C328 or C329

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    We are not certain if this is an edit issue or staging issue but receiving the following Edit error: Primary Site, M 2016 – Ed 7 (COC-NPCR) for site C328 or C329. Per the AJCC forum:
    When a specific site for Larynx cannot be determined and we use primary site 32.9, what definition of TNM table should we use, Supraglottis, Glottis, Subglottis or none? Can a Larynx NOS be staged at all?
    It cannot be staged unless you can identify the bulk of the tumor and assign the correct subsite. There is guidance in the AJCC chapter on this topic. If there is no primary tumor, how do you know it is a laryngeal cancer.

    Our software allows the cM and pM as 88 but the edit only allows 0,1 for this site. Please advise.

    Jim Hofferkamp

    Hi Barbara,
    This is a known issue and there has been a great deal of discussion on how to handle these cases. The next version of edits has been loosened so that it allows the value of 88 along with all of the valid values for the larynx chapter for c32.8 and c32.9 primaries. That should fix the edits issues, but it doesn’t really solve the coding issue.

    You have identified the problem. If the primary site is C32.8 or C32.9, the computer does not know which T values to use. No only is this a problem with the edits, but it is also a problem with the program central registries use to calculate stage.

    The Edits WG wrote an article that will be in the next issue of Journal of Registry Management addressing this issue. At this point we are strongly encouraging registrars to assign the primary based on the epicenter of the tumor. So if the epicenter of the tumor is located in the supraglottis but the tumor also involves the glottis, then the primary site should be coded to supraglottis.

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