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{
  "id" : "ss2018_merkel_cell_carcinoma_89481",
  "algorithm" : "eod_public",
  "version" : "1.0",
  "name" : "SS2018: Merkel Cell Carcinoma",
  "title" : "Summary Stage 2018: Merkel Cell Carcinoma",
  "subtitle" : "Summary Stage 2018",
  "notes" : "**Merkel Cell Carcinoma (8041, 8190, 8247)**\n\nC000-C006, C008-C009, C440-C449, C510-C512, C518-C519, C600-C602, C608-C609, C632, C809\nC000 External upper lip\nC001 External lower lip\nC002 External lip, NOS\nC003 Mucosa of upper lip\nC004 Mucosa of lower lip\nC005 Mucosa of lip, NOS\nC006 Commissure of lip\nC008 Overlapping lesion of lip\nC009 Lip, NOS\nC440 Skin of lip, NOS\nC441 Eyelid \nC442 External ear \nC443 Skin of other and unspecified parts of face \nC444 Skin of scalp and neck\nC445 Skin of trunk \nC446 Skin of upper limb and shoulder \nC447 Skin of lower limb and hip \nC448 Overlapping lesion of skin\nC449 Skin, NOS\nC510 Labium majus\nC511 Labium minus\nC512 Clitoris\nC518 Overlapping lesion of vulva\nC519 Vulva, NOS\nC600 Prepuce\nC601 Glans penis\nC602 Body of penis\nC608 Overlapping lesion of penis\nC609 Penis\nC632 Scrotum, NOS\nC809 Unknown primary site\n\n**Note 1:** The following sources were used in the development of this schema\n* SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998) (https://seer.cancer.gov/archive/manuals/EOD10Dig.3rd.pdf)\n* SEER Summary Staging Manual-2000: Codes and Coding Instructions (https://seer.cancer.gov/tools/ssm/)\n* Collaborative Stage Data Collection System, version 02.05:  https://cancerstaging.org/cstage/Pages/default.aspx \n* Chapter 46 *Merkel Cell Carcinoma*, 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.\n\n**Note 2:** Merkel cell carcinoma presenting in nodal or visceral site with primary site unknown is coded to C449, Skin, NOS. \n\n**Note 3:** See the chapter (schema) corresponding to the primary site for information about regional nodes. For example: For primary Anus Merkel cell, see the anus chapter (schema) for regional nodes information. \n•\tC210 Anus\n•\tC300 Nasal cavity and Ethmoid Sinus\n•\tC500 Breast (nipple)\n•\tC510-C512, C518-C519 Vulva\n•\tC600-C602, C608-C609 Penis\n•\tC632 Scrotum (Male Genital Other)",
  "footnotes" : "(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\n\n(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.\n\n(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)\n\n(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: 3-30\n\n(5) Bichakjian, C.K., Nghiem, P., Sober, A.J., et al. **Merkel Cell Carcinoma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 549-562",
  "last_modified" : "2018-03-12T16:39:57.473Z",
  "definition" : [ {
    "key" : "ss2018",
    "name" : "SS2018",
    "type" : "INPUT"
  }, {
    "key" : "description",
    "name" : "Description",
    "type" : "DESCRIPTION"
  } ],
  "rows" : [ [ "0", "In situ, intraepidermal, intraepithelial, noninvasive" ], [ "1", "Localized only (localized, NOS)\n- Confined to site of origin\n- Lesion(s) confined to dermis\n- Subcutaneous tissue (through entire dermis" ], [ "2", "Regional by direct extension only\n- Bone\n- Cartilage\n- Fascia\n- Skeletal muscle" ], [ "3", "Regional lymph node(s) involved only\n- Skin (C440-C449)\n- Single, Multiple, Ipsilateral, Bilateral or Contralateral lymph node(s)\n- Head and Neck\n  + All subsites: Cervical\n- Lip\n  + Facial (buccinator, buccal, nasolabial)\n  + Mandibular (submandibular, submaxillary, NOS)\n  + Parotid (infra-auricular, preauricular, NOS)\n  + Submental\n- External ear/auditory canal\n  + Mastoid (post-/retro-auricular) (occipital)\n  + Preauricular\n- Face, Other (cheek, chin, forehead, jaw, nose and temple)\n  + Facial (buccinator, buccal, nasolabial)\n  + Mandibular (submandibular, submaxillary, NOS)\n  + Parotid (infra-auricular, preauricular, NOS)\n  + Submental\n- Scalp\n  + Mastoid (post-/retro-auricular) (occipital)\n  + Parotid (infra-auricular, preauricular, NOS)\n  + Spinal accessory (posterior cervical)\n- Neck\n  + Axillary\n  + Mandibular, NOS\n  + Mastoid (post-/retro-auricular) (occipital)\n  + Parotid (infra-auricular, preauricular, NOS)\n  + Spinal accessory (posterior cervical)\n  + Submental\n  + Supraclavicular (transverse cervical)\n- Upper Trunk\n  + Axillary\n  + Cervical\n  + Internal mammary (parasternal)\n  + Supraclavicular (transverse cervical)\n- Lower Trunk\n  + Femoral (superficial inguinal)\n- Arm/Shoulder\n  + Axillary\n  + Epitrochlear for hand/forearm\n  + Spinal accessory for shoulder\n- Leg/Hip\n  + Femoral (superficial inguinal)\n  + Popliteal for heel and calf\n- Vulva (C510-C512, C518-C519)\n  + Deep inguinal, NOS\n  + Femoral\n  + Inguinal, NOS\n  + Inguinofemoral (groin)\n  + Node of Cloquet or Rosenmuller (highest deep inguinal)\n  + Superficial inguinal (femoral)\n- Penis (C600-C602, C608-C609)\n  + Iliac, NOS\n    * External\n    * Internal (hypogastric, obturator)\n  + Inguinal, NOS\n     * Node of Cloquet or Rosenmuller (highest deep inguinal)\n     * Superficial [femoral] \n  + Pelvic, NOS\n- Scrotum (C632)\n  + Iliac, NOS\n     * External\n    * Internal (hypogastric), NOS\n- Obturator\n  + Inguinal, NOS\n     * Deep inguinal, NOS\n        - Node of Cloquet or Rosenmuller (highest deep inguinal)\n     * Superficial inguinal (femoral)\n- Regional lymph node(s), NOS\n  + Lymph node(s), NOS" ], [ "4", "Regional by BOTH direct extension AND regional lymph node(s) involved\n- Codes (2) + (3)" ], [ "7", "Distant site(s)/lymph node(s) involved\n- Distant site(s) (including further contiguous extension)\n  + Bone\n  + Cartilage\n  + Fascia\n  + Lung\n  + Other visceral sites\n  + Skeletal muscle (excluding direct extension)\n  + Skin or subcutaneous tissue beyond regional lymph nodes\n  + Underlying cartilage\n- Distant lymph node(s), NOS\n  + Axillary (lower trunk)\n  + Femoral (cephalad/caudal) (upper trunk)\n  + Iliac (leg/hip)\n  + Supraclavicular (head and neck, arm/shoulder)\n- Distant metastasis, NOS\n  + Carcinomatosis\n  + Distant metastasis WITH or WITHOUT distant lymph node(s)" ], [ "9", "Unknown if extension or metastasis" ] ]
}




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