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SEER Inquiry System - Report
Produced: 06/08/2025 7:05 AM
Question 20120008
Inquiry Details
References:
2007 MP/H Rules
Question:
MP/H Rules/Recurrence--Ovary: How many primaries are accessioned if a patient was diagnosed with ovarian serous carcinoma four years ago and currently has sacral and pelvic masses positive for serous carcinoma on biopsy? Should this be disease progression or a new primary? See Discussion.
Discussion:
Should this be a new primary per the MP/H Rules (Other Sites, Rule M10) because the diagnoses were made more than one year apart? Or is the new disease metastasis? The pathologist did not compare the subsequent mass biopsies with the original pathology. Is a pathologist's comparison of slides the only criteria for determining recurrent disease? This case seems to fit the definition of metastatic disease rather than a recurrence, and therefore would not be a new primary.
Answer:
Accession a single primary, the original ovarian serous carcinoma. The MP/H Rules do not apply to metastases.
Metastases: When cancer cells appear in other nodes or organs that are not the primary site they are metastatic cells. Discontinuous (separate from the primary tumor) masses or cells in regional lymph nodes, distant lymph nodes, or distant sites are always metastases. In this case, the sacral and pelvic masses are distant metastases. The pathologist does not have to compare cells to the original tumor slides; the discontinuous tumor mass/cells in any site other than the primary site are metastases.
Recurrence: For a disease to recur there are several criteria that must be met. First and most important, the patient must have had a disease-free interval (a tumor cannot recur if it has always been present). The other criteria are: the "new tumor" has to occur in the original primary site, it must be the same histology as the original tumor, AND must meet the timing requirements in the MPH rules for that organ/site.
