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SEER Inquiry System - Report
Produced: 10/28/2025 2:11 PM
Question 20200029
Inquiry Details
References:
2018 SEER Manual, 219. Systemic Treatment/Surgery Sequence
Question:
Systemic/Surgery Sequence: The note associated with code 4 in Systemic Treatment/Surgery Sequence in the 2018 SEER Manual says: Code 4 is intended for situations with at least two episodes or courses of systemic therapy. Does this mean two different types of systemic therapy before and after surgery? See Discussion.
Discussion:
For example, chemotherapy and immunotherapy administered first, followed by surgery, then immunotherapy and hormone therapy after surgery. Or is code 4 used for two administrations of chemotherapy before surgery and two more courses after surgery?
Answer:
Assign code 4 for the example you describe. Code 4 also applies to cases with one course of chemotherapy before surgery and another course after surgery.
