Collaborative Staging Manual and Coding Instructions Part I General Instructions COLLABORATIVE STAGING MANUAL AND CODING INSTRUCTIONS version 1.0 Collaborative Staging Task Force of the American Joint Committee on Cancer NIH Publication Number 04-5496 U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute Version date: January 1, 2004 i Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions COPYRIGHT INFORMATION All material in this manual is in the public domain and may be reproduced or copied without permission. However, citation as to source is requested. SUGGESTED CITATION Collaborative Staging Task Force of the American Joint Committee on Cancer. Collaborative Staging Manual and Coding Instructions, version 1.0. Jointly published by American Joint Committee on Cancer (Chicago, IL) and U.S. Department of Health and Human Services (Bethesda, MD), 2004. NIH Publication Number 04-5496. Collaborative Staging (CS) Task Force Members Member Representing Stephen Edge, MD, Chair American Joint Committee on Cancer Gayle Clutter, RT, CTR National Program of Cancer Registries, Centers for Disease Control and Prevention Lynda Douglas, CTR American College of Surgeons; Central Registry April Fritz, BA, RHIT, CTR Surveillance, Epidemiology, and End Results Program, National Cancer Institute Missy Jamison National Program of Cancer Registries, Centers for Disease Control and Prevention Vencine Kelly, BA, CTR National Cancer Registrars Association Karen McCracken, CTR National Cancer Registrars Association Tom Rawson National Program of Cancer Registries, Centers for Disease Control and Prevention Lynn Ries, MS Surveillance, Epidemiology, and End Results Program, National Cancer Institute Nancy Schlag, BS, CTR North American Association of Central Cancer Registries Jennifer Seiffert, MLIS, CTR National Program of Cancer Registries, Centers for Disease Control and Prevention American Joint Committee on Cancer Staff Connie Bura Susan Burkhardt Valerie Vesich, CTR Physician Advisors to the Task Force James Armitage, MD Mark Arredondo, MD Laura Fajardo, MD Gini Fleming, MD Mary Gospodarowicz, MD Frederick Greene, MD Maureen MacIntyre, MD William MacKillop, MD David Page, MD Jatin Shah, MD Questions regarding this document and Collaborative Staging in general should be directed to: Valerie Vesich, CTR [email protected] 312-202-5435 American Joint Committee on Cancer 633 North Saint Clair Street Chicago, IL 60611 Version date: January 1, 2004 ii Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions TABLE OF CONTENTS PART I. INTRODUCTION AND GENERAL INSTRUCTIONS INTRODUCTION 1 Changes in Abstracting Rules 2 How the Collaborative Staging System Works 4 Mapping and the Computer Algorithm 4 Table 1. Allowable Values and Format for Collaborative Staging Data Items 5 Figure 1. Schematic Diagram of Relationships of Inputs and Outputs 7 for Collaborative Staging How Mapping Was Determined 8 GENERAL INSTRUCTIONS General Instructions for Using the Collaborative Staging System: 11 Codes and Coding Instructions Table 2. Site Specific Factors Used For Primary Site/Histology Schemas 13 Structure and Format of Site/Histology-Specific Code Schemas 14 Coding “None” Vs. “Unknown” in the Collaborative Staging System, TNM 14 and Summary Stage Choosing the Correct Coding Schema for a Case 15 Table 3. Histology-specific Coding Schemas 15 Table 4. Schemas Where Tumor Size Is Required for AJCC Staging 16 Table 5. Schemas That Do Not Use Tumor Size for AJCC Staging 17 Table 6. Schemas for Which TNM Is Not Applicable 18 Death Certificate Only Cases 18 Use of Autopsy Information in Collaborative Staging 18 Definitions of Adjacent Tissues, Structures, and Organs 19 Ambiguous Terminology 20 How to Code the Collaborative Staging System Data Elements 21 INDIVIDUAL DATA FIELD CODING GUIDELINES CS Tumor Size 25 CS Extension 28 CS Tumor Size/Ext Eval 30 CS Lymph Nodes 33 Coding Regional Lymph Nodes for Head and Neck Sites 35 Figure 2. Layout of Site-Specific Factors for Head and Neck Sites 36 Definitions of Levels for Head and Neck Sites 37 CS Reg Nodes Eval 39 Regional Nodes Positive 41 Regional Nodes Examined 42 CS Mets at Dx 43 CS Mets Eval 45 CS Site-Specific Factor 1 47 CS Site-Specific Factor 2 49 CS Site-Specific Factor 3 51 CS Site-Specific Factor 4 53 CS Site-Specific Factor 5 55 CS Site-Specific Factor 6 57 Version date: January 1, 2004 iii Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions Table of Contents, continued Additional Collaborative Staging Tables 59 Figure 3. Example of “Extension Size Table” for Breast Schema 60 APPENDICES Appendix 1. Determining Descriptive Tumor Size 62 Appendix 2. Output Values, Storage Codes, and