Summary Stage 2018: Skin (except Eyelid)
Summary Stage 2018
Notes
**Skin (except Eyelid)**
8000-8040, 8042-8180, 8191-8246, 8248-8700, 8940, 8982
C000-C002, C006, C440, C442-C449
C000 Vermilion border of upper lip (excludes external upper lip)
C001 Vermilion border of lower lip (excludes external lower lip)
C002 Vermilion border of lip, NOS (excludes external lip, NOS)
C006 Commissure of lip
C440 Skin of lip, NOS
C442 External ear
C443 Skin of other and unspecified parts of face
C444 Skin of scalp and neck
C445 Skin of trunk
C446 Skin of upper limb and shoulder
C447 Skin of lower limb and hip
C448 Overlapping lesion of skin
C449 Skin, NOS
**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/ssm2000/)
* Collaborative Stage Data Collection System, version 02.05: https://cancerstaging.org/cstage/Pages/default.aspx
* For *primary sites C000-C002, C006, C440, C442-C444*, Chapter 15 *Cutaneous Carcinoma Head and Neck*, 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, 8941-8981, 8983-9137, 9141-9582: *Soft Tissue*
* 8720-8790: *Melanoma Skin*
* 8935-8936: *GIST*
* 9140: *Kaposi Sarcoma*
* 9700-9701: *Mycosis Fungoides*
**Note 3:** Summary Stage is the only applicable staging system for primary sites C445-C449.
**Note 4:** Bilateral or contralateral nodes are classified as regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy.
* Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed
**Note 5:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins and are coded as regional nodes.
| SS2018 |
Description |
| 0 |
In situ, intraepidermal, intraepithelial, noninvasive
- Carcinoma in situ |
| 1 |
Localized only (localized, NOS)
- Lesion(s) confined to dermis
- Subcutaneous tissue (through entire dermis) |
| 2 |
Regional by direct extension only
- All Sites
+ Bone
+ Cartilage
+ Skeletal muscle
+ Underlying cartilage
- Head and Neck skin primaries only (C000-C002, C006, C440, C442-C444)
+ Bone erosion (minor or NOS)
+ Deep invasion
+ Gross cortical bone/marrow
+ Mandible
+ Maxilla
+ Orbital bone
+ Perineural invasion
+ Skull base foramen
+ Skull base invasion
+ Temporal bone |
| 3 |
Regional lymph node(s) involved only
- All sites (Single, Multiple, Ipsilateral) (See Code 7 for contralateral or bilateral nodes (except for head and neck skin primaries))
+ Regional lymph node(s), NOS
* Lymph node(s), NOS
- Head and Neck skin primaries only (C000-C002, C006, C440, C442-C444) (includes contralateral and bilateral nodes)
+ 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 trunk (C445)
+ Upper trunk
* Axillary
* Cervical
* Internal mammary
* Supraclavicular
+ Lower trunk
* Superficial inguinal (femoral) (lower trunk only)
- 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)
+ Inguinal
+ Popliteal for heel and calf |
| 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)
- Distant lymph node(s), NOS
- 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) Califano, J.A., Lydiatt, W.M., Shah, J.P., et al. **Cutaneous Carcinoma of the Head and Neck**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 171-181
