]> 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 schema. If the subsite cannot be determined, use the general code for Islets of Langerhans, C25.4, and use the Collaborative Stage schema for Pancreas, Other and Unspecified. &commontumorsizepancreas; CS Extension Note 1: Tumors of the head of the pancreas arise to the right of the superior mesenteric-portal vein confluence. Note 2: Islets of Langerhans are distributed throughout the pancreas; an islet tumor is coded to the subsite of the pancreas in which the tumor arises if the information is available. Note 3: The assignment of T1 and T2 categories for tumors of the pancreas 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 150 and 200 as appropriate to code CS Extension based on a statement of T when no other extension information is available. Code Description TNM 7th Map TNM 6th Map SS77 Map SS2000 Map 000 Tis Tis IS IS 100 Confined to pancreas ^ * L L 150 Stated as T1 with no other information on extension ^ * L L 200 Stated as T2 with no other information on extension ^ * L L 300 Localized, NOS ^ * L L 400 T3 T3 RE RE 420 ERROR ERROR ERROR ERROR 440 T3 T3 RE RE 500 T3 T3 RE RE 540 T3 T3 RE RE 550 T3 T3 RE D 570 Gallbladder T3 T3 RE D 575 Omentum T3 T3 RE D 580 Body of stomach T3 T3 D RE 590 T3 T3 D D 593 T3 T3 RE D 595 Stated as T3 with no other information on extension T3 T3 RE RE 600 T4 T4 RE RE 610 T4 T4 RE D 630 Liver (including porta hepatis) T4 T4 RE D 640 T4 T4 RE D 650 T4 T4 RE D 660 T4 T4 D RE 670 T4 T4 D D 680 T4 T4 D D 690 T4 T4 D D 780 T4 T4 D D 790 ERROR ERROR ERROR ERROR 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 100, 150, 200, and 300 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size Table for this schema. * For CS Extension codes 100, 150, 200, and 300 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size 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: Celiac axis and splenic nodes are classified as distant nodes for AJCC 7 staging and are coded in CS Mets at DX. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 * NONE NONE 100 N1 N1 RN RN 110 N1 N1 RN RN 200 N1 N1 D D 250 N1 N1 RN RN 800 Lymph nodes, NOS N1 N1 RN RN 999 Unknown; regional lymph nodes not stated Regional lymph nodes cannot be assessed Not documented in patient record NX * U U *For CS Lymph Nodes codes 000 and 999, the N category for AJCC 6 staging is based on the value of CS Mets at DX as shown in the CS Lymph Nodes Mets at DX AJCC 6 Table for this schema. &generalregnodeseval; &generalreglnpos; &generalreglnexam; CS Mets at DX Note 1: The lesser sac of the peritoneum, or omental bursa, is the cavity in the abdomen formed by the lesser and greater omentum; the pancreas forms part of the posterior wall of the lesser sac. Note 2: Celiac axis and splenic nodes are classified as distant for AJCC 7 staging. These nodes are now coded in CS Mets at DX. Code Description TNM 7th Map TNM 6th Map SS77 Map SS2000 Map 00 No distant metastasis M0 M0 NONE NONE 05 M1 M0 RN RN 07 M1 M0 D D 10 M1 M1 D D 20 10 + (05, 07) M1 M1 D D 40 M1 M1 D D 45 M1 M1 D D 50 M1 M1 D D 60 M1 M1 D D 99 M0 MX U U &generalmetseval; &commonssf1ampullaofvater; &commonssf2pancreas; &commonssf3pancreas; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; ¬appnewssf10; ¬appnewssf11; ¬appnewssf12; ¬appnewssf13; ¬appnewssf14; ¬appnewssf15; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusioncarcinoma; &commonhistexclusionspancreas; &commonstagepancreastnm7; AJCC TNM 6 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 IIB T0 NX M0 UNK T0 N0 M1 IV T0 N1 M1 IV T0 NX M1 IV T0 N0 MX UNK T0 N1 MX UNK T0 NX MX UNK Tis N0 M0 0 Tis N1 M0 ERROR Tis NX M0 0 Tis N0 M1 ERROR Tis N1 M1 ERROR Tis NX M1 ERROR Tis N0 MX 0 Tis N1 MX ERROR Tis NX MX 0 T1 N0 M0 IA T1 N1 M0 IIB T1 NX M0 UNK T1 N0 M1 IV T1 N1 M1 IV T1 NX M1 IV T1 N0 MX UNK T1 N1 MX UNK T1 NX MX UNK T2 N0 M0 IB T2 N1 M0 IIB T2 NX M0 UNK T2 N0 M1 IV T2 N1 M1 IV T2 NX M1 IV T2 N0 MX UNK T2 N1 MX UNK T2 NX MX UNK T3 N0 M0 IIA T3 N1 M0 IIB T3 NX M0 IINOS T3 N0 M1 IV T3 N1 M1 IV T3 NX M1 IV T3 N0 MX UNK T3 N1 MX UNK T3 NX MX UNK T4 N0 M0 III T4 N1 M0 III T4 NX M0 III T4 N0 M1 IV T4 N1 M1 IV T4 NX M1 IV T4 N0 MX UNK T4 N1 MX UNK T4 NX MX UNK TX N0 M0 UNK TX N1 M0 UNK TX NX M0 UNK TX N0 M1 IV TX N1 M1 IV TX NX M1 IV TX N0 MX UNK TX N1 MX UNK TX NX MX UNK &commonsummarystage; &commonextsizepancreas; Lymph Nodes Mets at DX AJCC 6 Table Note: For CS Lymph Nodes codes 000 and 999, the N category for AJCC 6 staging is determined by the value in CS Mets at DX as shown in this table. CS Mets at DX CS Lymph Nodes 000 0 CS Lymph Nodes 999 999 00 N0 NX 05 N1 N1 07 N1 N1 10 N0 NX 20 N1 N1 40 N0 NX 45 N1 N1 50 N0 NX 60 N0 NX 99 NX NX