C15.0-C15.5, C15.8-C15.9

Transcription

1 C15.0-C15.5, C15.8-C15.9 C15.0 Cervial esophagus C15.1 Thorai esophagus C15.2 Abdominal esophagus C15.3 Upper third of esophagus C15.4 Middle third of esophagus C15.5 Lower third of esophagus C15.8 Overlapping lesion of esophagus C15.9, NOS The ardia/egj, and the proximal 5m of the fundus and body of the stomah (C16.0-C16.2) have been moved from the Stomah hapter and added to effetive with AJCC TNM 7th Edition. A new shema EG Juntion was reated in CSv2 to aommodate this hange. Tumors arising at the EGJ, or arising in the stomah within 5 m of the EGJ and rossing the EGJ are staged using the shema for EG Juntion. All other aners with a midpoint in the stomah lying more than 5 m distal to the EGJ, or those within 5 m of the EGJ but not extending into the EGJ or esophagus, are staged using the stomah shema. Anatomi Limits of : Cervial (C15.0): From the lower border of the rioid artilage to the thorai inlet (suprasternal noth), about 18 m from the inisors. Intrathorai (inluding abdominal esophagus) (C C15.5): Upper thorai portion (C15.3): From the thorai inlet to the level of the traheal bifuration (18-24 m). Mid-thorai portion (C15.4): From the traheal bifuration midway to the gastroesophageal (GE) juntion (24-32 m). Lower thorai portion (C15.5: From midway between the traheal bifuration and the gastroesophageal juntion to the GE juntion, inluding the abdominal esophagus (C15.2) between m. Effetive with AJCC TNM 7th Edition, there are separate stage groupings for squamous ell arinoma and adenoarinoma. Sine squamous ell arinoma typially has a poorer prognosis than adenoarinoma, a tumor of mixed histopathologi type or a type that is not otherwise speified should be lassified as squamous ell arinoma. Effetive with AJCC TNM 7th Edition, histologi grade is required for stage grouping. 29 April 2010 Part II - Upper GI - 1 Version

2 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 Clinial Assessment of Regional Lymph Nodes CS Site-Speifi Fator 2 Speifi Loation of Tumor CS Site-Speifi Fator 3 Number of Regional Lymph Nodes with Extraapsular tumor CS Site-Speifi Fator 4 Distane to proximal edge of tumor from inisors CS Site-Speifi Fator 5 Distane to distal edge of tumor from inisors CS Site-Speifi Fator 6 CS Site-Speifi Fator 7 CS Site-Speifi Fator 8 CS Site-Speifi Fator 9 CS Site-Speifi Fator 10 CS Site-Speifi Fator 11 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 AJCC TNM 7 Stage Squamous AJCC TNM 7 Stage Adenoarinoma Lymph Nodes Clinial Evaluation 7th Table Lymph Nodes Pathologi Evaluation 7th Table Also Used When CS Reg Nodes Eval is Not d Lymph Nodes Mets at DX Table AJCC 6 Histologies Stage Table CS Tumor Size (Revised: 08/28/2009) Note: For esophagus, this field is used for size of tumor/length of involved esophagus. 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" 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" 29 April 2010 Part II - Upper GI - 2 Version