Display String Description String a. Allowable T Codes 63 b. Allowable N Codes 64 c. Allowable M Codes 65 d. Allowable Stage Codes 65 e. Allowable Summary Stage Codes 67 Appendix 3. Summary Stage Conversion Algorithm for All Schemas 68 Appendix 4. Site Specific Factors 72 Appendix 5. Histology Exclusion Groups 77 INDEX TO PART I 80 PART II. PRIMARY SITE SCHEMA HEAD AND NECK Colon 271 Lip, Upper 87 Rectosigmoid, Rectum 279 Lip, Lower 95 Anus 285 Lip, Other 103 Liver and Intrahepatic Bile Ducts 289 Base of Tongue, Lingual Tonsil 111 Gallbladder 295 Anterior 2/3 of Tongue 119 Extrahepatic Bile Ducts 299 Gum, Upper 127 Ampulla of Vater 303 Gum, Lower, and Retromolar Area 135 Other Biliary and Biliary, NOS 307 Gum, NOS 143 Pancreas: Head 311 Floor of Mouth 151 Pancreas: Body and Tail 315 Hard Palate 159 Pancreas: Other and Unspecified 319 Soft Palate, Uvula 167 Other and Ill-Defined Digestive Other Mouth 175 Organs 323 Cheek (Buccal) Mucosa, Vestibule 183 Parotid Gland 191 Submandibular Gland 199 RESPIRATORY AND INTRATHORACIC Other and Unspecified Major Nasal Cavity 327 Salivary Glands 207 Middle Ear 335 Tonsil, Oropharynx 215 Maxillary Sinus 343 Anterior Surface of Epiglottis 223 Ethmoid Sinus 351 Nasopharynx 231 Accessory (Paranasal) Sinuses 359 Pyriform Sinus, Hypopharynx 239 Larynx, Glottic 367 Pharynx, NOS, and Other Larynx, Supraglottic 375 Ill-Defined Oral Cavity 247 Larynx, Subglottic 383 Larynx, Overlapping Lesion or NOS 391 Trachea 399 GASTROINTESTINAL Lung 403 Esophagus 253 Heart, Mediastinum 411 Stomach 259 Pleura 415 Small Intestine 265 Other and Ill-Defined Respiratory Sites and Intrathoracic Organs 419 Version date: January 1, 2004 iv Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions Table of Contents, continued MUSCULOSKELETAL EYE Bone 423 Conjunctiva 563 Skin 427 Melanoma of Conjunctiva 567 Skin of Eyelid 431 Cornea, Retina, Choroid, Ciliary Melanoma of Skin 435 Body, Eyeball, Overlapping Mycosis Fungoides and Sezary and Other Eye 571 Disease 443 Melanoma of Iris and Ciliary Body 575 Peripheral Nerves and Autonomic Melanoma of Choroid 581 Nervous System; Connective, Melanoma of Other Eye 585 Subcutaneous and Other Lacrimal Gland 589 Soft Tissues 447 Orbit 593 Retroperitoneum, Peritoneum 453 Retinoblastoma 597 BREAST AND FEMALE GENITAL CENTRAL NERVOUS Breast 457 Brain and Cerebral Meninges 603 Vulva 467 Other Parts of Central Nervous Vagina 471 System 607 Cervix 475 Corpus 481 Ovary 487 ENDOCRINE Fallopian Tube 493 Thyroid Gland 611 Broad and Round Ligaments, Thymus, Adrenal Gland, and Other Parametrium and Other Adnexa 499 Endocrine Glands 615 Other and Unspecified Female Genital Organs 503 Placenta 507 KAPOSI SARCOMA of All Sites 619 MALE GENITAL HEMATOPOIETIC AND LYMPHOID Penis 513 Hodgkin and Non-Hodgkin Prostate 517 Lymphoma 623 Testis 527 Hematopoietic, Reticuloendothelial, Other and Unspecified Male Immunoproliferative and Genital Organs 533 Myeloproliferative Neoplasms 629 Scrotum 537 Kidney 541 OTHER Renal Pelvis, Ureter 545 Other and Ill-Defined Sites, Unknown Bladder 549 Primary Site 633 Urethra 555 Paraurethral Gland, Overlapping STANDARD TABLES 637 Lesion and Unspecified Urinary Organs 559 INDEX OF SCHEMA BY ICD-O-3 PRIMARY SITE CODE 641 ALPHABETIC INDEX TO PART II: SITE SCHEMA 646 Version date: January 1, 2004 v Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions Page left blank. Version date: January 1, 2004 vi Version 1.0 Collaborative Staging Manual and Coding Instructions Part I General Instructions INTRODUCTION The Collaborative Staging Task Force, formed in 1998, was convened to address the issue of discrepancies in staging guidelines among the three major staging systems used in the United States. This project is sponsored by the American Joint Committee on Cancer (AJCC) in collaboration with the National Cancer Institute Surveillance, Epidemiology and End Results Program (NCI-SEER); Centers for Disease Control and Prevention National Program of Cancer Registries (CDC/NPCR); National Cancer Registrars Association (NCRA); North American Association of Central Cancer Registries (NAACCR); American College of Surgeons Commission on Cancer (CoC), and Canadian Cancer Society / National Cancer Institute of Canada (CCS-NCIC). The initial focus of the Task Force was to develop a translation or other method of conversion between the TNM staging system of the AJCC and the SEER Summary Staging System. Such a translation would eliminate duplicate data collection by registrars reporting to clinical (facility-based) and epidemiologic (population-based central) registries, address the concerns of clinicians for more clinically relevant data as well as the public health sector’s