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{
  "id" : "ss2018_merkel_cell_carcinoma_89481",
  "algorithm" : "eod_public",
  "version" : "1.1",
  "name" : "SS2018: Merkel Cell Skin",
  "title" : "Summary Stage 2018: Merkel Cell Skin",
  "subtitle" : "Summary Stage 2018",
  "notes" : "**Merkel Cell Skin**\n\n8041, 8190, 8247 (C000-C006, C008-C009, C440-C449, C510-C512, C518-C519, C600-C602, C608-C609, C632, C809)\n\n**Note 1:** The following sources were used in the development of this chapter\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:** Lymph nodes with isolated tumor cells (ITCs) are counted as positive lymph nodes. ITCs are defined as any tumor deposits in lymph nodes less than or equal to 0.2 mm.\n\n**Note 3:** Merkel cell carcinoma presenting in nodal or visceral site with primary site unknown is coded to C449, Skin, NOS.",
  "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" : "2018-04-19T21:51:25.730Z",
  "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- All sites\n  + Regional lymph node(s), NOS\n     * Lymph node(s), NOS\n- Skin of head and neck (C000-C006, C008-C009, C440-C444)\n  + Levels I-VII \n  + Axillary (neck only, C444)\n  + Cervical, NOS\n  + Deep cervical, NOS\n  + Facial (buccinator, buccal, nasolabial)\n  + Internal jugular, NOS\n  + Parapharyngeal \n  + Parotid (infraauricular, intraparotid, periparotid, preauricular)\n  + Retroauricular (mastoid)\n  + Retropharyngeal\n  + Suboccipital\n- Skin of upper limb and shoulder (C446)\n  + Axillary\n  + Cervical\n  + Epitrochlear for hand/forearm\n  + Internal mammary (parasternal)\n  + Spinal accessory for shoulder\n  + Supraclavicular (transverse cervical)\n- Skin of lower limb and hip (C447)\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)" ], [ "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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