Summary Stage 2018: Nasopharynx
Summary Stage 2018
Notes
**Nasopharynx**
**2018-2024**
C110, C112-C113, C118-C119: 8000-8700
C111 and Schema Discriminator 1: Nasopharynx/PharyngealTonsil: 1 (8000-8700)
**2025+**
C110-C113, C118-C119: 8000-8700
C110-C113, C118-C119
C110 Superior wall of nasopharynx
C111 Posterior wall of nasopharynx *(excluding pharyngeal tonsil 2018-2024)*
C111 Posterior wall of nasopharynx *(including pharyngeal tonsil, 2025+)*
C112 Lateral wall of nasopharynx
C113 Anterior wall of nasopharynx
C118 Overlapping lesion of nasopharynx
C119 Nasopharynx, NOS
**Note 1:** **Sources 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 9 *Nasopharynx*, 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:** **Other Summary Stage Chapters with Nasopharynx sites**
* **GIST**: 8935-8936
* **Kaposi Sarcoma**: 9140
* **Melanoma Head and Neck**: 8720-8790
* **Mycosis Fungoides**: 9700-9701
* **Oropharynx-Independent and Oropharynx-Associated (2018-2024 only):** C111 and Schema Discriminator 1: Nasopharynx/PharyngealTonsil: 2 (8000-8700)
* **Soft Tissue**: 8710-8714, 8800-8934, 8940-9138, 9141-9582
| SS2018 |
Description |
| 0 |
**In situ: noninvasive, intraepithelial** |
| 1 |
**Localized only (localized, NOS)**
- Confined to nasopharynx, NOS
- Invasive tumor confined to one of the following subsites
+ Inferior wall (superior surface of soft palate)
+ Lateral wall
+ Posterior superior wall (vault)
- Involvement of two or more subsites
+ Lateral wall extending into eustachian tube/middle ear
+ Posterior, inferior, or lateral wall(s) |
| 2 |
**Regional by direct extension only**
- Any structure listed in Code 1 WITH fixation
- Bone, NOS
- Bony structures of skull base
- Cartilage, NOS
- Cervical vertebra
- Floor of orbit
- Hard palate
- Nasal cavity WITHOUT pharyngeal extension
- Oropharynx
- Paranasal sinus
- Pterygoid structures
- Skull base
- Soft palate, inferior surface including uvula WITHOUT pharyngeal extension
- Soft tissue, NOS (excluding soft tissue of neck) |
| 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)
+ Brain
+ Cranial nerve involvement
+ Hypopharynx
+ Infratemporal fossa/masticator space
+ Intracranial extension, NOS
+ Orbit except bone of floor of orbit
+ Parotid gland
+ Soft tissues of neck
- Distant lymph node(s), NOS
+ Mediastinal (excluding superior mediastinal node(s))
- Distant metastasis, NOS
+ Carcinomatosis
+ Distant mets 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) Lee, A.W.M., Lydiatt, W.M., Shah, J.P., et al. **Nasopharynx**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
