CS Tumor Size CS Extension CS Tumor Size/Ext Eval CS Lymph Nodes CS Lymph Nodes Eval Reg LN Pos Reg LN Exam CS Mets at DX CS Mets Eval

Transcription

1 Floor of Mouth C04.0-C04.1, C04.8-C04.9 C04.0 Anterior floor of mouth C04.1 Lateral floor of mouth C04.8 Overlapping lesion of floor of mouth C04.9 Floor of mouth, NOS CS Tumor Size CS Extension CS Tumor Size/Ext Eval CS Lymph Nodes CS Lymph Nodes Eval Reg LN Pos Reg LN Exam CS Mets at DX CS Mets Eval CS Site-Speifi Fator 1 Size of Lymph Nodes CS Site-Speifi Fator 2 OBSOLETE - Extraapsular Extension, Lymph Nodes for Head and Nek CS Site-Speifi Fator 3 Levels I-III, Lymph Nodes for Head and Nek CS Site-Speifi Fator 4 Levels IV-V and Retropharyngeal Lymph Nodes for Head and Nek CS Site-Speifi Fator 5 Levels VI-VII and Faial Lymph Nodes for Head and Nek CS Site-Speifi Fator 6 Parapharyngeal, Parotid, and Suboipital/Retroauriular Lymph Nodes, Lymph Nodes for Head and Nek CS Site-Speifi Fator 7 Upper and Lower Cervial Node Levels CS Site-Speifi Fator 8 Extraapsular Extension Clinially, Lymph Nodes for Head and Nek CS Site-Speifi Fator 9 Extraapsular Extension Pathologially, Lymph Nodes for Head and Nek CS Site-Speifi Fator 10 HPV (Human Papilloma Virus) Status CS Site-Speifi Fator 11 Measured Thikness (Depth) CS Site-Speifi Fator 12 CS Site-Speifi Fator 13 CS Site-Speifi Fator 14 CS Site-Speifi Fator 15 CS Site-Speifi Fator 16 CS Site-Speifi Fator 17 CS Site-Speifi Fator 18 CS Site-Speifi Fator 19 CS Site-Speifi Fator 20 CS Site-Speifi Fator 21 CS Site-Speifi Fator 22 CS Site-Speifi Fator 23 CS Site-Speifi Fator 24 CS Site-Speifi Fator 25 The following tables are available at the ollaborative staging website: Histology Inlusion Table AJCC 7th ed. Histology Exlusion Table AJCC 6th ed. AJCC TNM 7 Stage AJCC TNM 6 Stage Summary Stage Extension Size Table Lymph Nodes Size Table 29 April 2010 Part II - Oral Cavity and Palate - 1 Version

2 Floor of Mouth CS Tumor Size (Revised: 10/18/2009) Note 1: the speifi tumor size as stated in the medial reord. Use ode 992, 994, or 995 if the physiian's statement about T value is the ONLY information available about the size of the tumor. (Refer to the CS Extension table for instrutions on oding extension.) 000 No mass/tumor found millimeters (ode exat size in millimeters) millimeters or larger 990 Mirosopi fous or foi only, no size of fous given 991 Desribed as "less than 1 m" 992 Desribed as "less than 2 m," or "greater than 1 m," or "between 1 m and 2 m" Stated as T1 with no other information on size 993 Desribed as "less than 3 m," or "greater than 2 m," or "between 2 m and 3 m" 994 Desribed as "less than 4 m," or "greater than 3 m," or "between 3 m and 4 m" Stated as T2 with no other information on size 995 Desribed as "less than 5 m," or "greater than 4 m," or "between 4 m and 5 m" Stated as T3 with no other information on size 996 Desribed as "greater than 5m" 999 Unknown; size not stated Floor of Mouth CS Extension (Revised: 10/28/2009) Note 1: Periosteum is a fibrous membrane that wraps the outer surfae of bones. Cortial bone is the dense ompat outer layer of bone. Trabeular, anellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, dereasing weight and allowing room for blood vessels and marrow. Note 2: AJCC assigns T value based on size when bone involvement is limited to the ortex. Involvement through ortial bone is required for assignment of T4a. Note 3: Use ode 300 for loalized tumor ONLY if no information is available to assign ode 100, 400, 405, 410, or 415. Note 4: Use ode 405, 410, 415, 780, 810, or 815 if the physiian's assignment of T ategory is the ONLY information available about the extent of the tumor. TNM 7 TNM 6 SS77 SS In situ; noninvasive; intraepithelial Tis Tis IS IS 100 Invasive tumor on one side onfined to: Lamina propria Submuosa ^ * L L 300 Loalized, NOS ^ * L L 400 Tumor rosses midline ^ * L L 29 April 2010 Part II - Oral Cavity and Palate - 2 Version

3 TNM 7 TNM 6 SS77 SS Stated as T1 with no other information on extension ^ * L L 410 Stated as T2 with no other information on extension. ^ * L L 415 Stated as T3 with no other information on extension ^ * L L 500 Anterior 2/3 of tongue Base of tongue Gingiva (alveolar ridge), lower Periosteum of mandible 530 Sublingual gland, inluding duts Submandibular (submaxillary) glands, inluding duts 535 Cortial bone of mandible Mandible, NOS Cortial bone, NOS (not speified in higher odes) Bone, NOS (not speified in higher odes) 545 Cortial bone of maxilla Maxilla, NOS 550 Subutaneous soft tissue of hin/nek 600 Epiglottis Glossoepiglotti fold Glossopharyngeal sulus Lateral pharyngeal wall Pharyngeal (lingual) surfae Pharyngoepiglotti fold Tonsillar pillars and fossae Tonsils Valleula 605 (550 or 600) ^ * RE RE ^ * RE RE ^ * RE RE ^ * D D ^ * RE RE ^ * RE RE ^ * D D (Any struture in ode 550 or Any struture in ode 545) 620 Deep (extrinsi) musle of tongue: Genioglossus Geniohyoid Hyoglossus Mylohyoid Palatoglossus Styloglossus 630 OBSOLETE DATA RETAINED V0200 T4a T4a L L ERROR T4a RE RE (620) + any of (500, 530, or 600) (500, 530, 535, 550, or 600) T4a T4a RE RE (Any struture in ode Any struture in ode 500, 530, 535, or 600) 29 April 2010 Part II - Oral Cavity and Palate - 3 Version

