Csv2 ANSWER WORKSHEET

CSv2 ANSWER WORKSHEET

FIELD# FIELD NAME CODE AND RATIONALE/DOCUMENTATION 1 Patient Name - MCC case 2 CANCER IDENTIFICATION 2 Primary Site C44.4 Skin of scalp 3 Histology 8247 Merkel cell carcinoma 4 Behavior 3 5 Grade 9 6 Grade system type 7 Grade system value 8 Lymph-vascular invasion 1 Present STAGE OF DISEASE AT DIAGNOSIS 9 CS Mets at Dx - Bone 0 10 CS Mets at Dx - Lung 0 11 CS Mets at Dx - Liver 0 12 CS Mets at DX - Brain 0 COLLABORATIVE STAGING 13 CS Tumor Size 020 2 cm tumor 14 CS Extension 400 Localized NOS 15 CS Tumor Size/Ext Eval 3 16 CS Lymph Nodes 100 Regional nodes NOS 17 CS Lymph Nodes Eval 3 18 Regional Nodes Positive 01 19 Regional Nodes Examined 09 20 CS Mets at Dx 00 21 CS Mets Eval 0 No mets per PET 22 CS Site-Specific Factor 1 depth 999 Depth not recorded. This will be a Tx case 23 CS Site-Specific Factor 2 988 CS Site-Specific Factor 3 clinical 24 status of LN 010 Clinically negative, pathologically positive LN 25 CS Site-Specific Factor 4 988 26 CS Site-Specific Factor 5 988 27 CS Site-Specific Factor 6 988 28 CS Site-Specific Factor 7 988 29 CS Site-Specific Factor 8 988 30 CS Site-Specific Factor 9 988 31 CS Site-Specific Factor 10 988 32 CS Site-Specific Factor 11 988 33 CS Site-Specific Factor 12 988 34 CS Site-Specific Factor 13 988 35 CS Site-Specific Factor 14 988 36 CS Site-Specific Factor 15 988 CS Site-Specific Factor 16 size of 37 LN mets 500 LN metastasis measures 0.5cm CS Site-Specific Factor 17 38 extracapsular extension 020 No extracapsular extension clinically or pathologically 39 CS Site-Specific Factor 18 ITC 300 No ITC. LN met = 0.5 cm CS Site-Specific Factor 19 40 transection 010 Deep margin positive on shave biopsy. Neg on resection 41 CS Site-Specific Factor 20 TIL 999 Not in path report CS Site-Specific Factor 21 growth 42 pattern 999 Not in path report CS Site-Specific Factor 22 43 immunosuppression 000 No immunosuppression

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44 CS Site-Specific Factor 23 45 CS Site-Specific Factor 24 46 CS Site-Specific Factor 25 Rational for specific data elements:

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