EOD Primary Tumor
**Note 1:** 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 2:** For codes 100-500, the derived EOD T is based on depth of invasion (DOI) in conjunction with size. In addition, some of the anatomical structures listed are localized for Summary Stage 2018 while others are regional for Summary Stage 2018. The anatomical structures are divided into two groups: Group 1 is for localized tumors, while Group 2 is for regional tumor.
**Group 1 extension WITH any size tumor: Use the following for codes 100, 150, 200**
- Invasive tumor confined to
+ Labial mucosa (inner lip)
+ Lamina propria
+ Multiple foci
+ Submucosa (superficial invasion)
- Superficial extension to
+ Skin of lip
+ Subcutaneous soft tissue of lip
- Confined to lip, NOS
- Localized, NOS
**Group 2 extension WITH any size tumor: Use the following for codes 300, 400, 500**
- Bone, NOS
+ Cartilage (mandible, maxilla, NOS)
+ Cortical (mandible, maxilla, NOS)
+ Mandible, NOS (lower and other lip)
+ Maxilla, NOS (upper and other lip)
- Buccal mucosa (inner cheek)
- Gingiva, NOS
+ Lower gingiva (lower lip)
+ Upper gingiva (upper lip) (from commissure only for lower lip)
- Opposite lip (both lips)
**Note 3:** Once the correct group is determined, the codes are then determined based on the depth of invasion.
- Depth of invasion less than or equal to 5 mm or UNKNOWN depth of invasion (codes 100, 300)
- Depth of invasion greater than 5 mm to less than or equal to 10 mm (codes 150, 400)
- Depth of invasion greater than 10 mm (codes 200, 500)
**Note 4:** Invasion through cortical bone is required for assignment of code 650.
- Code 300, 400, or 500 (depending on the depth of invasion) when the tumor is limited to the cortical bone/cortex of the mandible or maxilla. Invasion of the bone, NOS (mandible, NOS or maxilla, NOS) is **not** equivalent to invasion through the cortical bone (code 650).
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