3 998 Cirumferential 999 Unknown; size not stated Not doumented in patient reord CS Extension (Revised: 01/26/2010) Note 1: Ignore intraluminal extension to adjaent segment(s) of esophagus or to ardia of stomah and ode depth of invasion or extra-esophageal spread as indiated. Note 2: T4 has been sublassified into T4a and T4b in the 7th Edition. Note 3: For this site, AJCC defines Tis as High grade dysplasia, in whih they Inlude "all non-invasive neoplasti epithelium that was previously alled arinoma in situ. Caners stated to be non-invasive or in situ are lassified as Tis." High grade dysplasia is generally not reportable in aner registries, but if a registry does ollet it, ode 000 should be used. TNM 7 TNM 6 SS77 SS In situ; non-invasive; intraepithelial; high grade dysplasia 100 Invasive tumor onfined to muosa, NOS (inluding intramuosal, NOS) Tis Tis IS IS T1a T1 L L 110 Invades lamina propria T1a T1 L L 120 Invades musularis muosae T1a T1 L L 160 Invades submuosa T1b T1 L L 170 Stated as T1 [NOS] T1NOS T1 L L 200 Musularis propria invaded T2 T2 L L 210 Stated as T2 [NOS] T2 T2 L L 300 Loalized, NOS T1NOS T1 L L 400 Adventitia and/or soft tissue invaded is desribed as "FIXED" T3 T3 RE RE 450 Stated as T3 [NOS] T3 T3 RE RE 29 April 2010 Part II - Upper GI - 3 Version

4 TNM 7 TNM 6 SS77 SS OBSOLETE DATA RETAINED V0200 T4 sublassified in AJCC 7th Edition; See s Tumor invades adjaent strutures Cervial esophagus: Blood vessel(s): Carotid artery Jugular vein Sublavian artery Thyroid gland Intrathorai, upper or mid-portion, esophagus: Blood vessel(s), major: Aorta Azygos vein Pulmonary artery/vein Vena ava Carina Diaphragm Main stem bronhus Trahea Intrathorai, lower portion (abdominal), esophagus: Blood vessel(s): Aorta Gastri artery/vein Vena ava Diaphragm, not fixed, or NOS Stomah, ardia (via serosa) 610 Tumor invades adjaent strutures Cervial esophagus: Hypopharynx Jugular vein Larynx Thyroid gland ERROR T4 RE RE T4a T4 RE RE Intrathorai, upper or mid-portion, esophagus: Blood vessel(s), major: Azygos vein Diaphragm Intrathorai, lower portion (abdominal), esophagus: Blood vessel(s): Gastri artery/vein Diaphragm, not fixed, or NOS Stomah, ardia (via serosa) Intrathorai esophagus: Pleura 29 April 2010 Part II - Upper GI - 4 Version

5 TNM 7 TNM 6 SS77 SS OBSOLETE DATA RETAINED V0200 T4 sublassified in AJCC 7th Edition; See s Cervial esophagus: Carina Cervial vertebra(e) Hypopharynx Larynx Trahea Intrathorai esophagus: Lung via bronhus Mediastinal struture(s), NOS Pleura Rib(s) Thorai vertebra(e) 660 Thorai/middle esophagus: Periardium 680 Cervial/upper esophagus: Pleura Abdominal/lower esophagus: Diaphragm fixed ERROR T4 RE RE T4a T4 RE D T4a T4 D D 700 Stated as T4 [NOS] T4NOS T4 RE RE 710 Stated as T4a [NOS] T4a T4 RE RE 29 April 2010 Part II - Upper GI - 5 Version

6 TNM 7 TNM 6 SS77 SS Tumor invades adjaent strutures Cervial esophagus: Blood vessel(s): Carotid artery Sublavian artery Carina Cervial vertebra(e) Trahea T4b T4 RE RE Intrathorai, upper or mid-portion, esophagus: Blood vessel(s), major: Aorta Pulmonary artery/vein Vena ava Carina Main stem bronhus Trahea Intrathorai, lower portion (abdominal), esophagus: Blood vessel(s): Aorta Vena ava Intrathorai esophagus: Adjaent Rib(s) Bronhus Mediastinal struture(s), NOS Thorai vertebra(e) 750 Cervial/upper esophagus: Lung Main stem bronhus 780 OBSOLETE DATA RETAINED V0200 T4 sublassified in AJCC 7th Edition; See 660 Thorai/middle esophagus: Periardium 800 OBSOLETE DATA RETAINED V0200 T4 sublassified in AJCC 7th Edition; See s 730 and 750 Further ontiguous extension: Cervial/upper esophagus: Lung Main stem bronhus Pleura Abdominal/lower esophagus: Diaphragm fixed 810 Further ontiguous extension Stated as T4b [NOS] 820 Tumor Invades adjaent strutures listed in odes 610,660,or 680, but stated as unresetable T4b T4 D D ERROR T4 RE D ERROR T4 D D T4b T4 D D T4b T4 D D 29 April 2010 Part II - Upper GI - 6 Version

