Summary Stage 2018: Nasal Cavity and Paranasal Sinuses
Summary Stage 2018
Notes
**Nasal cavity and Paranasal Sinuses**
8000-8700, 8941, 8982, 9700-9701
C300, C310-C311
C300 Nasal cavity (excluding nose, NOS C760)
C310 Maxillary sinus
C311 Ethmoid sinus
**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 12 *Nasal Cavity and Paranasal Sinuses*, 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
* 8710-8714, 8800-8934, 8940, 8950-8981, 8983-9137, 9141-9582: *Soft Tissue*
* 8720-8790: *Melanoma Head and Neck*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
**Note 3:** The bones of the lateral wall of the nasal cavity include the maxilla, the perpendicular plate of the palatine bone, the medial pterygoid plate, the labyrinth and inferior concha of the ethmoid. The roof of the nasal cavity is formed by the nasal bone. The floor of the nasal cavity, which forms the roof of the mouth, is composed of the bones of the hard palate: the horizontal plate of the palatine bone posteriorly and the palatine process of the maxilla anteriorly.
**Note 4:** Involvement of or extension to bone includes any type of tumor extension to the bone, such as erosion, invasion, extension, penetration, or destruction.
**Note 5:** "Bony invasion" does not include extension to palate, cribriform plate, or pterygoid plates. Extension to these structures is coded separately.
**Note 6:** “Bony invasion” does include involvement of perpendicular plate of ethmoid bone or ethmoid air cells.
**Note 7:** Code 2 for base of skull, NOS when there is no information available for more specific bony structures in the skull.
**Note 8:** Minimal extension to anterior cranial fossa implies tumor pushing through the cribriform plate, but without invasion of the dura or brain.
| SS2018 |
Description |
| 0 |
In situ: noninvasive, intraepithelial |
| 1 |
Localized only (localized, NOS)
- Nasal Cavity (C300)
+ Confined to nasal cavity, NOS
+ Invasive tumor confined to one or more of the following subsites WITHOUT bony invasion
* Floor
* Lateral wall, including
+ Meatus (superior, middle, inferior)
+ Nasal conchae (superior, middle, inferior)
* Septum
* Vestibule (edge of naris to mucocutaneous junction)
- Maxillary Sinus (C310)
+ Confined to maxillary sinus, NOS
+ Confined to mucosa of maxillary sinus (antrum)
* WITHOUT erosion or destruction of bone
- Ethmoid Sinus (C311)
+ Confined to ethmoid sinus
* WITH or WITHOUT bony invasion (involvement of perpendicular plate of ethmoid bone or ethmoid air cells) |
| 2 |
Regional by direct extension only
- All sites
+ Adjacent organs/structures, NOS
+ Base of skull, NOS
+ Nasopharynx
+ Pterygoid plates
- Nasal Cavity (C300)
+ Confined to one or more subsites listed in code 1 WITH bony invasion
+ Choana
+ Cribriform plate
+ Ethmoid sinus
+ Frontal sinus
+ Hard palate
+ Nasolacrimal duct
+ Palatine bone
- Maxillary sinus (C310)
+ Bone erosion or destruction
+ Ethmoid sinuses (anterior, posterior, NOS)
+ Floor or medial wall of orbit
+ Floor or posterior wall of maxillary sinus
+ Frontal sinus
+ Hard palate
+ Infratemporal fossa
+ Maxilla, NOS
+ Middle nasal meatus
+ Nasal cavity (floor, lateral wall, septum, turbinates)
+ Orbital contents including eye
+ Palatine bone
+ Pterygoid fossa
+ Pterygomaxillary fossa
+ Soft palate
+ Subcutaneous tissues
+ Temporal fossa
- Ethmoid Sinus (C311)
+ Confined to both ethmoid sinuses
* WITH or WITHOUT bony invasion (involvement of perpendicular plate of ethmoid bone or ethmoid air cells)
+ Anterior cranial fossa (minimal extension)
+ Anterior orbital contents
+ Brain
+ Clivus
+ Cranial nerves (other than V2, maxillary division of trigeminal nerve)
+ Cribriform plate
+ Dura
+ Frontal sinus
+ Maxillary sinus
+ Medial wall or floor of orbit
+ Middle cranial fossa
+ Nasal cavity WITH or WITHOUT bony invasion, one or more subsites
* Floor
* Lateral wall
- Meatus (superior, middle, inferior)
- Nasal conchae (superior, middle, inferior)
* Septum
- Turbinates
* Vestibule (edge of naris to mucocutaneous junction)
+ Orbital apex
+ Orbital plate
+ Skin of cheek
+ Skin of nose
+ Sphenoid sinus |
| 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) |
| 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)
+ Nasal Cavity (C300)
* Anterior cranial fossa (minimal extension)
* Anterior orbital contents
* Brain
* Clivus
* Cranial nerves (other than V2, maxillary division of trigeminal nerve)
* Dura
* Maxillary sinus
* Medial wall or floor of orbit
* Middle cranial fossa
* Orbital apex
* Orbital plate
* Skin of cheek
* Skin of nose
* Sphenoid sinus
+ Ethmoid Sinus (C311)
* Hard palate
- Distant lymph node(s), NOS
+ Mediastinal (excluding superior mediastinal node(s), Level VII)
- 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) Kraus, D.H., Lydiatt, W.M., Shah, J.P., et al. **Nasal Cavity and Paranasal Sinuses**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 137-147
