Schema Discriminator 1: Occult Head and Neck Lymph Nodes

This input is used for staging

Notes

**Note 1:** This schema discriminator is used to discriminate between head and neck tumors with unknown primary site coded as C760. Some situations require that a more specific primary site be assigned. * **Chapter 6: Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck** Occult head and neck tumor with cervical metastasis in level II/III lymph nodes without a p16 immunostain or with negative results and without an Epstein-Barr virus (EBV) encoded small RNAs (EBER) by in situ hybridization performed or with negative results are staged using Chapter 6 * **Chapter 9: Nasopharynx** Occult head and neck tumors with cervical metastasis in level II/III lymph nodes that is positive for Epstein–Barr virus (EBV+) encoded small RNAs (EBER) identified by in situ hybridization are staged using Chapter 9. Assign primary site C119; do NOT code this discriminator * **Chapter 10: HPV-Mediated (p16+) Oropharyngeal Cancer** Occult head and neck tumors with cervical metastasis in level II/III lymph nodes, p16 positive with histology consistent with HPV-mediated oropharyngeal carcinoma (OPC), should be staged using Chapter 10. Assign primary site C109; do NOT code this discriminator * **Ill Defined, Other (Summary Stage only)** If the tumor is not occult or does not have cervical metastasis in level II/III lymph nodes, it is not included in Chapter 6 and will be classified as Ill Defined, Other for Summary Staging **Note 2:** Assign this data item based on physician statement or from lab tests performed at diagnosis (pre-treatment). **Note 3:** If the code determined by available lab tests differs from the physician statement, the physician’s statement takes precedence.

NAACCR Item

NAACCR #3926

Metadata

SSDI
Code Description Disease
0 Not Occult EOD/SS schema (Ill Defined, Other; Soft Tissue Other for 8941)
1 Occult, Negative cervical nodes (regional head and neck nodes) EOD/SS schema (Ill Defined, Other; Soft Tissue Other for 8941)
2 Not tested for EBV or p16 in head and neck regional nodes (EBV and p16 both unknown) 6: Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
3 Unknown EBV, p16 negative in head and neck regional nodes 6: Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
4 Unknown p16, EBV negative in head and neck regional nodes 6: Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
5 Negative for both EBV and p16 in head and neck regional nodes 6: Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
<BLANK> Not C760, discriminator does not apply Positive p16 in head and neck regional nodes, EBV unknown or negative Assign primary site as C109 Positive EBV in head and neck regional nodes, p16 positive, negative, or unknown Assign primary site as C119 Various 10: HPV-Mediated (p16+) Oropharyngeal Cancer (C109) 9: Nasopharynx (C119)