Summary Stage 2018: Cervical Lymph Nodes and Unknown Primary Tumors of Head and Neck

Summary Stage 2018

Notes

**Cervical Lymph Nodes and Unknown Primary Tumor of the Head and Neck** 8010, 8046, 8051-8052, 8070-8074, 8082-8084, 8121, 8140, 8147, 8200, 8310, 8430, 8450, 8480, 8525, 8550, 8562, 8941 Schema Discriminator 1 Occult Head and Neck Lymph Nodes: 2, 3, 4, 5 C760 C760 Head, face & neck, 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 * Chapter 6 *Cervical Lymph Nodes and Unknown Primary Tumors of the 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:** *Schema Discriminator 1: Occult Head and Neck Lymph Nodes* is used to discriminate between Cervical Lymph Nodes and Unknown Primary Tumor of the Head and Neck, Ill-Defined Other and Soft Tissue Other when primary site is C760. **Note 3:** See the following schemas for the listed histologies * 8010, 8046, 8051-8052, 8070-8074, 8082-8084, 8121, 8140, 8147, 8200, 8310, 8430, 8450, 8480, 8525, 8550, 8562 (Schema Discriminator 1 Occult Head and Neck Lymph Nodes: 0,1): *Ill-defined Other* * 8941 (Schema Discriminator 1 Occult Head and Neck Lymph Nodes: 0, 1): *Soft Tissue* * 8710-8714, 8800-8934, 8940, 8950-9138, 9141-9582: *Soft Tissue* * 8935-8936: *GIST* * 9140: *Kaposi Sarcoma* * 9700-9701: *Mycosis Fungoides* **Note 4:** Codes 0, 1, 2, and 4 are not applicable for this chapter. **Note 5:** This chapter applies when cervical lymph nodes are involved with cancer and the primary site is not known but is suspected to be in the head and neck, i.e., in one or more of the sites listed below. Cancer registry standard setters have agreed that such cancers should be coded to primary site code C760 to accommodate staging recommended by AJCC. * Lip: C003-C005, C008-C009 * Base of Tongue: C019 * Other and Unspecified Parts of Tongue: C020-C024, C028, C029 * Gum: C030-C031, C039 * Floor of Mouth: C040-C041, C048-C049 * Palate: C050-C052, C058-C059 * Other and Unspecified Parts of Mouth: C060-C062, C068-C069 * Parotid gland: C079 * Major Salivary Glands: C080-C81, C088-C089 * Tonsil: C090-C91, C098-C099 * Oropharynx: C100-C104, C108-C109 * Nasopharynx: C110-C113, C118-C119 * Pyriform sin: C129 * Hypopharynx: C130-C132. C138-C139 * Other and Ill-defined Sites in Lip, Oral Cavity and Pharynx: C140, C142, C148 * Nasal cavity: C300 * Middle ear: C301 * Accessory Sinuses: C310-C313, C318-C319 * Larynx: C320-C323, C328-C329 * Skin of lip: C440 * Skin of ear & external auricular canal: C442 * Skin of other & unspecified parts of face: C443 * Skin of scalp & neck: C444 **Note 6:** If the physician indicates that the metastatic cervical lymph node is most likely from a head and neck primary, then code primary site as C760. If the differential diagnosis includes non-head and neck sites, for example, the path report states metastasis to the cervical lymph node could be from a head and neck primary, lung primary, or gynecologic primary OR if there is no information indicating origin of primary tumor, then code primary site as C809 (Ill Defined Other)

NAACCR Item

NAACCR #764
SS2018 Description
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
7 Distant site(s)/lymph node(s) involved - Distant site(s) (including further contiguous extension) + Bone, NOS + Cartilage, NOS + Cortical bone (mandible, maxilla, NOS) + Deep (extrinsic) muscle of tongue * Genioglossus * Hyoglossus * Palatoglossus * Styloglossus + Hard palate including cortical palatine bone + Internal carotid artery (encased) + Mandible, NOS + Masticator space + Maxilla, NOS + Maxillary sinus (antrum) + Nasal cavity + Pterygoid plates + Skin of cheek (WITH or WITHOUT ulceration) + Skull base + Soft palate + Specified bone (other than maxilla, mandible, palatine) + Tongue + Trabecular bone (mandible, maxilla, palatine, NOS) - 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 (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 (6) Patel, S.G., Lydiatt, W.M., Shah, J.P., et al. **Cervical Lymph Nodes and Unknown Primary Tumors 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