4 TNM 7 TNM 6 SS77 SS OBSOLETE DATA CONVERTED V0200 Assign to T1-3 ategory per site urator, see ode 550 ERROR ERROR ERROR ERROR Subutaneous soft tissue of hin/nek T4a T4a D D (Any struture in ode Any struture in ode 545) 700 OBSOLETE DATA RETAINED V0200 Mandible ERROR T4a RE RE 725 Trabeular bone of mandible T4a T4a RE RE 760 Skin of undersurfae of hin/nek T4a T4a RE RE 765 (725 or 760) T4a T4a D D (Any struture in ode 725 or Any struture in ode 545) 770 OBSOLETE DATA RETAINED V0200 ERROR T4a D D Maxillary sinus (antrum) 775 Trabeular bone of maxilla Maxillary sinus (antrum) T4a T4a D D 780 Stated as T4a with no other information on extension T4a T4a RE RE 788 Speified bone (other than mandible, maxilla, or bones in odes 790 and 800) 790 Mastiator spae Pterygoid plates 800 OBSOLETE DATA RETAINED V0200 T4b T4b D D T4b T4b D D ERROR T4b D D Further ontiguous extension: Base of skull Mastiator spae Pterygoid plates 805 Further ontiguous extension Skull base Internal arotid artery (enased) T4b T4b D D 810 Stated as T4b with no other information on extension T4b T4b D D 815 Stated as T4 [NOS] with no other information on extension T4NOS T4NOS RE RE 950 No evidene of primary tumor T0 T0 U U 29 April 2010 Part II - Oral Cavity and Palate - 4 Version

5 TNM 7 TNM 6 SS77 SS Unknown extension Primary tumor annot be assessed TX TX U U ^Note: For Extension odes 100 through 605 ONLY, the T ategory for AJCC 7th Edition staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size Table for this site. *Note: For Extension odes 100 through 605 ONLY, the T ategory for AJCC 6th Edition staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size Table for this site. Floor of Mouth CS Tumor Size/Ext Eval (Revised: 08/10/2009) Staging Basis 0 Does not meet riteria for AJCC pathologi staging: No surgial resetion done. Evaluation based on physial examination, imaging examination, or other non-invasive linial evidene. No autopsy evidene used. 1 Does not meet riteria for AJCC pathologi staging: No surgial resetion done. Evaluation based on endosopi examination, diagnosti biopsy, inluding fine needle aspiration biopsy, or other invasive tehniques, inluding surgial observation without biopsy. No autopsy evidene used. 2 Meets riteria for AJCC pathologi staging: p No surgial resetion done, but evidene derived from autopsy (tumor was suspeted or diagnosed prior to autopsy) 3 Either riteria meets AJCC pathologi staging: p Surgial resetion performed WITHOUT pre-surgial systemi treatment or radiation OR surgial resetion performed, unknown if pre-surgial systemi treatment or radiation performed AND Evaluation based on evidene aquired before treatment, supplemented or modified by the additional evidene aquired during and from surgery, partiularly from pathologi examination of the reseted speimen. No surgial resetion done. Evaluation based on positive biopsy of highest T lassifiation. 5 Does not meet riteria for AJCC y-pathologi (yp) staging: Surgial resetion performed AFTER neoadjuvant therapy and tumor size/extension based on linial evidene, unless the pathologi evidene at surgery (AFTER neoadjuvant) is more extensive (see ode 6). 6 Meets riteria for AJCC y-pathologi (yp) staging: yp Surgial resetion performed AFTER neoadjuvant therapy AND tumor size/extension based on pathologi evidene, beause pathologi evidene at surgery is more extensive than linial evidene before treatment. 29 April 2010 Part II - Oral Cavity and Palate - 5 Version

6 Staging Basis 8 Meets riteria for autopsy (a) staging: a Evidene from autopsy only (tumor was unsuspeted or undiagnosed prior to autopsy) 9 Unknown if surgial resetion done Not assessed; annot be assessed Unknown if assessed Floor of Mouth CS Lymph Nodes (Revised: 07/27/2009) Note 1: For head and nek shemas, this field inludes all lymph nodes defined as Levels I-VII and Other by AJCC. The omplete definitions are provided in the General Instrutions. Note 2: For head and nek shemes, additional information about lymph nodes (size of involved nodes, extraapsular extension, levels involved, and loation of involved nodes above or below the lower border of the rioid artilage)is oded in Site-Speifi Fators 1, 3-9. Note 3: If laterality of lymph nodes is not speified, assume nodes are ipsilateral. Midline nodes are onsidered ipsilateral. Note 4: For head and nek aners, if lymph nodes are desribed only as "supralaviular", try to determine if they are in Level IV (deep to the sternoleidomastoid musle, in the lower jugular hain) or Level V (in the posterior triangle, inferior to the transverse ervial artery) and ode appropriately. If the speifi level annot be determined, onsider them as Level V nodes. Note 5: The desription of lymph nodes has been standardized aross the head and nek shemas. All lymph node levels and groups listed here are onsidered regional nodes for AJCC staging. Summary Stage 1977 and Summary Stage 2000 divide these nodes into regional and distant groups. TNM 7 TNM 6 SS77 SS None; no regional lymph node involvement N0 N0 NONE NONE 100 Single positive ipsilateral regional node: Level I node Level IA - Submental Level IB - Submandibular (submaxillary), sublingual Level II node - Upper jugular Jugulodigastri (subdigastri) Upper deep ervial Level III node - Middle jugular Middle deep ervial Level IV node - Lower jugular Juguloomohyoid (supraomohyoid) Lower deep ervial Virhow node ^ * RN RN Cervial, NOS Deep ervial, NOS Internal jugular, NOS Regional lymph node, NOS 29 April 2010 Part II - Oral Cavity and Palate - 6 Version

7 TNM 7 TNM 6 SS77 SS Single positive ipsilateral regional node: Level V node - Posterior triangle group ^ * D D Posterior ervial Level VA - Spinal aessory Level VB - Transverse ervial, supralaviular (see note 4) Level VI node - Anterior ompartment group Laterotraheal Paralaryngeal Paratraheal - above suprasternal noth Perithyroidal Prerioid (Delphian) Pretraheal - above suprasternal noth Reurrent laryngeal Level VII node - Superior mediastinal group (for other mediatinal nodes see CS Mets at DX) Esophageal groove Paratraheal - below suprasternal noth Pretraheal - below suprasternal noth Other groups: Faial Buinator (bual) Nasolabial Parotid Infraauriular Intraparotid Periparotid Preauriular Parapharyngeal Retroauriular Retropharyngeal Suboipital 180 Stated as N1, no other information N1 N1 RN RN 190 Stated as N2a, no other information N2a N2a RN RN 200 Multiple positive ipsilateral nodes listed in ode 100 ^ * RN RN 220 Multiple positive ipsilateral nodes, any listed in ode 120 (WITH OR WITHOUT nodes listed in ode 100) ^ * D D 290 Stated as N2b, no other information N2b N2b RN RN 300 Regional lymph nodes as listed in ode 100: Positive ipsilateral node(s), not stated if single or multiple 320 Regional lymph nodes listed in ode 120: Positive ipsilateral node(s), not stated if single or multiple ^ * RN RN ^ * D D 29 April 2010 Part II - Oral Cavity and Palate - 7 Version

