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{
"id" : "extension_baj",
"algorithm" : "cs",
"version" : "02.05.50",
"name" : "Extension",
"title" : "CS Extension",
"notes" : "**Note 1**: Direct extension to or other involvement of structures considered M1 in AJCC staging is coded in the data item CS Mets at DX. This includes: sternum; skeletal muscle; skin of chest; contralateral lung or mainstem bronchus; separate tumor nodule(s) in contralateral lung.\n\n**Note 2**: Distance from Carina: Assume tumor is greater than or equal to 2 centimeters (cm) from carina if lobectomy, segmental resection, or wedge resection is done.\n\n**Note 3**: Opposite Lung: If no mention is made of the opposite lung on a chest x-ray, assume it is not involved. \n\n**Note 4**: Bronchopneumonia: Bronchopneumonia is not the same thing as obstructive pneumonitis and should not be coded as such. Bronchopneumonia is an acute inflammation of the walls of the bronchioles, usually a result of spread of infection from the upper to the lower respiratory tract. Obstructive pneumonitis is a combination of atelectasis, bronchiectasis with mucous plugging, and parenchymal inflammation that develops distal to an obstructing endobronchial lesion.\n\n**Note 5**: Pulmonary Artery/Vein: An involved pulmonary artery/vein in the mediastinum is coded to 700 (involvement of major blood vessel). However, if the involvement of the artery/vein appears to be only within lung tissue and not in the mediastinum, it is not coded to 700.\n\n**Note 6**: Vocal cord paralysis (resulting from involvement of recurrent branch of the vagus nerve), superior vena cava (SVC) obstruction, or compression of the trachea or the esophagus may be related to direct extension of the primary tumor or to lymph node involvement. The treatment options and prognosis associated with these manifestations of disease extent fall within the T4-Stage IIIB category; therefore, generally use code 700 for these manifestations. However, if the primary tumor is peripheral and clearly unrelated to vocal cord paralysis, SVC obstruction, or compression of the trachea or the esophagus, code these manifestations as mediastinal lymph node involvement (code 200) in CS Lymph Nodes, unless there is a statement of involvement by direct extension from the primary tumor.\n\n**Note 7**: Pleural effusion and pericardial effusion are coded in CS Mets at DX.\n\n**Note 8**: In some cases, the determination of the T category for TNM 6 or 7 staging is based on this field, CS Tumor Size, CS Mets at DX, and CS Site-Specific Factor 1.\n\n**Note 9**: Code to the highest applicable code for CS Extension and then code the absence or presence of separate ipsilateral tumor nodules in CS Site-Specific Factor 1, Separate Tumor Nodules/Ipsilateral lung. Code separate tumor nodules in contralateral lung in CS Mets at DX.\n\n**Note 10**: Specific information about visceral pleura invasion is captured in codes 410-430 and CS Site-Specific Factor 2, Visceral Pleural Invasion (VPI)/Elastic Layer. Elastic layer involvement has prognostic significance for lung cancer.",
"footnotes" : "- For CS Extension codes 000-440, 455-520, 540-600, 730, and 950-999, the T category for AJCC 7 staging is assigned based on the values of CS Tumor Size, CS Extension, and CS Site Specific Factor 1, as shown in the Size Extension AJCC 7 Table for this schema.\n- For CS Extension codes 000-999, the T category for AJCC 6 staging is assigned based on the values of CS Tumor Size, CS Extension, CS Mets at Dx and CS Site Specific Factor 1 as shown in the Size Extension Mets AJCC 6 Table for this schema.\n- For CS Extension codes 000, 950, 980 and 999, Summary Stage 77 is assigned based on the values of CS Extension and Site Specific Factor 1 as shown in the Summary Stage 77 Table for this schema.\n- For CS Extension codes 000-700, 740, 950-999, Summary Stage 2000 is assigned based on the values of CS Extension and Site Specific Factor 1 as shown in the Summary Stage 2000 Table for this schema.",
"last_modified" : "2015-05-27T16:19:05.972Z",
"definition" : [ {
"key" : "extension",
"name" : "Code",
"type" : "INPUT"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "ajcc7_t",
"name" : "AJCC 7 T",
"type" : "ENDPOINT"
}, {
"key" : "ajcc6_t",
"name" : "AJCC 6 T",
"type" : "ENDPOINT"
}, {
"key" : "t77",
"name" : "Summary Stage 1977 T",
"type" : "ENDPOINT"
}, {
"key" : "t2000",
"name" : "Summary Stage 2000 T",
"type" : "ENDPOINT"
} ],
"rows" : [ [ "000", "In situ, intraepithelial, noninvasive", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "JUMP:determine_correct_table_for_ss77t_ns45", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "100", "Tumor confined to one lung\nWITHOUT extension or conditions described in codes 200-800 \nEXCLUDING primary in main stem bronchus\nEXCLUDING superficial tumor as described in code 110", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "110", "Superficial tumor of any size with invasive component limited to bronchial wall, with or without proximal extension to the main stem bronchus", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "115", "Stated as T1a with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "120", "Stated as T1b with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "125", "Stated as T1[NOS] with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "200", "Extension from other parts of lung to main stem bronchus, NOS \nEXCLUDING superficial tumor as described in code 110\nTumor involving main stem bronchus greater than or equal to 2.0 cm from carina (primary in lung or main stem bronchus)", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "210", "Tumor involving main stem bronchus, NOS\n(Distance from carina not stated and no surgery as described in Note 2)", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "220", "Direct tumor invasion into an adjacent ipsilateral lobe", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "230", "Tumor confined to hilus", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "250", "OBSOLETE DATA CONVERTED V0204\nSee code 680\n\nTumor confined to carina", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "ERROR:", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "300", "Localized, NOS", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "400", "Atelectasis/obstructive