7 TNM 7 TNM 6 SS77 SS No evidene of primary tumor T0 T0 U U 999 Unknown extension Primary tumor annot be assessed Not doumented in patient reord TX TX U U 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 - Upper GI - 7 Version

8 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 Not doumented in patient reord CS Lymph Nodes (Revised: 12/06/2009) Note 1: only regional nodes and nodes, NOS, in this field. Distant nodes are oded in the field Mets at DX. Note 2: In 7th Edition, regional lymph nodes for any part of esophagus fall in the range from periesophageal/ervial to elia region. Note 3: Lymph nodes from the supralaviular region down to the elia region previously onsidered to be distant are now regional. Note 4: Lymph node stations/groups are listed in parentheses when appliable. See page 107 of the AJCC TNM 7th Ed. for an illustration. TNM 7 TNM 6 SS77 SS None; no regional lymph node involvement N0 N0 NONE NONE 29 April 2010 Part II - Upper GI - 8 Version

9 TNM 7 TNM 6 SS77 SS Regional lymph nodes (inluding ontralateral or bilateral) For all subsites: Peri-/paraesophageal (8L, 8M) Cervial esophagus only: Cervial, NOS Anterior deep ervial (laterolateral) (reurrent laryngeal) Internal jugular, NOS: Deep ervial, NOS: Upper, NOS: Jugulodigastri (subdigastri) Intrathorai esophagus, upper or middle, only: Internal jugular, NOS: Deep ervial, NOS: Lower, NOS: Jugulo-omohyoid (supraomohyoid) Middle Upper ervial, NOS: Jugulodigastri (subdigastri) Intrabronhial: Carinal (traheobronhial) (10R, 10L) (traheal bifuration) Hilar (bronhopulmonary) (proximal lobar) (pulmonary root) Peritraheal Left gastri (superior gastri) (17): Cardia (ardial) Lesser urvature Perigastri, NOS Posterior mediastinal (traheoesophageal) Intrathorai esophagus, lower (abdominal) only: Left gastri (superior gastri) (17): Cardia (ardial) Lesser urvature Perigastri, NOS Posterior mediastinal (3P) (traheoesophageal) 200 Cervial only: Salene (inferior deep ervial) (1) Supralaviular (transverse ervial) (1) 220 Intrathorai, upper thorai or middle, only: Superior mediastinal 250 Upper thorai esophagus only: Cervial lymph nodes Lower thorai (abdominal) esophagus only: Celia lymph nodes (20) ^ N1 RN RN ^ N1 D RN ^ N1 D RN ^ * D D 29 April 2010 Part II - Upper GI - 9 Version