8 TNM 7 TNM 6 SS77 SS Regional lymph nodes listed in ode 100: Positive bilateral or ontralateral nodes 420 Regional lymph nodes, any listed in ode 120: Positive bilateral or ontralateral nodes (WITH or WITHOUT nodes listed in ode 100) ^ * RN RN ^ * D D 490 Stated as N2, no other information N2 N2 RN RN 500 Regional lymph nodes listed in ode 100: Positive node(s), not stated if ipsilateral, or bilateral, or ontralateral, AND not stated if single or multiple 520 Regional lymph nodes listed in ode 120: Positive node(s), not stated if ipsilateral, or bilateral, or ontralateral, AND not stated if single or multiple ^ * RN RN ^ * D D 600 Stated as N2, NOS N2NOS N2NOS RN RN 700 Stated as N3, no other information N3 N3 RN RN 800 Lymph nodes, NOS ^ * RN RN 999 Unknown; not stated Regional lymph nodes annot be assessed NX NX U U ^ For odes 100, 120, 200, 220, 300, 320, 400, 420, 500, 520, and 800 ONLY, the N ategory for AJCC 7th Edition staging is assigned based on the value of Site-Speifi Fator 1, Size of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this site. * For odes 100, 120, 200, 220, 300, 320, 400, 420, 500, 520, and 800 ONLY, the N ategory for AJCC 7th Edition staging is assigned based on the value of Site-Speifi Fator 1, Size of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this site. 29 April 2010 Part II - Oral Cavity and Palate - 8 Version

9 Floor of Mouth CS Lymph Nodes Eval (Revised: 10/26/2009) Note 1: This field is used primarily to derive the staging basis for the N ategory in the TNM system. It reords how the ode for the item "CS Lymph Nodes" was determined based on the diagnosti methods employed and their intent. Note 2: In the 7th edition of the AJCC manual, the linial and pathologi lassifiation rules for the N ategory were hanged to reflet urrent medial pratie. The N is designated as linial or pathologi based on the intent (workup versus treatment) mathing with the assessment of the T lassifiation. When the intent is workup, the staging basis is linial, and when the intent is treatment, the staging basis is pathologi. A. Mirosopi assessment inluding biopsy of regional nodes or sentinel nodes if being performed as part of the workup to hoose the treatment plan, is therefore part of the linial staging. When it is part of the workup, the T ategory is linial, and there has not been a resetion of the primary site adequate for pathologi T lassifiation (whih would be part of the treatment). B. Mirosopi assessment of regional nodes if being performed as part of the treatment is therefore part of the pathologi staging. When it is part of the treatment, the T ategory is pathologi, and there has been a resetion of the primary site adequate for pathologi T lassifiation (all part of the treatment). Note 3: Mirosopi assessment of the highest N ategory is always pathologi (ode 3). Note 4: If lymph node dissetion is not performed after neoadjuvant therapy, use ode 0 or 1. Note 5: Only odes 5 and 6 are used if the node assessment is performed after neoadjuvant therapy. Staging Basis 0 Does not meet riteria for AJCC pathologi staging: No regional lymph nodes removed for examination. Evidene based on physial examination, imaging examination, or other non-invasive linial evidene. No autopsy evidene used. 1 Does not meet riteria for AJCC pathologi staging based on at least one of the following riteria: No regional lymph nodes removed for examination. Evidene based on endosopi examination, or other invasive tehniques inluding surgial observation, without biopsy. No autopsy evidene used. OR Fine needle aspiration, inisional ore needle biopsy, or exisional biopsy of regional lymph nodes or sentinel nodes as part of the diagnosti workup, WITHOUT removal of the primary site adequate for pathologi T lassifiation (treatment). 2 Meets riteria for AJCC pathologi staging: p No regional lymph nodes removed for examination, but evidene derived from autopsy (tumor was suspeted or diagnosed prior to autopsy). 3 Meets riteria for AJCC pathologi staging based on at least one of the following riteria: p Any mirosopi assessment of regional nodes (inluding FNA, inisional ore needle bx, exisional bx, sentinel node bx or node resetion), WITH removal of the primary site adequate for pathologi T lassifiation (treatment) or biopsy assessment of the highest T ategory. OR Any mirosopi assessment of a regional node in the highest N ategory, regardless of the T ategory information. 29 April 2010 Part II - Oral Cavity and Palate - 9 Version

10 Staging Basis 5 Does not meet riteria for AJCC y-pathologi (yp) staging: Regional lymph nodes removed for examination AFTER neoadjuvant therapy AND lymph node evaluation based on linial evidene, unless the pathologi evidene at surgery (AFTER neoadjuvant) is more extensive (see ode 6). 6 Meets riteria for AJCC y-pathologi (yp) staging: yp Regional lymph nodes removed for examination AFTER neoadjuvant therapy AND lymph node evaluation based on pathologi evidene, beause the pathologi evidene at surgery is more extensive than linial evidene before treatment. 8 Meets riteria for AJCC autopsy (a) staging: a Evidene from autopsy; tumor was unsuspeted or undiagnosed prior to autopsy. 9 Unknown if lymph nodes removed for examination Not assessed; annot be assessed Unknown if assessed Floor of Mouth Reg LN Pos (Revised: 03/30/2009) Note: Reord this field even if there has been preoperative treatment. 00 All nodes examined negative nodes positive (ode exat number of nodes positive) or more nodes positive 95 Positive aspiration or ore biopsy of lymph node(s) 97 Positive nodes - number unspeified 98 No nodes examined 99 Unknown if nodes are positive; not appliable Floor of Mouth Reg LN Exam (Revised: 03/02/2009) 00 No nodes examined nodes examined (ode exat number of regional lymph nodes examined) or more nodes examined 29 April 2010 Part II - Oral Cavity and Palate - 10 Version