pneumonitis that extends to the hilar region but does not involve the entire lung \nOr atelectasis/obstructive pneumonitis, NOS", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "410", "Extension to but not into pleura, including invasion of elastic layer \nBUT not through the elastic layer.", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "420", "Invasion of pleura, including invasion through the elastic layer", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "430", "Invasion of pleura, NOS", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "440", "Pulmonary ligament", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "450", "OBSOLETE DATA RETAINED V0200\n\nExtension to:\n Pleura, visceral or NOS (WITHOUT pleural effusion)\n Pulmonary ligament ", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "455", "Stated as T2a with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "460", "Stated as T2b with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "465", "Stated as T2 [NOS] with no other information on size or extension ", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "500", "Tumor of/involving main stem bronchus less than 2.0 cm from carina", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "520", "500 + 400", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "530", "OBSOLETE DATA RETAINED V0200\n\n 450 + 500", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "540", "500 + any of (410-440)", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "550", "Atelectasis/obstructive pneumonitis involving entire lung", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "560", "Parietal pericardium or pericardium, NOS", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "570", "Stated as T3 with no other information on extension", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "590", "Invasion of phrenic nerve", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "600", "Direct extension to:\n Brachial plexus, inferior branches or NOS, from superior sulcus\n Chest (thoracic) wall\n Diaphragm\n Pancoast tumor (superior sulcus syndrome), NOS\n Parietal pleura\nNote: For separate lesion in chest wall or diaphragm, see CS Mets at DX.", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "610", "Superior sulcus tumor WITH encasement of subclavian vessels\nOR WITH unequivocal involvement of superior branches of brachial plexus (C8 or above)", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "650", "OBSOLETE DATA RETAINED V0200\nSeparate tumor nodules reclassified in AJCC 7th Edition, coded in CS Site-Specific Factor 1 \n\nMultiple masses/separate tumor nodule(s) in the SAME lobe\n\"Satellite nodules\" in SAME lobe", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "680", "Tumor confined to carina", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:L", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "700", "Blood vessel(s), major (EXCEPT aorta and inferior vena cava, see codes 740 and 770)\n Azygos vein\n Pulmonary artery or vein\n Superior vena cava (SVC syndrome)\nCarina from lung/mainstem bronchus\nCompression of esophagus or trachea not specified as direct extension\nEsophagus\nMediastinum, extrapulmonary or NOS\nNerve(s):\n Cervical sympathetic (Horner syndrome)\n Recurrent laryngeal (vocal cord paralysis)\n Vagus\nTrachea", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:RE", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "705", "700 + (600 or 610)", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "710", "Heart\nVisceral pericardium", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "720", "OBSOLETE DATA RETAINED V0200\nPleural effusion reclassified as distant metastasis in AJCC 7th Edition, see CS Mets at DX code 15\n \nMalignant pleural effusion\nPleural effusion, NOS", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "730", "Adjacent rib\nSee also code 785", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "740", "Aorta", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "745", "740 + 710", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "748", "740 + 730", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "750", "Vertebra(e)\nNeural foramina", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "760", "OBSOLETE DATA RETAINED V0200\nSeparate pleural tumor foci reclassified as distant metastasis in AJCC 7th Edition, see CS Mets at DX code 24\n\nPleural tumor foci separate from direct pleural invasion", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "770", "Inferior vena cava", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "780", "OBSOLETE DATA RETAINED V0200\n\n730 plus any of (610-720) or (740-770)", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "785", "730 + (700 or 710)", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "790", "OBSOLETE DATA RETAINED V0200\nPericardial effusion reclassified as distant metastasis, see CS Mets at DX code 20\n\nPericardial effusion, NOS; malignant pericardial effusion", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "795", "OBSOLETE DATA CONVERTED V0204\nSee code 810\n\nStated as T4 with no other information on extension", "ERROR:", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "ERROR:", "ERROR:" ], [ "800", "Further contiguous extension \n(Except to structures specified in CS Mets at DX codes 23 and 37)", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "810", "Stated as T4 with no other information on extension", "VALUE:T4", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "VALUE:D", "VALUE:D" ], [ "950", "No evidence of primary tumor", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "JUMP:determine_correct_table_for_ss77t_ns45", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "980", "Tumor proven by presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy; \"occult\" carcinoma", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "JUMP:determine_correct_table_for_ss77t_ns45", "JUMP:determine_correct_table_for_ss00t_ns46" ], [ "999", "Unknown; extension not stated\nPrimary tumor cannot be assessed\nNot documented in patient record", "JUMP:determine_correct_table_for_ajcc7_t_ns43", "JUMP:determine_correct_table_for_ajcc6_tm_ns44", "JUMP:determine_correct_table_for_ss77t_ns45", "JUMP:determine_correct_table_for_ss00t_ns46" ] ]
}