The Registry Partners December 2019 CTR Coding Break reviews common exceptions to AJCC staging. The presentation walks through exceptions where the CTR may assign a clinical N within the pathological N category and where site-specific T values with the assignment of any N and M0 result in a specific stage group. Melanoma, Kidney, GIST, and Thyroid are some of the sites reviewed and the AJCC 8th edition in situ rule is discussed. Per the AJCC 8th edition Chapter 1 Principles of Cancer Staging, for some cancer sites in which lymph node involvement is rare, patients whose nodal status is not determined to be positive for tumor should be designated as cN0. These circumstances are identified in specific disease site chapters for these sites. The assignment of cN0 will ensure it is not confused with a case in which the nodes were microscopically proven to not contain tumor that is pN0. The presentation concludes with clinical and pathological N reminders with a Kidney case example for staging.
Happy Holidays again from Registry Partners!