11 95 No regional nodes removed, but aspiration or ore biopsy of regional nodes performed 96 Regional lymph node removal doumented as sampling and number of nodes unknown/not stated 97 Regional lymph node removal doumented as dissetion and number of nodes unknown/not stated 98 Regional lymph nodes surgially removed but number of lymph nodes unknown/not stated and not doumented as sampling or dissetion; nodes examined, but number unknown 99 Unknown if nodes were examined; not appliable or negative Floor of Mouth CS Mets at DX (Revised: 07/23/2009) Note: Supralaviular and transverse ervial lymph nodes are oded in CS Lymph Nodes beause they are ategorized as N rather than M in AJCC TNM. TNM 7 TNM 6 SS77 SS No; none M0 M0 NONE NONE 10 Distant lymph node(s) Mediastinal Distant lymph node(s), NOS 40 Distant metastases exept distant lymph node(s)(ode 10) Carinomatosis 50 (10) + (40) Distant lymph node(s) plus other distant metastases 60 Distant metastasis, NOS Stated as M1, NOS 99 Unknown if distant metastasis Distant metastasis annot be assessed M1 M1 D D M1 M1 D D M1 M1 D D M1 M1 D D M0 MX U U Floor of Mouth CS Mets Eval (Revised: 08/10/2009) Note: This item reflets the validity of the lassifiation of the item CS Mets at DX only aording to the diagnosti methods employed. Staging Basis 0 Does not meet riteria for AJCC pathologi staging of distant metastasis: Evaluation of distant metastasis based on physial examination, imaging examination, and/or other non-invasive linial evidene. No pathologi examination of metastati tissue performed or pathologi examination was negative. 29 April 2010 Part II - Oral Cavity and Palate - 11 Version

12 Staging Basis 1 Does not meet riteria for AJCC pathologi staging of distant metastasis: Evaluation of distant metastasis based on endosopi examination or other invasive tehnique, inluding surgial observation without biopsy. No pathologi examination of metastati tissue performed or pathologi examination was negative. 2 Meets riteria for AJCC pathologi staging of distant metastasis: p No pathologi examination of metastati speimen done prior to death, but positive metastati evidene derived from autopsy (tumor was suspeted or diagnosed prior to autopsy). 3 Meets riteria for AJCC pathologi staging of distant metastasis: p Speimen from metastati site mirosopially positive WITHOUT pre-surgial systemi treatment or radiation OR speimen from metastati site mirosopially positive, unknown if pre-surgial systemi treatment or radiation performed OR speimen from metastati site mirosopially positive prior to neoadjuvant treatment. 5 Does not meet riteria for AJCC y-pathologi (yp) staging of distant metastasis: Speimen from metastati site mirosopially positive WITH pre-surgial systemi treatment or radiation, BUT metastasis based on linial evidene. 6 Meets riteria for AJCC y-pathologi (yp) staging of distant metastasis: Speimen from metastati site mirosopially positive WITH pre-surgial systemi treatment or radiation, BUT metastasis based on pathologi evidene. 8 Meets riteria for AJCC autopsy (a) staging of distant metastasis: yp a Evidene from autopsy based on examination of positive metastati tissue AND tumor was unsuspeted or undiagnosed prior to autopsy. 9 Not assessed; annot be assessed Unknown if assessed Floor of Mouth CS Site-Speifi Fator 1 Size of Lymph Nodes (Revised: 12/01/2009) Note: the largest diameter, whether measured linially or pathologially, of any involved regional lymph node(s). Do not ode the size of any nodes oded in CS Mets at DX. 000 No involved regional nodes millimeters (ode exat size in millimeters) millimeters or larger 29 April 2010 Part II - Oral Cavity and Palate - 12 Version

13 OBSOLETE DATA CONVERTED V0200 See ode millimeters 989 OBSOLETE DATA CONVERTED V0200 See ode millimeters or larger 990 Mirosopi fous or foi only, no size of fous given 991 Desribed as "less than 1m" 992 Desribed as "less than 2m" or "greater than 1m" or "between 1m and 2m" 993 Desribed as "less than 3m" or "greater than 2m" or "between 2m and 3m" 994 Desribed as "less than 4m" or "greater than 3m" or "between 3m and 4m" 995 Desribed as "less than 5m" or "greater than 4m" or "between 4m and 5m" 996 Desribed as "less than 6m" or "greater than 5m" or "between 5m and 6m" 997 Desribed as "more than 6m" 999 Regional lymph node(s) involved, size not stated Unknown if regional lymph node(s) involved Floor of Mouth CS Site-Speifi Fator 2 OBSOLETE - Extraapsular Extension, Lymph Nodes for Head and Nek (Revised: 12/30/2009) Note 1: This CS Site-Speifi Fator is obsolete beginning with CS Version 2 (odes and notes). Old data are retained, but new ases are not oded with this Fator. Use ode 988 for this field. Note 2: the status of extraapsular extension whether assessed linially or pathologially of any involved regional lymph node(s) oded in the CS Lymph Nodes field. Do not ode extraapsular extension in any nodes oded in CS Mets at DX in this field. Note 3: A statement of the presene or absene of extraasular extension in a pathology report takes priority over linial assessment. However, if the pathology report ontains no statement about extraapsular extension, either positive or negative, the linial assessment should be oded. If nodes are involved but there is neither a linial assessment of extranodal extension nor a statement about it in the pathology report, use ode 999. Note 4: Aording to AJCC (page 24), "Imaging studies showing amorphous speulated margins of involved nodes or involvement of internodal fat resulting in loss of normal oval-to-round nodal shape strongly suggest extraapsular (extranodal) tumor spread; however, pathologi examination is neessary for doumentation of the extent of suh disease." Note 5: CS Site-Speifi Fator 2 is obsolete beginning with CS Version 2 (odes and notes). Old data are retained, but new ases are not oded with this Fator. Use ode 988 for this field. 000 OBSOLETE DATA RETAINED V0200 No extraapsular extension 29 April 2010 Part II - Oral Cavity and Palate - 13 Version

