]> M-8247 C51.0 Labium majus C51.1 Labium minus C51.2 Clitoris C51.8 Overlapping lesion of vulva C51.9 Vulva, NOS Note 1: This schema is used for Merkel cell carcinoma only. Note 2: The AJCC 7th edition stages cancer of the perineum with vulva. Cancer of the perineum can be coded to several different primary site codes each of which includes sites other than perineum. Involvement of the vulva and perineum should be assigned to vulva as the primary site in the absence of a statement that the tumor extended from the perineum to the vulva. Collaborative Stage only includes C51.0-C51.9 (vulva) and does not include primaries of the perineum in this schema. In addition, basal and squamous cell carcinomas of the skin of the perineum would be coded to C44.5 and would not be reportable. &commontumorsizeskinmerkel; CS Extension Note 1: In the case of multiple simultaneous tumors, code the tumor with the greatest extension. Note 2: Skin ulceration does not alter the AJCC T category. Note 3: In-transit metastasis is coded in CS Lymph Nodes. Note 4: The depth of stromal invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion. Note 5: Use codes 110-130 and 410-430 for tumors limited to the skin or subcutaneous/submucosal tissues of vulva and perineum only. Use code 602 for tumors involving fascia or musculature of vulva and perineum. Note 6: The assignment of the T1, T2, and T3 categories for Merkel cell carcinomas is based on tumor size. A physician's statement of the T category may be used to code both 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. Use codes 450, 460, 470, and 810 as appropriate to code CS Extension based on a statement of T when no other extension information is available. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 Tis Tis IS IS 100 TX * L L 105 ERROR ERROR ERROR ERROR 110 Vulva only: Stromal invasion less than or equal to 1 mm ^ * L L 120 Vulva only: Stromal invasion greater than 1 mm ^ * L L 130 Vulva only: Stromal invasion but level of invasion in mm not stated ^ * L L 150 Submucosa ^ * L L 200 Confined to vulva, NOS ^ * L L 300 Localized, NOS ^ * L L 400 ERROR ERROR ERROR ERROR 410 ^ * RE RE 420 Vulva and perineum, stromal invasion greater than 1 mm ^ * RE RE 430 Vulva and perineum, level of invasion in mm not stated ^ * RE RE 450 Stated as T1 with no other information on extension ^ * L L 460 Stated as T2 with no other information on extension ^ * L L 470 Stated as T3 with no other information on extension ^ * L L 500 T4 * L L 510 500 + (410, 420, 430) T4 * RE RE 600 ERROR T3 RE RE 605 T4 T3 RE RE 610 Vagina (lower/distal 1/3 vagina) T4 T3 RE RE 612 Vagina NOS T4 T3 RE RE 618 Vagina (upper/proximal 2/3 vagina) T4 T3 RE RE 620 T4 T3 D RE 700 T4 T4 D D 750 ERROR T4 D D 760 T4 T4 D D 765 T4 T4 D D 770 ERROR ERROR ERROR ERROR 775 (605-700, 760) + 500 T4 T4 D D 778 765 + 500 T4 T4 D D 800 Further contiguous extension T4 T4 D D 810 Stated as T4 with no other information on extension T4 T4 RE RE 950 No evidence of primary tumor T0 T0 U U 999 TX TX U U ^ For CS Extension codes 105-470 ONLY the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size and CS Extension as shown in the Extension Size AJCC 7 Table for this schema. * For CS Extension codes 100-510 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size and CS Extension, as shown in the Extension Size AJCC 6 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: Bilateral nodes are considered regional nodes for tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Clinical assessment of bilateral regional nodal involvement is required for tumors where lymphoscintigraphy is not performed. Note 3: Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are considered regional for AJCC staging but may be distant for Summary Stage. Use code 107 for involvement of nodes in secondary nodal basins not otherwise specified. Note 4: In-transit metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph nodes or distal to the primary lesion. In-transit metastasis is coded in the CS Lymph Nodes field. Note 5: Isolated tumor cells (ITCs) should be considered positive nodes. If only ITCs are present, use code 010. Note 6: If the only information about lymph nodes is a statement of N1 involvement without a clinical or pathologic designation, use code 140. