Summary Stage 2018: Lip
Summary Stage 2018
Notes
**Lip**
8000-8040, 8042-8180, 8191-8246, 8248-8700, 8982, 9700-9701
C003-C005, C008-C009
C003 Mucosa of upper lip
C004 Mucosa of lower lip
C005 Mucosa of lip, NOS
C008 Overlapping lesion of lip
C009 Lip, NOS (excludes skin of lip C440)
**Note 1:** The following sources were used in the development of this chapter
* SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998) (https://seer.cancer.gov/archive/manuals/EOD10Dig.3rd.pdf)
* SEER Summary Staging Manual-2000: Codes and Coding Instructions (https://seer.cancer.gov/tools/ssm/)
* Collaborative Stage Data Collection System, version 02.05: https://cancerstaging.org/cstage/Pages/default.aspx
* Chapter 7 *Lip and Oral Cavity*, in the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. Used with permission of the American College of Surgeons, Chicago, Illinois.
**Note 2:** See the following chapters for the listed histologies
* 8041, 8190, 8247: *Merkel Cell Skin*
* 8710-8714, 8800-8934, 8940-8981, 8983-9137, 9141-9582: *Soft Tissue*
* 8720-8790: *Melanoma Head and Neck*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
**Note 3:** Periosteum is a fibrous membrane that wraps the outer surface of bones. Cortical bone is the dense compact outer layer of the bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, decreasing weight and allowing room for blood vessels and marrow.
**Note 4:** Involvement through cortical bone is required for assignment of code 2.
| SS2018 |
Description |
| 0 |
In situ: noninvasive, intraepithelial |
| 1 |
Localized only (localized, NOS)
- Confined to lip, NOS
- Labial mucosa (inner lip)
- Lamina propria
+ Multiple foci
+ Submucosa (superficial invasion)
- Musculature
- Skin of lip
- Subcutaneous soft tissue of lip |
| 2 |
Regional by direct extension only
- Bone, NOS
+ Cartilage (mandible, maxilla, NOS)
+ Cortical (mandible, maxilla, NOS)
+ Mandible, NOS
+ Maxilla, NOS
+ Trabecular (mandible, maxilla, NOS)
- Buccal mucosa (inner cheek)
- Commissure
- Gingiva, NOS
+ Lower gingiva
+ Upper gingiva
- Opposite lip (both lips) |
| 3 |
Regional lymph node(s) involved only
- Level I
+ Level IA - Submental
+ Level IB - Submandibular (submaxillary), sublingual
- Level II - Upper jugular
+ Jugulodigastric (subdigastric)
+ Upper deep cervical
+ Level IIA - Anterior
+ Level IIB - Posterior
- Level III - Middle jugular
+ Middle deep cervical
- Level IV - Lower jugular
+ Jugulo-omohyoid (supraomohyoid)
+ Lower deep cervical
+ Virchow node
- Level V - Posterior triangle group
+ Posterior cervical
+ Level VA - Spinal accessory
+ Level VB - Transverse cervical, supraclavicular
- Level VI - Anterior compartment group
+ Laterotracheal
+ Paralaryngeal
+ Paratracheal - above suprasternal notch
+ Perithyroidal
+ Precricoid (Delphian)
+ Prelaryngeal
+ Pretracheal - above suprasternal notch
+ Recurrent laryngeal
- Level VII - Superior mediastinal group (for other mediastinal node(s) see code 7)
+ Esophageal groove
+ Paratracheal - below suprasternal notch
+ Pretracheal - below suprasternal notch
- Other groups
+ Cervical, NOS
+ Deep cervical, NOS
+ Facial
* Buccinator (buccal)
* Mandibular
* Nasolabial
+ Internal jugular, NOS
+ Parapharyngeal
+ Parotid
* Infraauricular
* Intraparotid
* Periparotid
* Preauricular
+ Retroauricular (mastoid)
+ Retropharyngeal
+ Suboccipital
- Regional lymph node(s), NOS
+ Lymph node(s), NOS |
| 4 |
Regional by BOTH direct extension AND regional lymph node(s) involved
- Codes (2) + (3) |
| 7 |
Distant site(s)/lymph node(s) involved
- Distant site(s) (including further contiguous extension)
+ Floor of mouth
+ Inferior alveolar nerve
+ Internal carotid artery (encased)
+ Masticator space
+ Nose
+ Pterygoid plates
+ Skin of face/neck
+ Skull base
+ Specified bone (other than mandible and maxilla)
- Distant lymph node(s), NOS
+ Mediastinal (excluding superior mediastinal node(s))
- Distant metastasis, NOS
+ Carcinomatosis
+ Distant metastasis WITH or WITHOUT distant lymph node(s) |
| 9 |
Unknown if extension or metastasis |
(1) Fritz AG, Ries LAG (eds). **SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998)**, National Cancer Institute, NIH Pub. No. 98-2313, Bethesda, MD, 1998
(2) Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds.). **SEER Summary Staging Manual-2000: Codes and Coding Instructions**, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001.
(3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05.** American Joint Committee on Cancer (Chicago, IL)
(4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging.** In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 3-30
(5) Lydiatt, W.M., Patel, S.G., Shah, J.P., et al. **Staging Head and Neck Cancers**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 55-65
(6) Ridge, J.A., Lydiatt, W.M., Shah, J.P., et al. **Lip and Oral Cavity**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 79-94