14 001 OBSOLETE DATA RETAINED V0200 Extraapsular extension linially, not assessed pathologially Nodes desribed as "fixed", not assessed pathologially 005 OBSOLETE DATA RETAINED V0200 Extraapsular extension present pathologially 888 OBSOLETE DATA CONVERTED V0200 See ode 987 Not appliable; no lymph node involvement 987 OBSOLETE DATA CONVERTED AND RETAINED V0200 Data onverted from ode 888 Not appliable; no lymph node involvement 988 Not appliable: Information not olleted for this ase 999 OBSOLETE DATA RETAINED V0200 Unknown if regional lymph node(s) involved, not stated Regional lymph nodes annot be assessed Floor of Mouth CS Site-Speifi Fator 3 Levels I-III, Lymph Nodes for Head and Nek (Revised: 03/30/2009) Note: Site-Speifi Fators 3-6 are used to ode the presene or absene of lymph node involvement in eah of 7 different levels and other groups defined by AJCC. The definitions of the levels are the same for all appliable head and nek sites. One digit is used to represent lymph nodes of a single level, with the three digits of Site-Speifi Fator 3 representing lymph nodes of, respetively, Levels I-III; the digits of Site-Speifi Fator 4 representing lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of Site-Speifi Fator 5 representing lymph nodes of Levels VI and VII and the faial nodes; and the digits of Site-Speifi Fator 6 representing the remaining Other groups as defined by AJCC. In eah digit, a ode 1 means Yes, the nodes are involved. 000 No lymph node involvement in Levels I, II, or III 100 Level I lymph node(s) involved 010 Level II lymph node(s) involved 001 Level III lymph node(s) involved 110 Level I and II lymph nodes involved 101 Level I and III lymph nodes involved 011 Level II and III lymph nodes involved 111 Level I, II and III lymph nodes involved 29 April 2010 Part II - Oral Cavity and Palate - 14 Version

15 999 Unknown if regional lymph node(s) involved, not stated Regional lymph nodes annot be assessed Floor of Mouth CS Site-Speifi Fator 4 Levels IV-V and Retropharyngeal Lymph Nodes for Head and Nek (Revised: 03/30/2009) Note: Site-Speifi Fators 3-6 are used to ode the presene or absene of lymph node involvement in eah of 7 different levels and other groups defined by AJCC. The definitions of the levels are the same for all appliable head and nek sites. One digit is used to represent lymph nodes of a single level, with the three digits of Site-Speifi Fator 3 representing lymph nodes of, respetively, Levels I-III; the digits of Site-Speifi Fator 4 representing lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of Site-Speifi Fator 5 representing lymph nodes of Levels VI and VII and the faial nodes; and the digits of Site-Speifi Fator 6 representing the remaining Other groups as defined by AJCC. In eah digit, a ode 1 means Yes, the nodes are involved. 000 No lymph node involvement in Levels IV or V or retropharyngeal 100 Level IV lymph node(s) involved 010 Level V lymph node(s) involved 001 Retropharyngeal nodes involved 110 Level IV and V lymph nodes involved 101 Level IV and retropharyngeal nodes involved 011 Level V and retropharyngeal nodes involved 111 Level IV and V and retropharyngeal lymph nodes involved 999 Unknown if regional lymph node(s) involved, not stated Regional lymph nodes annot be assessed Floor of Mouth CS Site-Speifi Fator 5 Levels VI-VII and Faial Lymph Nodes for Head and Nek (Revised: 03/30/2009) Note 1: Site-Speifi Fators 3-6 are used to ode the presene or absene of lymph node involvement in eah of 7 different levels and other groups defined by AJCC. The definitions of the levels are the same for all appliable head and nek sites. One digit is used to represent lymph nodes of a single level, with the three digits of Site-Speifi Fator 3 representing lymph nodes of, respetively, Levels I-III; the digits of Site-Speifi Fator 4 representing lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of Site-Speifi Fator 5 representing lymph nodes of Levels VI and VII and the faial nodes; and the digits of Site-Speifi Fator 6 representing the remaining Other groups as defined by AJCC. In eah digit, a ode 1 means Yes, the nodes are involved. Note 2: Faial nodes inluding buinator, mandibular, and nasolabial lymph nodes. 000 No lymph node involvement in Levels VI or VII or faial nodes 29 April 2010 Part II - Oral Cavity and Palate - 15 Version

16 100 Level VI lymph node(s) involved 010 Level VII lymph node(s) involved 001 Faial lymph node(s) involved 110 Level VI and VII lymph nodes involved 101 Level VI and faial nodes involved 011 Level VII and faial nodes involved 111 Level VI and VII and faial lymph nodes involved 999 Unknown if regional lymph node(s) involved, not stated Regional lymph nodes annot be assessed Floor of Mouth CS Site-Speifi Fator 6 Parapharyngeal, Parotid, and Suboipital/Retroauriular Lymph Nodes, Lymph Nodes for Head and Nek (Revised: 08/25/2009) Note: Site-Speifi Fators 3-6 are used to ode the presene or absene of lymph node involvement in eah of 7 different levels and other groups defined by AJCC. The definitions of the levels are the same for all appliable head and nek sites. One digit is used to represent lymph nodes of a single level, with the three digits of Site-Speifi Fator 3 representing lymph nodes of, respetively, Levels I-III; the digits of Site-Speifi Fator 4 representing lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of Site-Speifi Fator 5 representing lymph nodes of Levels VI and VII and the faial nodes; and the digits of Site-Speifi Fator 6 representing the remaining Other groups as defined by AJCC. In eah digit, a ode 1 means Yes, the nodes are involved. 000 No involvement of any group: Parapharyngeal lymph nodes Parotid (preauriular, periparotid, and/or intraparotid) lymph nodes Suboipital/retroauriular lymph nodes 100 Parapharyngeal lymph node(s) involved 010 Parotid (preauriular, periparotid, and/or intraparotid) lymph node(s) involved 001 Suboipital/retroauriular lymph node(s) involved 110 Involvement of two groups: Parapharyngeal lymph nodes Parotid (preauriular, periparotid, and/or intraparotid) lymph nodes 101 Involvement of two groups: Parapharyngeal lymph nodes Suboipital/retroauriular lymph nodes 011 Involvement of two groups: Parotid (preauriular, periparotid, and/or intraparotid) lymph nodes Suboipital lymph nodes 29 April 2010 Part II - Oral Cavity and Palate - 16 Version