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 N0 NONE NONE 010 Isolated tumor cells (ITCs) only ^ N0 NONE NONE 100 ERROR N1 RN RN 105 ^ * RN RN 106 ^ N0 RN D 107 ^ N0 D D 108 ^ * RN D 109 ^ * D D 110 ERROR ERROR ERROR ERROR 114 ^ * RN RN 115 ^ * RN RN 120 ^ * RN RN 125 ^ * RN RN 130 Stated as N1 [NOS] with no other information on pathologic or clinical evaluation ^ * RN RN 500 ERROR N2 RN RN 510 N2 N0 RE RE 520 N2 * RE RN 540 N2 * RN RN 550 N2 N1 RN D 560 N2 N1 D D 570 N2 * RN D 580 N2 * D D 600 Regional lymph nodes, NOS ^ N1 RN RN 650 N2 N1 RN RN 700 N2 N1 RE RE 800 Lymph nodes, NOS N1NOS N1 RN RN 999 NX NX U U ^ When CS Lymph Nodes Eval is coded, forCS Lymph Nodes codes 010, 105-109, 114-130, and 600, ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, as shown in the Lymph Node and Nodal Status Eval AJCC 7 Table. When CS Lymph Nodes Eval is blank, forCS Lymph Nodes codes 010, 105-109, 114-130, and 600, ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the Lymph Node and Nodal Status Eval Blank AJCC 7 Table. * For CS Lymph Nodes codes 105, 108, 109, 114-130, 520, 540, 570, and 580, the N category for AJCC 6 staging is assigned based on the value of CS Site Specific Factor 11. Regional Lymph Node - Laterality, as shown in the Lymph Nodes and SSF 11 AJCC 6 Table. &commonregnodesevalmerkelcell; &commonreglnpos_active; &generalreglnexam; CS Mets at DX Note: External and internal iliac nodes are coded in CS Lymph Nodes. (Clarification V0204) Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 00 No distant metastasis M0 * NONE NONE 10 M1a M1 D D 11 M1a M1 RN D 12 M1a M1 D D 13 M1a M1 D D 15 Metastasis to skin or subcutaneous tissue M1a M1 D D 20 Stated as M1a with no other information on distant metastases M1a M1 D D 30 Lung M1b M1 D D 35 M1b M1 D D 36 M1b M1 D D 37 M1b M1 D D 40 ERROR M1 D D 45 M1c M1 D D 50 ERROR M1 D D 55 M1c M1 D D 56 M1c M1 D D 57 M1c M1 D D 60 M1NOS M1 D D 99 M0 * U U For CS Mets at DX codes 00 and 99, the M category for AJCC 6 staging is assigned based on the coding of CS Lymph Nodes as shown in the Lymph Nodes Mets at DX AJCC 6 Table for this schema. &generalmetseval; &commonssf1merkelcell; ¬appssfactor2; &commonssf3merkelcell; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; ¬appnewssf10; &commonssf11vulva; ¬appnewssf12; ¬appnewssf13; ¬appnewssf14; ¬appnewssf15; &commonssf16merkelcell; &commonssf17merkelcell; &commonssf18merkelcell; &commonssf19merkelcell; &commonssf20merkelcell; &commonssf21merkelcell; &commonssf22merkelcell; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusionskinmerkelcell; &commonhistologyexclusions1; &commonstagemerkelcelltnm7; &commonstagevulva; &commonsummarystage; Extension Size AJCC 6 Table Note: For CS Extension codes 110-300 and 410-470 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size and CS Extension, as shown in this table. CS Extension CS Tumor Size 000 0 CS Tumor Size 001-020 1 20 CS Tumor Size 021-989 21 989 CS Tumor Size 990-992 990 992 CS Tumor Size 993-995 993 995 CS Tumor Size 996 996 CS Tumor Size 999 999 100 ERROR T1NOS T2 T1NOS T2 T2 TX 110 ERROR T1a T2 T1a T2 T2 TX 120 ERROR T1b T2 T1b T2 T2 TX 130 ERROR T1NOS T2 T1NOS T2 T2 TX 150 ERROR T1NOS T2 T1NOS T2 T2 TX 200 ERROR T1NOS T2 T1NOS T2 T2 TX 300 ERROR T1NOS T2 T1NOS T2 T2 TX 410 ERROR T1a T2 T1a T2 T2 TX 420 ERROR T1b T2 T1b T2 T2 TX 430 ERROR T1NOS T2 T1NOS T2 T2 TX 450 ERROR T1NOS T2 T1NOS T2 T2 T1NOS 