10 TNM 7 TNM 6 SS77 SS Cervial esophagus only: Common hepati (regional) (18) Diaphragmati (15) Pulmonary ligament (9) Spleni (19) Intrathorai esophagus, upper or middle, only: Common hepati (18) (regional) Diaphragmati (15) Spleni (19) Lower thorai (abdominal) esophagus only: Aortopulmonary (5) Pulmonary ligament (9) 300 All esophagus subsites: Anterior mediastinal (6) Mediastinal, NOS Cervial esophagus only: Aortopulmonary (5) Paratraheal (2R,2L, 4R, 4L) Posterior mediastinal (3P) Superior mediastinal Intrathorai esophagus,upper or middle, only: Aortopulmonary (5) Pulmonary ligament (9) Intrathorai esophagus, lower (abdominal) only: Common hepati (18) Diaphragmati (15) Paratraheal (2R,2L, 4R,4L) Spleni (19) Superior mediastinal ^ * D D ^ N1 RN RN 500 Regional lymph node(s), NOS ^ N1 RN RN 600 Stated as linial N2 (linial assessment; no lymph nodes removed) 610 Stated as pathologi N2; no information on whih nodes were involved 700 Stated as linial N3a (linial assessment; no lymph nodes removed) 710 Stated pathologially as N3a; no information on whih nodes were involved 800 Lymph nodes, NOS; Stated as N1 N2 N1 RN RN N2 N1 RN RN N3 N1 RN RN N3 N1 RN RN ^ N1 RN RN 999 Unknown; not stated Regional lymph node(s) annot be assessed Not doumented in patient reord NX NX U U ^ For odes and 800, the N ategory is assigned based on the number of positive lymph nodes. ^ For odes and 800 ONLY: when CS Regional Nodes Eval is 0, 1, 5, or 9, the N ategory is assigned from the Lymph Nodes Clinial Evaluation 7th Edition Table, using Reg LN Pos and CS Site-Speifi Fator 1; when CS 29 April 2010 Part II - Upper GI - 10 Version

11 Regional Nodes Eval is 2, 3, 6, 8, or not oded, the N ategory is determined from the Lymph Nodes Pathologi Evaluation 7th Edition Table using Reg LN Pos. * For odes 250 and 260 the N and M ategories for AJCC 6th Edition are assigned based on the oding of this field and CS Mets at DX as shown in the Lymph Nodes Mets at DX Table AJCC 6 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). 29 April 2010 Part II - Upper GI - 11 Version

12 Staging Basis 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. 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 Not doumented in patient reord Reg LN Pos (Revised: 12/10/2009) 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 Not doumented in patient reord 29 April 2010 Part II - Upper GI - 12 Version

13 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 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 Not doumented in patient reord CS Mets at DX (Revised: 01/07/2010) Note 1: Lymph nodes from the supralaviular region down to the elia region previously onsidered to be distant are now regional. Note 2: Lymph node stations/groups are listed in parentheses when appliable. See page 107 of the AJCC TNM 7th Ed. for an illustration. TNM 7 TNM 6 SS77 SS No; none M0 M0 NONE NONE 10 Distant lymph node(s), NOS M1 M1NOS D D 11 OBSOLETE DATA RETAINED V0200 Considered regional in AJCC 7th Edition See CS Lymph Nodes ode 250 Upper thorai esophagus only: Cervial lymph nodes M1 Lower thorai (abdominal) esophagus only: Celia lymph nodes (20) M1 ERROR M1a D D 29 April 2010 Part II - Upper GI - 13 Version

14 TNM 7 TNM 6 SS77 SS OBSOLETE DATA REVIEWED AND CHANGED V0200 The speified lymph nodes in ode 12 were onsidered distant in AJCC 6th Edition and are onsidered regional in AJCC 7th Edition EXCEPT for ommon hepati and spleni lymph nodes whih are still onsidered distant and are inluded in ode 15. See CS Lymph Nodes ode 260 for lymph nodes other than ommon hepati and spleni ERROR ERROR ERROR ERROR Speified distant lymph node(s), other than ode 11, inluding: Cervial esophagus only: Common hepati (18) Diaphragmati (15) Pulmonary ligament (9) Spleni (19) Intrathorai esophagus, upper or middle, only: Common hepati (18) Diaphragmati (15) Spleni (19) Lower thorai (abdominal) esophagus only: Aortopulmonary (5) Pulmonary ligament (9) 15 Common hepati (18) Spleni (19) 40 Distant metastases exept distant lymph node(s) (odes 10 or 15) Carinomatosis any of 10 to 15 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 Not doumented in patient reord M1 M1NOS D D M1 M1b D D M1 M1b D D M1 M1b D D M0 MX U U 29 April 2010 Part II - Upper GI - 14 Version

15 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. 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 Not doumented in patient reord 29 April 2010 Part II - Upper GI - 15 Version