17 111 Involvement of three groups: Parapharyngeal lymph nodes Parotid (preauriular, periparotid, and/or intraparotid) lymph nodes, Suboipital/retroauriular lymph nodes 999 Unknown if regional lymph node(s) involved, not stated Regional lymph nodes annot be assessed Floor of Mouth CS Site-Speifi Fator 7 Upper and Lower Cervial Node Levels (Revised: 03/30/2009) Note 1: AJCC requires that nodes be designated as involving upper or lower levels within the nek. The boundary between upper and lower levels is the lower border of the rioid artilage. Note 2: Nodes in Levels I, II, and III are upper level nodes. Nodes in Level IV and VII are lower level nodes. Level VA nodes are upper level nodes, and Level VB are lower level nodes. Level VI nodes span both upper and lower levels. Nodes inluded in "Other groups" (Faial, Parotid, Parapharyngeal, Retropharyngeal, Retroauriular, and Suboipital) are all upper level nodes. Note 3: the loation of nodal involvement in relation to the lower border of the rioid artilage of all involved nodes, whether assessed linially or pathologially, as stated by a physiian. Note 4: If there is no physiian statement of upper and/or lower level nodal involvement, assign levels I, II, III, and VA nodes to upper level. Assign level IV, VB, and VII to lower level. If Level V (A and B not speified) and/or Level VI nodes are involved with no further information about loation, use ode 040. Note 5: A desription of "mid nek" requires larifiation with the physiian. 040, unknown level, if "mid nek" is the only information available. 000 No lymph nodes involved 010 Upper level lymph nodes involved (all involved nodes above the lower border of the rioid artilage) 020 Lower level lymph nodes involved (all involved nodes below the lower border of the rioid artilage) 030 Upper and lower level lymph nodes involved (all involved nodes both above and below the lower border of the rioid artilage) 040 Unknown level lymph nodes involved (unable to determine if involved nodes above or below the lower border of the rioid artilage) 988 Not appliable: Information not olleted for this ase 999 Unknown if regional lymph node(s) involved, not stated 29 April 2010 Part II - Oral Cavity and Palate - 17 Version

18 Floor of Mouth CS Site-Speifi Fator 8 Extraapsular Extension Clinially, Lymph Nodes for Head and Nek (Revised: 10/16/2009) Note 1: the status of extraapsular extension aessed linially for any involved regional lymph node(s) oded in the CS Lymph Nodes field. Do not ode extraapsular extensio in any nodes oded in CS Mets at DX in this field. Note 2: If nodes are involved linially, and doumentation of physial examination or imaging is available without a statement of extraapsular extension, use ode 010. Note 3: If the only doumentation is a referene to linially involved nodes with no referene to extraapsular extension, use ode 030. Note 4: If there is no information about linial assessment of nodes, use ode 999. Note 5: Clinial assessment an be by physial examination or imaging. Aording to AJCC, "ECS an be diagnosed linially by a matted mass of nodes adherent to overlying skin, adjaent soft tissue, or linial evidene of ranial nerve tissue. Radiologi signs of ECS inlude amorphous, spiulated margins of a metastati node and stranding of the perinodal soft tissue in previously untreated patients." 000 No lymph nodes involved linially 010 Nodes involved linially, no extraapsular extension linially 020 Nodes involved linially, extraapsular extension linially (nodes desribed as fixed or matted) 030 Nodes involved linially, unknown if extraapsular extension 988 Not appliable: Information not olleted for this ase 997 Clinial examination of lymph nodes performed, unknown results 998 No linial examination of lymph nodes 999 Unknown if regional lymph node(s) involved linially, not stated Regional lymph nodes annot be aessed Floor of Mouth CS Site-Speifi Fator 9 Extraapsular Extension Pathologially, Lymph Nodes for Head and Nek (Revised: 08/25/2009) Note 1: the status of extraapsular extension assessed pathologially of any involved regional lymph node(s) oded in the CS Lymph Nodes field. Do not ode extraapsular extension in any nodes oded in CS Mets at DX in this field. Note 2: If nodes are involved pathologially but there is no statement of extranodal extension in the pathology report, use ode 010. Note 3: "mirosopi" or "marosropi" extranodal extension as stated in the final diagnosis. If not stated in the final diagnosis, ode "mirosopi" if extranodal extension is desribed only in the mirosopi setion of the pathology report and "marosopi" if extranodal extension is desribed in the gross setion of the pathology report. Note 4: "Marosopi" extension takes priority over "mirosopi" extension. Note 5: Use ode 040 if pathologi extraapsular extension is desribed with no further information and the pathology report is not available for review. Note 6: Use ode 050 if nodes involved pathologially with no further information about extraapsular extension. 000 No lymph nodes involved pathologially 29 April 2010 Part II - Oral Cavity and Palate - 18 Version

19 010 Nodes involved pathologially, no extraapsular extension pathologially 020 Nodes involved pathologially, MICROSCOPIC extraapsular extension pathologially 030 Nodes involved pathologially, MACROSCOPIC extraapsular extension pathologially 040 Nodes involved pathologially, extraapsular extension pathologially, unknown if mirosopi or marosopi 050 Nodes involved pathologially, unknown if extraapsular extension 988 Not appliable: Information not olleted for this ase 997 Pathologi examination of lymph nodes performed, results not available 998 No pathologi examination of lymph nodes 999 Unknown if regional lymph node(s) involved pathologially, not stated Floor of Mouth CS Site-Speifi Fator 10 HPV (Human Papilloma Virus) Status (Revised: 10/12/2009) Note 1: There is evidene that human papilloma virus (HPV) plays a role in the pathogenesis of some aners. Note 2: Reord the results of any HPV testing performed on pathologi speimens from the primary tumor or a metastati site, inluding regional nodes. HPV testing may be performed for prognosti purposes; testing may also be performed on metastati sites to aid in the determination of the primary site. Note 3: The highest risk HPV types are types 16 and 18. Other high risk types are 31, 33, 35, 36, 45, 51, 52, 56, 58, 59, 68, 26, 53, 66, 67, 69, 70, 73, 82, 85 Low risk types are 6, 11, 32, 34, 40, 42, 44, 54, 61, 62, 64, 71, 72, 74, 81, 83, 84, 87, 89. The HPV vaine is designed to protet against types 16 and 18 (assoiated with ervial aner) and types 6 and 11 (assoiated with genital warts). Note 4: High risk may be abbreviated "hrhpv" or "HR-HPV". Note 5: Some tests for HPV, suh as a hybrid apture test, only report negative or positive for high risk HPV without identifying types; use odes 025 and 050, respetively to report those test results. 000 HPV test negative; not positive for any HPV types Negative, NOS 010 LOW RISK positive (all positive type(s) are low risk) 020 HIGH RISK positive, speified type(s) other than types 16 or 18, WITH or WITHOUT positive results for low risk type(s) 030 HIGH RISK positive for HPV 16 WITHOUT positive results for HPV 18 or positivity of HPV 18 unknown, WITH or WITHOUT positive results for other high-risk types, WITH or WITHOUT positive results for low risk type(s) 040 HIGH RISK positive for HPV 18 WITHOUT positive results for HPV 16 or positivity of HPV 16 unknown, WITH or WITHOUT positive results for other high-risk types, WITH or WITHOUT positive results for low risk type(s) 29 April 2010 Part II - Oral Cavity and Palate - 19 Version

