Collaborative Stage

Note 1: Code the status of extracapsular extension accessed clinically for any involved regional lymph node(s) coded in the CS Lymph Nodes field. Do not code extracapsular extensio in any nodes coded in CS Mets at DX in this field.
Note 2: If nodes are involved clinically, and documentation of physical examination or imaging is available without a statement of extracapsular extension, use code 010.
Note 3: If the only documentation is a reference to clinically involved nodes with no reference to extracapsular extension, use code 030.
Note 4: If there is no information about clinical assessment of nodes, use code 999.
Note 5: Clinical assessment can be by physical examination or imaging. According to AJCC, "ECS can be diagnosed clinically by a matted mass of nodes adherent to overlying skin, adjacent soft tissue, or clinical evidence of cranial nerve tissue. Radiologic signs of ECS include amorphous, spiculated margins of a metastatic node and stranding of the perinodal soft tissue in previously untreated patients."

Code	Description
000	No lymph nodes involved clinically
010	Nodes involved clinically, no extracapsular extension clinically
020	Nodes involved clinically, extracapsular extension clinically (nodes described as fixed or matted)
030	Nodes involved clinically, unknown if extracapsular extension
988	Not applicable: Information not collected for this case
997	Clinical examination of lymph nodes performed, unknown results
998	No clinical examination of lymph nodes
999	Unknown if regional lymph node(s) involved clinically, not stated Regional lymph nodes cannot be accessed Not documented in patient record

CS Site-Specific Factor 8
Extracapsular Extension Clinically, Lymph Nodes for Head and Neck