]> M-8153, 8240-8242, 8246, 8249 Note 1: Carcinoid tumor of the appendix is typically not reportable. Use this schema if your institution collects this tumor as reportable by agreement. Note 2: This schema is also used for neurendocrine carcinoma and malignant gastrinomas. Note 3: Not all histologies included in this schema were staged in AJCC 6th Edition. The algorithm will derive an AJCC 6 TNM and stage group only for histology codes 8153 and 8246. CS Tumor Size Note: The assignment of T1, T1a, and T1b categories for carcinoid tumors of the appendix is based on tumor size. A physician's statement of the T category may be used to code CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently: for example the record may document size but not extension, other than the physician's statement of the T category. Use codes 991 and 992 as appropriate to code CS Tumor Size based on a statement of T when no other size information is available. Code Description 000 No mass/tumor found 001-988 989 989 mm or larger 990 Microscopic focus or foci only and no size of focus given 991 992 993 994 995 998 999 CS Extension Note 1: AJCC does not include an in situ category for carcinoid tumors of appendix. Any case so coded will be mapped to TX for AJCC 7 stage and in situ Summary Stage. Cases coded with 000 will continue to map to Tis if AJCC 6 staging is applicable. Note 2: The assignment of T1, T1a, and T1b categories for carcinoid of appendix is based on tumor size. A physician's statement of the T category may be used to code CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently: for example the record may document size but not extension, other than the physician's statement of the T category. Use code 320, 330, or 335, 410, 490, or 850 as appropriate to code CS Extension based on a statement of T when no other extension information is available. Note 3: Codes 405-750 are used for contiguous extension from the site of origin. Discontinuous involvement is coded in CS Mets at DX. Note 4: Tumor that is adherent to other organs or structures, macroscopically, is classified cT4b. If tumor is present in adhesion(s) upon microscopic examination, the tumor is classified as pT4b. Use code 565 for macroscopic adhesions if no pathologic confirmation, and for pathologically confirmed tumor in adhesions. However, if no tumor is present in adhesion(s) upon microscopic examination, the classification is based upon extent of tumor invasion into or through the wall; use codes 000, 100, 160, 200, 370, 451, and 470 as appropriate to describe the microscopically confirmed depth of tumor invasion for these cases. Use codes 601-650, 670, 701, and 751-800 to code invasion of underlying structures from the adherent tumor. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 TX Tis IS IS 050 TX Tis IS IS 100 Invasive tumor confined to mucosa, NOS (including intramucosal, NOS) ^ Tis L L 110 Invades lamina propria ^ Tis L L 120 Invades muscularis mucosae ^ Tis L L 130 ERROR T1 L L 140 ERROR T1 L L 150 ERROR T1 L L 160 Invades submucosa (superficial invasion) ^ T1 L L 200 Invades muscularis propria ^ T2 L L 300 ^ T1 L L 310 ERROR ERROR ERROR ERROR 320 Stated as T1a with no other information on extension ^ T1 L L 330 Stated as T1b with no other information on extension ^ T1 L L 335 Stated as T1 [NOS] with no other information on extension ^ T1 L L 340 ERROR ERROR ERROR ERROR 350 ERROR ERROR ERROR ERROR 370 Extension to cecum ^ T1 L L ERROR ERROR ERROR ERROR 401 ^ T3 L L 410 ^ TX L L 420 ERROR ERROR ERROR ERROR 450 ERROR ERROR ERROR ERROR 451 ^ T3 RE RE 458 Fat, NOS ^ T3 RE RE 460 ERROR T3 RE RE 470 Extension to ileum T3 T4 RE RE 490 Stated as T3 with no other information on extension T3 TX RE RE 500 ERROR ERROR ERROR ERROR 501 ERROR T4 RE RE 550 ERROR T4 RE RE 565 T4 T3 RE RE 570 T4 T4 RE RE 600 ERROR ERROR ERROR ERROR 601 T4 T4 RE RE 650 T4 T4 RE RE 660 ERROR T4 RE RE 670 Skeletal muscle T4 T4 D D 700 ERROR ERROR ERROR ERROR 701 T4 T4 D D 750 ERROR ERROR ERROR ERROR 751 T4 T4 D D 800 T4 T4 D D 850 Stated as T4 with no other information on extension T4 T4 D D 950 No evidence of primary tumor T0 T0 U U 999 TX TX U U ^ For CS Extension codes 100-120, 160-300, 320-335, 370, 401-410, and 451 ONLY, the T category is assigned based on the value of CS Tumor Size, as shown in the Extension Size AJCC 7 Table for this schema. &generalcstsexteval; CS Lymph Nodes Note 1: Code only regional nodes and nodes, NOS , in this field. Distant nodes are coded in CS Mets at DX. Note 2: Superior and inferior mesenteric nodes are coded in CS Mets at DX. Mesenteric nodes, NOS are coded in CS Lymph Nodes. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 N0 NONE NONE 100 N1 * RN RN 200 N1 * RN RN 300 N1 * RN RN 400 Stated as N1 with no other information on regional lymph nodes N1 N1 RN RN 450 ERROR N2 RN RN 800 Lymph nodes, NOS N1 N1 RN RN 999 NX NX U U * For CS Lymph Nodes codes 100-300 ONLY: when CS Lymph Nodes Eval is 0, 1, 5, or 9, the N category is assigned from the Lymph Nodes Clinical Evaluation AJCC 6 Table, using Regional Nodes Positive and CS Site-Specific Factor 2; when CS Lymph Nodes Eval is 2, 3, 6, 8, or not coded, the N category is determined from the Lymph Nodes Pathologic Evaluation 6 Table Also Used When CS Reg Nodes Eval is Not Coded using Regional Nodes Positive. &generalregnodeseval; &commonreglnpos_active; &generalreglnexam; CS Mets at DX Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 00 Nodistant metastasis M0 M0 NONE NONE 08 Superior mesenteric lymph node(s) M1 M1 RN D 10 Distant lymph node(s) other than those in code 08 (Includes inferior mesenteric lymph node(s)) M1 M1 D D 40 M1 M1 D D 50 M1 M1 D D 60 M1 M1 RN D 99 M0 MX U U &generalmetseval; CS Site-Specific Factor 1 OBSOLETE - Carcinoembryonic Antigen (CEA) Note: This CS Site-Specific Factor is obsolete beginning with CS Version 2 (codes, code descriptions, and notes). Old data are retained during conversion, but new cases are not coded 000 080 or 999. Use only code 988 for this field for all cases entered in CS Version 2. Code Description 000 010 020 030 080 988 Not applicable: Information not collected for this schema 999 CS Site-Specific Factor 2 Clinical Assessment of Regional Lymph Nodes Note 1: Only include information from imaging and physical examination in this item. Do not include information on regional lymph nodes that is based on surgical observation or diagnostic lymph node biopsy. Note 2: Use code 400 if regional lymph nodes are involved clinically but there is no indication of the number of nodes involved. Note 3: If there is no diagnostic work-up to assess regional lymph nodes, use code 999. Do not apply the inaccessible nodes rule that presumes unmentioned nodes to be negative. Code Description 000 100 200 400 888 988 999 ¬appssfactor3; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; ¬appnewssf10; ¬appnewssf11; ¬appnewssf12; CS Site-Specific Factor 13 Serum Chromogranin A (CgA) Lab Value Note 1: Chromogranins are a family of proteins in secretory granules found throughout the neuroendocrine system. Serum Chromagranin A (CgA) has been shown to be a useful marker for neuroendocrine tumors. Note 2: Record, to the nearest nanogram/milliliter (ng/ml), the highest CgA lab value documented in the medical record prior to treatment. For example, apretreatment CgA of 400 ng/ml would be recorded as 400. Note 3: Code 000 is reserved for exactly 0 ng/ml (no measurable amount of CgA). Do not round tiny values down to 0 ng/ml; any measured value less than or equal to 1 ng/ml should be coded 001. For code 001, also round 1.1 1.4 ng/ml down to 1 ng/ml. For codes 002 980, round values to the nearest nanogram/milliliter. Note 4: Use code 997 if there is no actual pre-treatment CgA lab value available but an interpretation of the test result is stated. Code Description 000 0 nanogram/milliliter (ng/ml), exactly 001 1 or less ng/ml; stated as less than 1 ng/ml with no exact value 002-979 980 980 or greater ng/mL 988 997 998 Test not done (test was not ordered and was not performed) 999 ¬appnewssf14; ¬appnewssf15; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusionnet; &commonhistologyexclusions1; AJCC TNM 7 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 III T0 NX M0 UNK T1NOS N0 M0 I T1NOS N1 M0 III T1NOS NX M0 UNK T1a N0 M0 I T1a N1 M0 III T1a NX M0 UNK T1b N0 M0 I T1b N1 M0 III T1b NX M0 UNK T2 N0 M0 II T2 N1 M0 III T2 NX M0 UNK T3 N0 M0 II T3 N1 M0 III T3 NX M0 UNK T4 N0 M0 III T4 N1 M0 III T4 NX M0 III TX N0 M0 UNK TX N1 M0 III TX NX M0 UNK T0 N0 M1 IV T0 N1 M1 IV T0 NX M1 IV T1NOS N0 M1 IV T1NOS N1 M1 IV T1NOS NX M1 IV T1a N0 M1 IV T1a N1 M1 IV T1a NX M1 IV T1b N0 M1 IV T1b N1 M1 IV T1b NX M1 IV T2 N0 M1 IV T2 N1 M1 IV T2 NX M1 IV T3 N0 M1 IV T3 N1 M1 IV T3 NX M1 IV T4 N0 M1 IV T4 N1 M1 IV T4 NX M1 IV TX N0 M1 IV TX N1 M1 IV TX NX M1 IV &commonstagecolorect; &commonsummarystage; Extension Size AJCC 7 Table Note: For CS Extension codes 100-120160-300, 320-335, 370, 401-410, and 451 ONLY, the T category for AJCC 7staging is assigned based on the value of CS Tumor Size, as shown in this table. CS Extension CS Tumor Size 000 0 CS Tumor Size 001-010 1 10 CS Tumor Size 011-020 11 20 CS Tumor Size 021-040 21 40 CS Tumor Size 041-989 41 989 CS Tumor Size 990 990 CS Tumor Size 991 991 CS Tumor Size 992 992 CS Tumor Size 993-994 993 994 CS Tumor Size 995 995 CS Tumor Size 998 998 CS Tumor Size 999 999 100 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 110 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 120 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 160 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 200 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 300 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 320 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR T1a 330 ERROR T1a T1b T2 T3 T1a T1b T1b T2 T3 ERROR T1b 335 ERROR T1a T1b T2 T3 T1NOS T1NOS T1NOS T2 T3 ERROR T1NOS 370 ERROR T2 T2 T2 T3 T1a T1b T2 T3 T3 ERROR TX 401 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX 410 ERROR T2 T2 T2 T3 T2 T2 T1b T2 T3 ERROR TX 451 ERROR T1a T1b T2 T3 T1a T1b T2 T3 T3 ERROR TX 458 ERROR T1a T1b T2 T3 T1a T1a T1b T2 T3 ERROR TX &commonextralymphnodesclinicalevalcolorectal; &commonextralymphnodespathologicevalcolorectal;