16 CS Site-Speifi Fator 1 Clinial Assessment of Regional Lymph Nodes (Revised: 12/31/2009) Note: In the rare instane that the number of linially positive nodes is stated but a linial N ategory is not stated, ode 1-2 nodes as 100 (N1), 3-6 nodes as 200 (N2), and 7 or more nodes as 300 (N3). 000 Nodes not linially evident 100 Clinially N1 200 Clinially N2 300 Clinially N3 400 Clinially positive regional nodes, NOS 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 988 Not appliable: Information not olleted for this ase (May inlude ases onverted from ode 888 used in CSv1 for "Not appliable" or when the item was not olleted. If this item is required to derive T, N, M, or any stage, use of ode 988 may result in an error.) 999 Unknown if nodes are linially evident CS Site-Speifi Fator 2 Speifi Loation of Tumor (Revised: 12/30/2009) 010 Cervial 020 Upper Thorai 030 Middle Thorai 040 Abdominal 050 Lower Thorai 070 Upper third 080 Middle third 090 Lower third 100 Overlapping lesion of the 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 29 April 2010 Part II - Upper GI - 16 Version

17 988 Not appliable: Information not olleted for this ase (May inlude ases onverted from ode 888 used in CSv1 for "Not appliable" or when the item was not olleted. If this item is required to derive T, N, M, or any stage, use of ode 988 may result in an error.) 999 Unknown;, NOS CS Site-Speifi Fator 3 Number of Regional Lymph Nodes with Extraapsular tumor (Revised: 12/30/2009) Note: Reord the information from the Pathology report. If there is no Pathology report or it is unavailable, reord ode All nodes examined negative nodes (ode exat number of nodes with extraapsular tumor) 097 Positive nodes - not stated if extraapsular tumor present 098 No nodes examined 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 988 Not appliable: Information not olleted for this ase (May inlude ases onverted from ode 888 used in CSv1 for "Not appliable" or when the item was not olleted. If this item is required to derive T, N, M, or any stage, use of ode 988 may result in an error.) 999 Unknown if nodes are positive; unknown if extraapsular tumor present; Not doumented in patient reord CS Site-Speifi Fator 4 Distane to proximal edge of tumor from inisors (Revised: 12/30/2009) Note: The distane to the proximal edge of tumor from the inisors is the distane from the gross tumor edge to the esophageal transetion line. Reord the information from the Pathology report. If there is no Pathology report or it is unavailable, reord ode Proximal edge of tumor involved Centimeters (ode exat distane to proximal edge in entimeters) 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 29 April 2010 Part II - Upper GI - 17 Version

18 988 Not appliable: Information not olleted for this ase (May inlude ases onverted from ode 888 used in CSv1 for "Not appliable" or when the item was not olleted. If this item is required to derive T, N, M, or any stage, use of ode 988 may result in an error.) 990 Distane to proximal edge not stated 999 Unknown Not doumented in patient reord CS Site-Speifi Fator 5 Distane to distal edge of tumor from inisors (Revised: 12/30/2009) Note: Reord the information from the Pathology report. If there is no Pathology report or it is unavailable, reord ode Distal edge of tumor involved Centimeters (ode exat distane to proximal edge in entimeters) 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 988 Not appliable: Information not olleted for this ase (May inlude ases onverted from ode 888 used in CSv1 for "Not appliable" or when the item was not olleted. If this item is required to derive T, N, M, or any stage, use of ode 988 may result in an error.) 990 Distane to distal edge not stated 999 Unknown Not doumented in patient reord CS Site-Speifi Fator 6 (Revised: 06/30/2008) 888 OBSOLETE DATA CONVERTED V0200 See ode 988 Not appliable for this site 988 Not appliable for this shema CS Site-Speifi Fator 7 (Revised: 06/30/2008) 988 Not appliable for this shema 29 April 2010 Part II - Upper GI - 18 Version