20 050 HIGH RISK positive for HPV 16 AND HPV 18, WITH or WITHOUT positive results for other high-risk types, WITH or WITHOUT positive results for low risk type(s) 060 HIGH RISK positive, NOS, type(s) not speified 070 Positive, NOS, risk and type(s) not stated 988 Not appliable: Information not olleted for this ase 997 Test ordered, results not in hart 998 Test not done (test was not ordered and was not performed), inluding no pathologi speimen available for HPV testing 999 Unknown or no information Floor of Mouth CS Site-Speifi Fator 11 Measured Thikness (Depth) (Revised: 11/15/2009) Note 1: MEASURED THICKNESS (Depth) of the invasive tumor not size, diameter, or any other measurement. Reord the atual measurement in tenths of millimeters as stated on the pathology repot. Do not reord the measurement from a radiographi report. Note 2: Reord the measurement labeled speifially as thikness or depth of tumor. In the absene of a label,use the "ut surfae" dimension, or the third dimension from a desription of 3 dimensions (N1 x N2 x N3). For example, from a tumor size reorded as 2m x 1m x 0.5m, reord No mass/tumor found Exat thikness in tenths of millimeters Examples: millimeter millimeter millimeters millimeters, 1 entimeter millimeters millimeters or larger 987 Not appliable, in situ arinoma 988 Not appliable: Information not olleted for this ase 990 Miroinvasion Mirosopi fous or foi only; no depth given 998 No surgial speimen 999 Unknown, thikness not stated 29 April 2010 Part II - Oral Cavity and Palate - 20 Version

21 Floor of Mouth CS Site-Speifi Fator 12 (Revised: 06/30/2008) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 13 (Revised: 06/30/2008) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 14 (Revised: 06/30/2008) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 15 (Revised: 06/30/2008) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 16 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 17 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 18 (Revised: 02/23/2009) 988 Not appliable for this shema 29 April 2010 Part II - Oral Cavity and Palate - 21 Version

22 Floor of Mouth CS Site-Speifi Fator 19 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 20 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 21 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 22 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 23 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 24 (Revised: 02/23/2009) 988 Not appliable for this shema Floor of Mouth CS Site-Speifi Fator 25 (Revised: 02/23/2009) 988 Not appliable for this shema 29 April 2010 Part II - Oral Cavity and Palate - 22 Version

23 Malignant Melanoma Floor of Mouth C04.0-C04.1, C04.8-C04.9 (M ) C04.0 Anterior floor of mouth C04.1 Lateral floor of mouth C04.8 Overlapping lesion of floor of mouth C04.9 Floor of mouth, NOS CS Tumor Size CS Extension CS Tumor Size/Ext Eval CS Lymph Nodes CS Lymph Nodes Eval Reg LN Pos Reg LN Exam CS Mets at DX CS Mets Eval CS Site-Speifi Fator 1 Size of Lymph Nodes CS Site-Speifi Fator 2 OBSOLETE - Extraapsular Extension, Lymph Nodes for Head and Nek CS Site-Speifi Fator 3 Levels I-III, Lymph Nodes for Head and Nek CS Site-Speifi Fator 4 Levels IV-V and Retropharyngeal Lymph Nodes for Head and Nek CS Site-Speifi Fator 5 Levels VI-VII and Faial Lymph Nodes for Head and Nek CS Site-Speifi Fator 6 Parapharyngeal, Parotid, and Suboipital/Retroauriular Lymph Nodes, Lymph Nodes for Head and Nek CS Site-Speifi Fator 7 Upper and Lower Cervial Node Levels CS Site-Speifi Fator 8 Extraapsular Extension Clinially, Lymph Nodes for Head and Nek CS Site-Speifi Fator 9 Extraapsular Extension Pathologially, Lymph Nodes for Head and Nek CS Site-Speifi Fator 10 HPV (Human Papilloma Virus) Status CS Site-Speifi Fator 11 Measured Thikness (Depth) CS Site-Speifi Fator 12 CS Site-Speifi Fator 13 CS Site-Speifi Fator 14 CS Site-Speifi Fator 15 CS Site-Speifi Fator 16 CS Site-Speifi Fator 17 CS Site-Speifi Fator 18 CS Site-Speifi Fator 19 CS Site-Speifi Fator 20 CS Site-Speifi Fator 21 CS Site-Speifi Fator 22 CS Site-Speifi Fator 23 CS Site-Speifi Fator 24 CS Site-Speifi Fator 25 The following tables are available at the ollaborative staging website: Histology Inlusion Table AJCC 7th ed. Histology Exlusion Table AJCC 6th ed. AJCC TNM 7 Stage AJCC TNM 6 Stage Summary Stage Malignant Melanoma Floor of Mouth CS Tumor Size (Revised: 02/03/2010) 000 No mass/tumor found 29 April 2010 Part II - Oral Cavity and Palate - 23 Version

24 millimeters (ode exat size in millimeters) millimeters or larger 990 Mirosopi fous or foi only and no size of fous given 991 Desribed as "less than 1 m" 992 Desribed as "less than 2 m," or "greater than 1 m," or "between 1 m and 2 m" 993 Desribed as "less than 3 m," or "greater than 2 m," or "between 2 m and 3 m" 994 Desribed as "less than 4 m," or "greater than 3 m," or "between 3 m and 4 m" 995 Desribed as "less than 5 m," or "greater than 4 m," or "between 4 m and 5 m" 999 Unknown; size not stated Malignant Melanoma Floor of Mouth CS Extension (Revised: 01/04/2010) Note 1: AJCC does not inlude a Tis or TX ategory for melanoma of muosa of head and nek sites. Extension odes of 000 and 999 will be mapped to NA and AJCC stage group will be derived as NA. Note 2: AJCC does not inlude a T1 or T2 ategory for muosal melanoma of head and nek sites. Note 3: Use ode 300 for loalized tumor ONLY if no information is available to assign ode 105, 405, or 460. Note 4: Use ode 460,775, 810, or 815 if the physiian's assignment of T ategory is the ONLY information available about the extent of the tumor. TNM 7 TNM 6 SS77 SS In situ; noninvasive; intraepithelial NA NA IS IS 100 OBSOLETE DATA RETAINED V0200 ERROR NA L L Invasive tumor onfined to: Lamina propria Submuosa 105 Tumor onfined to muosa T3 NA L L 300 Loalized, NOS T3 NA L L 400 OBSOLETE DATA RETAINED V0200 ERROR NA L L Tumor rosses midline 405 Tumor onfined to muosa rossing midline T3 NA L L 29 April 2010 Part II - Oral Cavity and Palate - 24 Version

