size, as shown in the Extension Size Table for
this site.

**Pancreas: Other and Unspecified**\
**CS TS/Ext-Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Other and Unspecified**\
**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   | No regional lymph node involvement       | N0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Regional lymph node(s):                  | N1   | RN   | RN   |
|      |                                          |      |      |      |
|      | Celiac                                   |      |      |      |
|      |                                          |      |      |      |
|      | Hepatic                                  |      |      |      |
|      |                                          |      |      |      |
|      | Infrapyloric (subpyloric)                |      |      |      |
|      |                                          |      |      |      |
|      | Lateral aortic (lumbar)                  |      |      |      |
|      |                                          |      |      |      |
|      | Pancreaticosplenic (pancreaticolienal)   |      |      |      |
|      |                                          |      |      |      |
|      | Peripancreatic, NOS:                     |      |      |      |
|      |                                          |      |      |      |
|      | Anterior, NOS:                           |      |      |      |
|      |                                          |      |      |      |
|      | Anterior pancreaticoduodenal             |      |      |      |
|      |                                          |      |      |      |
|      | Anterior proximal mesenteric             |      |      |      |
|      |                                          |      |      |      |
|      | Pyloric                                  |      |      |      |
|      |                                          |      |      |      |
|      | Inferior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Posterior, NOS:                          |      |      |      |
|      |                                          |      |      |      |
|      | Pericholedochal (common bile duct)       |      |      |      |
|      |                                          |      |      |      |
|      | Posterior pancreaticoduodenal            |      |      |      |
|      |                                          |      |      |      |
|      | Posterior proximal mesentery             |      |      |      |
|      |                                          |      |      |      |
|      | Superior to the head and body of         |      |      |      |
|      | pancreas                                 |      |      |      |
|      |                                          |      |      |      |
|      | Retroperitoneal                          |      |      |      |
|      |                                          |      |      |      |
|      | Splenic (lienal), NOS                    |      |      |      |
|      |                                          |      |      |      |
|      | Gastroepiploic (gastro-omental), left    |      |      |      |
|      |                                          |      |      |      |
|      | Splenic hilum                            |      |      |      |
|      |                                          |      |      |      |
|      | Suprapancreatic                          |      |      |      |
|      |                                          |      |      |      |
|      | Superior mesenteric                      |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Other and Unspecified**\
**CS Reg Nodes Eval**\
**SEE STANDARD TABLE**

**Pancreas: Other and Unspecified**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Pancreas: Other and Unspecified**\
**Reg LN Exam**\
**SEE STANDARD TABLE**\
\
**Pancreas: Other and Unspecified**\
**CS Mets at DX**

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | No; none                                 | M0   | NONE | NONE |
+------+------------------------------------------+------+------+------+
| 10   | Distant lymph node(s)                    | M1   | D    | D    |
|      |                                          |      |      |      |
|      | Distant lymph node(s), NOS               |      |      |      |
+------+------------------------------------------+------+------+------+
| 40   | Distant metastases except distant lymph  | M1   | D    | D    |
|      | node(s) (code 10)                        |      |      |      |
|      |                                          |      |      |      |
|      | Distant metastasis, NOS (includes        |      |      |      |
|      | seeding of peritoneum, even if limited   |      |      |      |
|      | to the lesser sac region; positive       |      |      |      |
|      | peritoneal cytology)                     |      |      |      |
|      |                                          |      |      |      |
|      | 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         |      |      |      |
+------+------------------------------------------+------+------+------+

**Pancreas: Other and Unspecified**\
**CS Mets Eval**\
**SEE STANDARD TABLE**\
\
**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 1**

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

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

**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 2**

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

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

**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 3**

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

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

**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 4**

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

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

**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 5**

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

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

**Pancreas: Other and Unspecified**\
**CS Site-Specific Factor 6**

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

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

**Collaborative Staging Codes**

## **Other and Ill-Defined Digestive Organs** **C26.0, C26.8-C26.9**

C26.0 Intestinal tract, NOS

C26.8 Overlapping lesion of digestive system

C26.9 Gastrointestinal tract, NOS

**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 Digestive Organs**\
**CS Tumor Size**\
**SEE STANDARD TABLE**\
\
**Other and Ill-Defined Digestive Organs**\
**CS Extension**

**Note 1:  ** 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.

**Note 2:  ** Definition of Adjacent Structures: Connective tissues
large enough to be given a specific name would be considered adjacent
structures. For example, the brachial artery has a name, as does the
broad ligament. Continuous tumor growth from one organ into an adjacent
named structure would be coded to 60 in the schemes for ill-defined or
non-specific sites.

+------+------------------------------------------+------+------+------+
| Code | Description                              | TNM  | SS77 | SS   |
|      |                                          |      |      | 2000 |
+------+------------------------------------------+------+------+------+
| 00   | In situ; non-invasive; intraepithelial   | NA   | IS   | IS   |
+------+------------------------------------------+------+------+------+
| 10   | Invasion of submucosa                    | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 30   | Localized, NOS                           | NA   | L    | L    |
+------+------------------------------------------+------+------+------+
| 40   | Adjacent connective tissue (see Note 1)  | NA   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 60   | Adjacent organs/structures (see Note 2)  | NA   | RE   | RE   |
+------+------------------------------------------+------+------+------+
| 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 Digestive Organs**\
**CS TS/Ext-Eval**

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

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

**Other and Ill-Defined Digestive 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 node(s)                   | NA   | RN   | RN   |
|      |                                          |      |      |      |
|      | Intra-abdominal                          |      |      |      |
|      |                                          |      |      |      |
|      | Paracaval                                |      |      |      |
|      |                                          |      |      |      |
|      | Pelvic                                   |      |      |      |
|      |                                          |      |      |      |
|      | Subdiaphragmatic                         |      |      |      |
|      |                                          |      |      |      |
|      | 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 Digestive Organs**\
**CS Reg Nodes Eval**

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

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

**Other and Ill-Defined Digestive Organs**\
**Reg LN Pos**\
**SEE STANDARD TABLE**\
\
**Other and Ill-Defined Digestive Organs**\
**Reg LN Exam**\
**SEE STANDARD TABLE**

**Other and Ill-Defined Digestive 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    |
|      |                                          |      |      |      |
|      | Cannot be assessed                       |      |      |      |
|      |                                          |      |      |      |
|      | Not documented in patient record         |      |      |      |
+------+------------------------------------------+------+------+------+

**Other and Ill-Defined Digestive Organs**\
**CS Mets Eval**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 1**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 2**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 3**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 4**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 5**

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

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

**Other and Ill-Defined Digestive Organs**\
**CS Site-Specific Factor 6**

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

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

**Site-Specific Surgery Codes**

Pancreas

**C250--C259**

(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

25 **Local** **excision** of tumor, NOS

30 **Partial pancreatectomy**, NOS; example: distal

[]{.mark}

35 Local or partial pancreatectomy and duodenectomy

36 WITHOUT distal/partial gastrectomy

37 WITH partial gastrectomy (Whipple)

40 Total pancreatectomy

60 Total pancreatectomy and subtotal gastrectomy or duodenectomy

70 Extended pancreatoduodenectomy

80 Pancreatectomy, NOS

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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