Summary Stage 2018: Melanoma Skin
Summary Stage 2018
Notes
**Melanoma Skin**
8720-8790 (C000-C002, C006, C210, C440-C449, C500, C510-C512, C518-C519, C600-C602, C608-C609, C632)
**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 47 *Melanoma of the Skin*, 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:** For melanoma of sites other than those above
* C003-C005, C008-C069, C090-C148, C300-C329: See Melanoma Head and Neck
* C690: See Melanoma Conjunctiva
* C693, C694: See Melanoma Uvea
* For all other sites, use the appropriate site-specific schema
**Note 3:** Lymph nodes with isolated tumor cells (ITCs) are counted as positive lymph nodes. ITCs are defined as any tumor deposits in lymph nodes less than or equal to 0.2 mm.
**Note 4:** If there is a discrepancy between the Clark level and the pathological description of extent (invasion into the layers of the dermis), use the higher (more extensive) code.
**Note 5:** Code the greatest extent of invasion from any procedure performed on the lesion, whether it is described as a biopsy or an excision. For example, if a punch biopsy with involvement of Clark level IV is followed by a re-excision with residual tumor involving Clark level II, code 2 (Clark level IV).
**Note 6:** Satellite lesions/nodules or in-transit metastases are coded as regional nodes (code 3).
| SS2018 |
Description |
| 0 |
In situ, intraepithelial, noninvasive
- Basement membrane of the epidermis is intact
- In situ, intraepidermal, intraepithelial, noninvasive
+ Clark level I |
| 1 |
Localized only (localized, NOS)
- Papillary dermis invaded
+ Clark level II
- Papillary-reticular dermal interface invaded
+ Clark level III
- Reticular dermis invaded
+ Clark level IV
- Skin/dermis, NOS |
| 2 |
Regional by direct extension only
- Subcutaneous tissue (through entire dermis)
+ Clark level V |
| 3 |
Regional lymph node(s) involved only
- All sites
+ Regional lymph node(s), NOS
* Lymph node(s), NOS
- Skin of head and neck (C000-C002, C006, C440-C444)
+ Levels I-VII
+ Axillary (neck only, C444)
+ Cervical, NOS
+ Deep cervical, NOS
+ Facial (buccinator, buccal, nasolabial)
+ Internal jugular, NOS
+ Parapharyngeal
+ Parotid (infraauricular, intraparotid, periparotid, preauricular)
+ Retroauricular (mastoid)
+ Retropharyngeal
+ Suboccipital
- Skin of upper limb and shoulder (C446)
+ Axillary
+ Cervical
+ Epitrochlear for hand/forearm
+ Internal mammary (parasternal)
+ Spinal accessory for shoulder
+ Supraclavicular (transverse cervical)
- Skin of lower limb and hip (C447)
+ Femoral (superficial inguinal)
+ Popliteal for heel and calf
- Vulva (C510-C512, C518-C519)
+ Deep inguinal, NOS
+ Femoral
+ Inguinal, NOS
+ Inguinofemoral (groin)
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal (femoral)
- Penis (C600-C602, C608-C609)
+ Iliac, NOS
* External
* Internal (hypogastric, obturator)
+ Inguinal, NOS
* Node of Cloquet or Rosenmuller (highest deep inguinal)
* Superficial [femoral]
+ Pelvic, NOS
- Scrotum (C632)
+ Iliac, NOS
* External
* Internal (hypogastric), NOS
- Obturator
+ Inguinal, NOS
* Deep inguinal, NOS
- Node of Cloquet or Rosenmuller (highest deep inguinal)
* Superficial inguinal (femoral) |
| 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)
+ Bone
+ Central nervous system (CNS)
+ Lung
+ Skeletal muscle (including direct extension)
+ Skin or subcutaneous tissue beyond regional lymph nodes
+ Underlying cartilage
+ Visceral metastasis, NOS
- Distant lymph node(s), NOS
+ Axillary (lower trunk)
+ Femoral (cephalad/caudal) (upper trunk)
+ Iliac (leg/hip)
- 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) Gershenwald, J.E., Scolyer, R.A., et al. **Melanoma of the Skin**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 563-585
