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A cancer staging client library
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{
  "id" : "mets_hcn",
  "algorithm" : "cs",
  "version" : "02.05.50",
  "name" : "Mets",
  "title" : "CS Mets at DX",
  "notes" : "**Note 1**:  Liver metastasis implies the presence of tumor inside the liver parenchyma as one or more nodules.  Adherence to the liver capsule, even if extensive, should not be considered liver metastasis.\n\n**Note 2**:  Lymph nodes from the supraclavicular region down to the celiac region previously considered to be distant are now regional.\n\n**Note 3**: When a patient has more than one area of GIST, it is important to try to distinguish between intra-abdominal metastasis and tumor multiplicity. Distant metastases are relatively rare in GISTs, but they are increasingly detected with sophisticated radiological studies. Intra-abdominal metastasis will present as tumor involvement in the abdominal cavity outside the main tumor mass, in the peritoneum, omentum, serosae of organs, and the cul-de-sac, among other areas. Code this form of metastasis in CS Mets at DX. \n\nTumor multiplicity, in contrast, will present with anatomically separate, multiple tumors of different sizes arising independently in the GI tract. This form of tumor multiplicity usually will be seen in patients with neurofibromatosis type 1 or familial GIST syndrome, but in rare instances may be seen in patients without these conditions. This form of multiplicity should not be coded as metastasis, but the presence of multiple tumors should be coded in CS Site-Specific Factor 10, Tumor Multiplicity.\n\nWhen a solitary omental or mesenteric tumor mass is found with a primary GIST elsewhere, do not code this as a metastasis. Code it as multiple tumors in CS Site-Specific Factor 10, Tumor Multiplicity.\n\nWhen multiple tumor areas are present and it is not stated whether these are metastases or independent tumors, consult with a physician if possible to determine how to code them. If a decision cannot be made, code as 99.",
  "last_modified" : "2015-05-27T16:19:30.123Z",
  "definition" : [ {
    "key" : "mets",
    "name" : "Code",
    "type" : "INPUT"
  }, {
    "key" : "description",
    "name" : "Description",
    "type" : "DESCRIPTION"
  }, {
    "key" : "ajcc7_m",
    "name" : "AJCC 7 M",
    "type" : "ENDPOINT"
  }, {
    "key" : "ajcc6_m",
    "name" : "AJCC 6 M",
    "type" : "ENDPOINT"
  }, {
    "key" : "m77",
    "name" : "Summary Stage 1977 M",
    "type" : "ENDPOINT"
  }, {
    "key" : "m2000",
    "name" : "Summary Stage 2000 M",
    "type" : "ENDPOINT"
  } ],
  "rows" : [ [ "00", "No distant metastasis", "VALUE:M0", "VALUE:NA", "VALUE:NONE", "VALUE:NONE" ], [ "10", "Distant lymph node(s), NOS", "VALUE:M1", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "11", "OBSOLETE DATA RETAINED V0200\nConsidered regional in AJCC 7th Edition\nSee CS Lymph Nodes code 250\n\nUpper thoracic esophagus only:\n    Cervical lymph nodes\nLower thoracic (abdominal) esophagus only:\n    Celiac lymph nodes", "ERROR:", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "12", "OBSOLETE DATA RETAINED V0200\nConsidered regional in AJCC 7th Edition staging EXCEPT for common hepatic and splenic lymph nodes which are still considered distant and are included in code 15\nSee CS Lymph Nodes code 265\n\nSpecified distant lymph node(s), other than code 11, including:\nCervical esophagus only:\n    Common hepatic\n    Diaphragmatic\n    Pulmonary ligament\n    Splenic\nIntrathoracic esophagus, upper or middle, only:\n    Common hepatic\n    Diaphragmatic\n    Splenic\nLower thoracic (abdominal) esophagus only:\n    Aortopulmonary\n    Pulmonary ligament", "ERROR:", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "15", "Common hepatic (18)\nSplenic (19)", "VALUE:M1", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "40", "Distant metastasis except distant lymph node(s) \nCarcinomatosis", "VALUE:M1", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "50", "OBSOLETE DATA REVIEWED AND CHANGED V0203\nSee codes 40 and 55\n\n40 + any of (10 to 12)\n\nDistant lymph node(s) plus other distant metastases", "ERROR:", "ERROR:", "ERROR:", "ERROR:" ], [ "55", "40 + (10 or 15)  Distant metastasis plus distant lymph node(s)", "VALUE:M1", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "60", "Distant metastasis, NOS\n\nStated as M1 with no other information on distant metastasis", "VALUE:M1", "VALUE:NA", "VALUE:D", "VALUE:D" ], [ "99", "Unknown; distant metastasis not stated\nDistant metastasis cannot be assessed\nNot documented in patient record", "VALUE:M0", "VALUE:NA", "VALUE:U", "VALUE:U" ] ]
}