Rectal Cancer: CS Mets at Dx
Code 10 is distant nodes, NOS
Codes 11–12 are specific distant lymph nodes staged differently in SS77
Code 40 is distant mets
Via bloodstream (hematogenous)
Examples: liver, lung, brain
Code 50 is a combination of any distant lymph nodes and any distant metastases
For rectum and rectosigmoid, assign code 10 when node involvement is to distant nodes, NOS. Code 11 is assigned for rectosigmoid when there is involvement of internal iliac or obturator nodes. These were staged differently in summary stage 77 and a specific code is assigned to allow the data to be mapped correctly. Code 12 is assigned when named distant lymph node regions are involved. Distant metastasis, excluding lymph nodes, is assigned code 40. Code 50 is used when there is both distant lymph node involvement and discontinuous distant metastasis.