25 TNM 7 TNM 6 SS77 SS Extension via muosa to: Anterior 2/3 of tongue Gingiva (alveolar ridge), lower Base of tongue Epiglottis Glossoepiglotti fold Glossopharyngeal sulus Lateral pharyngeal wall Pharyngeal (lingual) surfae Pharyngoepiglotti fold Tonsillar pillars and fossae Tonsils Valleula T3 NA RE RE 460 Stated as T3 with no other information on extension T3 NA L L 500 OBSOLETE DATA RETAINED V0200 ERROR NA RE RE Anterior 2/3 of tongue Base of tongue Gingiva (alveolar ridge), lower 510 Involvement of deep soft tissue or musulature of strutures in ode 105 or 405 Soft tissue NOS T4a NA L L T4a NA RE RE (Involvement of deep soft tissue or musulature of strutures in ode 105 or Muosal involvement of strutures in ode 450) 530 Sublingual gland, inluding duts Submandibular (submaxillary) glands, inluding duts 600 OBSOLETE DATA RETAINED V0200 T4a NA RE RE ERROR NA RE RE Epiglottis Glossoepiglotti fold Glossopharyngeal sulus Lateral pharyngeal wall Pharyngeal (lingual) surfae Pharyngoepiglotti fold Tonsillar pillars and fossae Tonsils Valleula 620 Extension to deep extrinsi musle of tongue: Genioglossus Geniohyoid Hyoglossus Mylohyoid Palatoglossus Styloglossus T4a NA L L 29 April 2010 Part II - Oral Cavity and Palate - 25 Version

26 TNM 7 TNM 6 SS77 SS T4a NA RE RE (Any struture in ode 620 with muosal involvement of any struture in ode 450) T4a NA RE RE (Any struture in ode 620 with involvement of any struture in ode 530) 630 OBSOLETE DATA RETAINED V0200 ERROR NA RE RE any of (500, 530, or 600) 635 Involvement of deep soft tissue or musulature of any struture in ode OBSOLETE DATA CONVERTED V0200 See ode 740 Subutaneous soft tissue of hin/nek 700 Cortial bone: Mandible Maxilla Cartilage: Mandible Maxilla Mandible NOS Maxilla NOS Bone NOS exluding skull base Cartilage NOS T4a NA RE RE ERROR ERROR ERROR ERROR T4a NA RE RE 740 Subutaneous soft tissue of hin/nek T4a NA RE RE 760 Skin of undersurfae of hin/nek T4a NA RE RE 770 OBSOLETE DATA CONVERTED V0200 See ode 700 ERROR ERROR ERROR ERROR Further ontiguous extension: Maxillary sinus 775 Stated as T4a with no other information on extension T4a NA L L 800 Contiguous extension: Skull base Mastiator spae Pterygoid plates Internal arotid artery (enased) T4b NA D D 29 April 2010 Part II - Oral Cavity and Palate - 26 Version

27 TNM 7 TNM 6 SS77 SS Further ontiguous extension: Brain Dura Lower ranial nerves (IX, X, XI, XII) Prevertebral spae Mediastinal strutures T4b NA D D 810 Stated as T4b with no further information on extension T4b NA D D 815 Stated as T4 NOS with no other information on extension 950 OBSOLETE DATA RETAINED V0200 No evidene of primary tumor 999 Unknown extension Primary tumor annot be assessed T4NOS NA L L ERROR NA U U NA NA U U Malignant Melanoma Floor of Mouth CS Tumor Size/Ext Eval (Revised: 11/13/2009) Staging Basis 7 Staging Basis 6 0 Does not meet riteria for AJCC pathologi staging: No surgial resetion done. Evaluation based on physial examination, imaging examination, or other non-invasive linial evidene. No autopsy evidene used. 1 Does not meet riteria for AJCC pathologi staging: No surgial resetion done. Evaluation based on endosopi examination, diagnosti biopsy, inluding fine needle aspiration biopsy, or other invasive tehniques, inluding surgial observation without biopsy. No autopsy evidene used. 2 Meets riteria for AJCC pathologi staging: p No surgial resetion done, but evidene derived from autopsy (tumor was suspeted or diagnosed prior to autopsy) 29 April 2010 Part II - Oral Cavity and Palate - 27 Version

28 Staging Basis 7 Staging Basis 6 3 Either riteria meets AJCC pathologi staging: p Surgial resetion performed WITHOUT pre-surgial systemi treatment or radiation OR surgial resetion performed, unknown if pre-surgial systemi treatment or radiation performed AND Evaluation based on evidene aquired before treatment, supplemented or modified by the additional evidene aquired during and from surgery, partiularly from pathologi examination of the reseted speimen. No surgial resetion done. Evaluation based on positive biopsy of highest T lassifiation. 5 Does not meet riteria for AJCC y-pathologi (yp) staging: Surgial resetion performed AFTER neoadjuvant therapy and tumor size/extension based on linial evidene, unless the pathologi evidene at surgery (AFTER neoadjuvant) is more extensive (see ode 6). 6 Meets riteria for AJCC y-pathologi (yp) staging: yp Surgial resetion performed AFTER neoadjuvant therapy AND tumor size/extension based on pathologi evidene, beause pathologi evidene at surgery is more extensive than linial evidene before treatment. 8 Meets riteria for autopsy (a) staging: a Evidene from autopsy only (tumor was unsuspeted or undiagnosed prior to autopsy) 9 Unknown if surgial resetion done Not assessed; annot be assessed Unknown if assessed Malignant Melanoma Floor of Mouth CS Lymph Nodes (Revised: 12/26/2009) Note 1: For head and nek shemas, this field inludes all lymph nodes defined as Levels I-VII and Other by AJCC. The omplete definitions are provided in the General Instrutions. Note 2: For head and nek shemas, additional information about lymph nodes (size of involved nodes, extraapsular extension, levels involved, and loation of involved nodes above or below the lower border of the rioid artilage) is oded in Site-Speifi Fators 1, 3-9. Note 3: For head and nek aners, if lymph nodes are desribed only as "supralaviular", try to determine if they are in Level IV (deep to the sternoleidomastoid musle, in the lower jugular hain) or Level V (in the posterior triangle, inferior to the transverse ervial artery) and ode appropriately. If the speifi level annot be determined, onsider them as Level V nodes. TNM 7 TNM 6 SS77 SS None; no regional lymph node involvement N0 NA NONE NONE 29 April 2010 Part II - Oral Cavity and Palate - 28 Version