460 ERROR T1NOS T2 T1NOS T2 T2 T2 470 ERROR T1NOS T2 T1NOS T2 T2 T2 500 ERROR T1NOS T2 T1NOS T2 T2 TX 510 ERROR T1NOS T2 T1NOS T2 T2 TX Extension Size AJCC 7 Table Note: For Extension codes 105-470 ONLY, the T category for AJCC 7 staging 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 001-020 1 20 CS Tumor Size 021-050 21 50 CS Tumor Size 051-989 51 989 CS Tumor Size 990-991 990 991 CS Tumor Size 992 992 CS Tumor Size 993-994 993 994 CS Tumor Size 995 995 CS Tumor Size 996 996 CS Tumor Size 999 999 110 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 120 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 130 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 150 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 200 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 300 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 410 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 420 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 430 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 450 ERROR T1 T2 T3 T1 T1 T1 T1 T3 T1 460 ERROR T1 T2 T3 T1 T2 T2 T2 T3 T2 470 ERROR T1 T2 T3 T1 T3 T3 T3 T3 T3 Lymph Nodes and SSF 11 AJCC 6 Table Note: For CS Lymph Nodes codes 105, 108, 109, 114-130, 520, 540, 570, and 580, the N category for AJCC 6 staging is assigned based on the value of CS Site-Specific Factor 11, Regional Lymph Node - Laterality, as shown in this table. Lymph Node Code CS SSF 11 000 0 CS SSF 11 010 10 CS SSF 11 020 20 CS SSF 11 030 30 CS SSF 11 988 988 CS SSF 11 998 998 CS SSF 11 999 999 105 ERROR N1 N2 N1 N1 ERROR N1 108-109 ERROR N1 N2 N1 N1 ERROR N1 114-130 ERROR N1 N2 N1 N1 ERROR N1 520-540 ERROR N1 N2 N1 N1 ERROR N1 570-580 ERROR N1 N2 N1 N1 ERROR N1 Lymph Node and Nodal Status Eval AJCC 7 Table Note: For CS Lymph Nodes codes 010, 105-109, 114-130, and 600 ONLY, the N category is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, as shown in the following table. CS Lymph Nodes Eval CS Lymph Nodes CS SSF 3 000, 005 0 5 CS SSF 3 010 10 CS SSF 3 020 20 CS SSF 3 100 100 CS SSF 3 150 150 CS SSF 3 888, 988 888 988 CS SSF 3 999 999 0,1,5,9 010 ERROR N1a N1b ERROR N2 ERROR N1a 0,1,5,9 105-109,114-130,600 ERROR ERROR N1 ERROR N2 ERROR N1 2,3,6,8 010 ERROR N1a N1b ERROR ERROR ERROR N1a 2,3,6,8 105-109,114 ERROR N1a N1b ERROR N2 ERROR N1NOS 2,3,6,8 115 ERROR N1a N1b ERROR N2 ERROR N1a 2,3,6,8 120 ERROR N1a N1b ERROR N2 ERROR N1b 2,3,6,8 125-130,600 ERROR N1a N1b ERROR N2 ERROR N1NOS Lymph Node and Nodal Status Eval Blank AJCC 7 Table Note: When CS Lymph Nodes Eval is blank, for CS Lymph Nodes codes 010, 105-109, 114-130, and 600 ONLY, the N category is assigned based on the value of CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the following table. Regional Nodes Positive CS Lymph Nodes CS SSF 3 000, 005 0 5 CS SSF 3 010 10 CS SSF 3 020 20 CS SSF 3 100 100 CS SSF 3 150 150 CS SSF 3 888, 988 888 988 CS SSF 3 999 999 00,98 010 ERROR N1a N1b ERROR N2 ERROR N1a 00,98 105-109,114-130,600 ERROR N1 N1 ERROR N2 ERROR N1 01-90,95,97,99 010 ERROR N1a N1b ERROR N2 ERROR N1a 01-90,95,97,99 105-109 ERROR N1a N1b ERROR N2 ERROR N1NOS 01-90,95,97,99 114 ERROR N1a N1b ERROR N2 ERROR N1 01-90,95,97,99 115 ERROR N1a N1b ERROR N2 ERROR N1a 01-90,95,97,99 120 ERROR N1a N1b ERROR N2 ERROR N1b 01-90,95,97,99 125 ERROR N1a N1b ERROR N2 ERROR N1NOS 01-90,95,97,99 130,600 ERROR N1a N1b ERROR N2 ERROR N1NOS Lymph Nodes Mets at DX AJCC 6 Table Note: For CS Mets at DX codes 00 and 99, the M category for AJCC 6 staging is assigned as shown in this table. CS Lymph Nodes CS Mets at DX 00 0 CS Mets at DX 99 99 000 M0 MX 010 M0 MX 100 M0 MX 105 M0 MX 106 M1 M1 107 M1 M1 108 M1 M1 109 M1 M1 110 ERROR ERROR 114 M0 MX 115 M0 MX 120 M0 MX 125 M0 MX 130 M0 MX 500 M0 MX 510 M0 MX 520 M0 MX 540 M0 MX 550 M1 M1 560 M1 M1 570 M1 M1 580 M1 M1 600 M0 MX 650 M0 MX 700 M0 MX 800 M0 MX 999 MX MX