Summary Stage 2018: Lip
Summary Stage 2018
Notes
**Lip**
8000-8040, 8042-8180, 8191-8246, 8248-8700, 8940-8960, 8965-8983, 9000, 9050-9111, 9270, 9300-9312, 9340-9363, 9380-9539, 9541
C003-C005, C008-C009
C003: Mucosa of upper lip
C004: Mucosa of lower lip
C005: Mucosa of lip, NOS
C008: Overlapping lesion of lip
C009: Lip, NOS (excludes skin of lip C440)
**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 7 *Oral Cavity*, 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 Lip sites**
* **GIST**: 8935-8936
* **Kaposi Sarcoma**: 9140
* **Melanoma Head and Neck**: 8720-8790
* **Merkel Cell Carcinoma**: 8041, 8190, 8247
* **Mycosis Fungoides**: 9700-9701
* **Soft Tissue**: 8710-8714, 8800-8934, 8963-8964, 8990-8992, 9010-9045, 9120-9138, 9141-9262, 9271-9290, 9320-9330, 9364-9373, 9540, 9542-9582
**Note 3:** **Periosteum**
* Periosteum is a fibrous membrane that wraps the outer surface of bones.
* Cortical bone is the dense compact outer layer of the bone.
* Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, decreasing weight and allowing room for blood vessels and marrow.
**Note 4:** **Cortical bone**
* Involvement through cortical bone is required for assignment of code 2.
| SS2018 |
Description |
| 0 |
**In situ: noninvasive, intraepithelial** |
| 1 |
**Localized only (localized, NOS)**
* Confined to lip, NOS
* Labial mucosa (inner lip)
* Lamina propria
- Multiple foci
- Submucosa (superficial invasion)
* Musculature
* Skin of lip
* Subcutaneous soft tissue of lip |
| 2 |
**Regional by direct extension only**
* Bone, NOS
- Cartilage (mandible, maxilla, NOS)
- Cortical (mandible, maxilla, NOS)
- Mandible, NOS
- Maxilla, NOS
- Trabecular (mandible, maxilla, NOS)
* Buccal mucosa (inner cheek)
* Commissure
* Gingiva, NOS
- Lower gingiva
- Upper gingiva
* Opposite lip (both lips) |
| 3 |
**Regional lymph node(s) involved only**
* Level I
- Level IA - Submental
- Level IB - Submandibular
* 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)
- Floor of mouth
- Inferior alveolar nerve
- Internal carotid artery (encased)
- Masticator space
- Nose
- Pterygoid plates
- Skin of face/neck
- Skull base
- Specified bone (other than mandible and maxilla)
* 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) Ridge, J.A., Lydiatt, W.M., Shah, J.P., et al. **Oral Cavity**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
