Collaborative Stage

Note 1: This CS Site-Specific Factor is to be collected for cases diagnosed through 12/31/2009. Cases diagnosed 01/01/2010 forward DO NOT require collection of this Factor. Use code 988 if collection of this field is not required (cases diagnosed 01/01/2010 forward).
Note 2: Code apex involvement if CLEARLY documented in the patient record, otherwise if apex involvement is ambiguous/unknown assign code 550.
Note 3: Historically, apex involvement has affected the stage classification, although it does not affect the AJCC 6th or 7th edition. This item allows collection of information about the involvement of the prostate apex with cancer, both clinically and at prostatectomy.
Note 4: Code 2 should be avoided if possible. Historically, most cases coded as 2 mapped to regional extension. By splitting code 2 into codes 3 and 4, the proportion of localized and regional cases is more accurate.
Note 5: In codes 110-550, the first digit represents the clinical status of apex involvement found on needle core biopsy, imaging or physical examination. The second digit represents apex involvement found at prostatectomy. The third digit is always 0.

                        ____                       ____                    __0__
               Clinical Apex         Pathologic Apex         Always "0"
                 Involvement            Involvement

The digits are defined as follows:
        1 - No involvement of prostatic apex:
                 statement of normal apex
                 negative apex involvement (i.e. needle biopsy indicates both apices negative, prostatectomy indicates malignancy only in lobes/base)
        2 - Into prostatic apex/arising in prostatic apex, NOS
                 involvement of apex BUT involvement of other part(s) of prostate unknown
                 NOTE: avoid using this code if more detailed information is available to assign code 3 or code 4 (see Note 3)
        3 - Arising in prostatic apex
                 apex is only site of malignancy
        4 - Extension into prostatic apex
                 involvement of apex AND other part(s) of prostate but no statement whether it arose in or extended into apex
                statement indicating malignancy started in other part(s) of prostate and extends into apex
        5 - Apex extension unknown
                 no description of apex involvement
                 always 2nd digit when prostatectomy not performed

When abstracting and coding apex involvement, try to determine if the cancer has extended into the apex from another part of the prostate or has arisen in the apex.

Code	Description
000	OBSOLETE DATA RETAINED V0102 Test not done (test was not ordered and was not performed)
010	OBSOLETE DATA RETAINED V0102 Positive/elevated
020	OBSOLETE DATA RETAINED V0102 Negative/normal; within normal limits
030	OBSOLETE DATA RETAINED V0102 Borderline; undetermined whether positive or negative
080	OBSOLETE DATA RETAINED V0102 Ordered, but results not in chart
110	No involvement of prostatic apex clinically and on prostatectomy
120	Clinical apex involvement: No involvement AND Prostatectomy apex involvement: Into/arising in, NOS.
130	Clinical apex involvement: No involvement AND Prostatectomy apex involvement: Arising in
140	Clinical apex involvement: No involvement AND Prostatectomy apex involvement: Extension into
150	Clinical apex involvement: No involvement AND Prostatectomy apex involvement: Unknown
210	Clinical apex involvement: Into/arising in, NOS AND Prostatectomy apex involvement: No involvement
220	Clinical apex involvement: Into/arising in, NOS AND Prostatectomy apex involvement: Into/arising in, NOS
230	Clinical apex involvement: Into/arising in, NOS AND Prostatectomy apex involvement: Arising in
240	Clinical apex involvement: Into/arising in, NOS AND Prostatectomy apex involvement: Extension into
250	Clinical apex involvement: Into/arising in, NOS AND Prostatectomy apex involvement: Unknown
310	Clinical apex involvement: Arising in AND Prostatectomy apex involvement: No involvement
320	Clinical apex involvement: Arising in AND Prostatectomy apex involvement: Into/arising in, NOS
330	Clinical apex involvement: Arising in AND Prostatectomy apex involvement: Arising in
340	Clinical apex involvement: Arising in AND Prostatectomy apex involvement: Extension into
350	Clinical apex involvement: Arising in AND Prostatectomy apex involvement: Unknown
410	Clinical apex involvement: Extension into AND Prostatectomy apex involvement: No involvement
420	Clinical apex involvement: Extension into AND Prostatectomy apex involvement: Into/arising in, NOS
430	Clinical apex involvement: Extension into AND Prostatectomy apex involvement: Arising in
440	Clinical apex involvement: Extension into AND Prostatectomy apex involvement: Extension into
450	Clinical apex involvement: Extension into AND Prostatectomy apex involvement: Unknown
510	Clinical apex involvement: Unknown AND Prostatectomy apex involvement: No involvement
520	Clinical apex involvement: Unknown AND Prostatectomy apex involvement: Into/arising in, NOS
530	Clinical apex involvement: Unknown AND Prostatectomy apex involvement: Arising in
540	Clinical apex involvement: Unknown AND Prostatectomy apex involvement: Extension into
550	Clinical apex involvement: Unknown AND Prostatectomy apex involvement: Unknown
988	Not applicable: Information not collected for this case (May include cases converted from code 888 used in CSv1 for "Not applicable" or when the item was not collected. If this item is required to derive T, N, M, or any stage, use of code 988 may result in an error.)
999	OBSOLETE DATA RETAINED V0102 Unknown or no information Not documented in patient record

Prostate

CS Site-Specific Factor 4Prostate Apex Involvement (OBSOLETE: Prostatic Acid Phosphatase (PAP))

CS Site-Specific Factor 4
Prostate Apex Involvement (OBSOLETE: Prostatic Acid Phosphatase (PAP))