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SEER Inquiry System - Report
Produced: 10/27/2025 4:19 AM
Question 20091124
Inquiry Details
References:
#1: 2007 SEER Manual, C-507
#2: 2007 SEER Manual, 113. 9
Question:
CS Eval--Lung: How is the CS Reg Nodes Eval field to be coded when the FNA of a paratracheal lymph node is positive for adenocarcinoma and the patient subsequently undergoes neoadjuvant chemoradiation therapy followed by an excision of multiple lymph node fragments that show adenocarcinoma? See Discussion.
Discussion:
The CSv1 scheme for lung shows that code 1 under CS Reg Nodes Eval is a path staging basis. However, the definition for code 1 also states that no regional lymph nodes were removed for examination. Would we use code 1 because the case represents path staging basis? If we select code 5 because regional lymph nodes were dissected, the staging basis would be clinical. If we select code 6, the staging basis would be y.
Answer:
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
Use code "6" for the CS LN evaluation field. As explained on page 113 in the 2007 SEER Manual, when post-operative disease is more extensive despite neoadjuvant therapy, this can be coded in the evaluation field. In this case, only an FNA was done on lymph nodes pre-operatively, but actual lymph nodes were removed and documented in the post-neoadjuvant excision of the lymph nodes which documented that they are histologically positive -- proving that the neoadjuvant therapy did not work.
Cancer Site Category:
Lung
Data Item Category:
N/A
Other Category:
N/A
Year:
2009
