Appendix Q1 - PANCREAS

Q.1: PANCREAS

For Cases Diagnosed prior to January 1, 2003

C25.0-25.9

SURGICAL APPROACH

Code	Description
0	None; no cancer-directed surgery of primary site
1	Endoscopy, NOS (laparoscopy)
2		Not image guided
3		Image guided
4	Open, NOS
5		Not assisted by endoscopy
6		Assisted by endoscopy
9	Unknown; not stated; death certificate only

SURGERY OF PRIMARY SITE

Code	Description
00	None; no cancer-directed surgery of primary site
10	Local excision of tumor, NOS
20	Partial pancreatectomy, NOS
40	Total pancreatectomy
50	Local or partial pancreatectomy and duodenectomy
51		Without subtotal gastrectomy
52		With subtotal gastrectomy (Whipple)
60	Total pancreatectomy and subtotal gastrectomy or duodenectomy
70	Extended pancreatoduodenectomy
80	Pancreatectomy, NOS
90	Surgery, NOS
99	Unknown if cancer-directed surgery performed; death certificate only

SURGICAL MARGINS

Code	Description
0	All margins grossly and microscopically negative
1	Margins involved, NOS
2		Microscopic involvement
5		Macroscopic involvement
7	Margins not documented
8	No cancer-directed surgery of primary site
9	Unknown whether margins were involved or negative; death certificate only

SCOPE OF REGIONAL LYMPH NODE SURGERY

The regional lymph nodes are:

Celiac (head only)
Hepatic artery
Infrapyloric (head only)
Lateral aortic
Pancreaticolienal (body and tail only)
Peripancreatic (superior, inferior, anterior, posterior splenic)
Retroperitoneal
Splenic (body and tail only)
Subpyloric (head only)
Superior mesenteric

Code	Description
0	No regional lymph nodes removed
1		Regional lymph nodes removed, NOS
2		Extended lymphadenectomy Note: An extended pancreaticoduodenectomy incorporates selected aspects of the Whipple procedure and regional pancreatectomy. A wide Kocher maneuver removes all lymphatic tissue over the medical aspect of the right kidney, inferior vena cava, and left renal vein.
9	Unknown; not stated; death certificate only

NUMBER OF REGIONAL LYMPH NODES EXAMINED

Code	Description
00	No regional lymph nodes removed
01	One regional lymph node removed
02	Two regional lymph nodes removed
..
90	Ninety or more regional lymph nodes removed
95	No regional lymph nodes removed but aspiration of regional lymph nodes was performed
96	Regional lymph node removal documented as a sampling and number of lymph nodes unknown/not stated
97	Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated
98	Regional lymph nodes surgically removed but number of lymph nodes unknown/not stated and not documented as sampling or dissection
99	Unknown; not stated; death certificate only

SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S) OR DISTANT LYMPH NODE(S)

Code	Description
0	None; no surgery to other regional or distant sites
1	Surgery to other sites or nodes, NOS; unknown if regional or distant
2		Removal of other regional sites, only
3		Removal of distant nodes
4		Removal of distant site
5		Combination of 2 with 3 and/or 4
9	Unknown; not stated; death certificate only

RECONSTRUCTION/RESTORATION - FIRST COURSE

Code	Description
9	Not applicable (There are no known reconstructive procedures for this site.)

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