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SEER Inquiry System - Report
Produced: 05/21/2024 12:28 PM
Question 20240010
Inquiry Details
References:
#1: Solid Tumor Rules. Other Sites, May 2023 update
#2: WHO Class Male Genital Tumors, 223-224. 5th edition
Question:
Solid Tumor Rules/Histology--Prostate: Other Sites Solid Tumor RulesTable 3 (Prostate Histologies), Note 1 in the Adenocarcinoma with neuroendocrine differentiation (8574/3) row, conflicts with Note 2 and requires further clarification. See Discussion.
Discussion:
Note 1 states that this histology is treatment-related neuroendocrine prostatic carcinoma demonstrating complete neuroendocrine differentiation or partial neuroendocrine differentiation with adenocarcinoma after androgen-deprivation therapy (ADT). Conversely, Note 2 says to code 8574/3 only when there is no history of previous prostate adenocarcinoma or history of androgen-deprivation therapy.
The WHO Blue Book does confirm this is a treatment-related histology, so it seems we would only use this for an adenocarcinoma with neuroendocrine differentiation (or even possibly a mixed histology tumor with adenocarcinoma and small cell carcinoma components) if the patient had previous treatment.
If this histology is treatment-related, why would we use this code for a patient without a history of prostate adenocarcinoma or androgen-deprivation therapy? Should Note 2 be corrected?
Does this histology apply to a post-treatment diagnosis of mixed adenocarcinoma and small cell carcinoma? If yes, should this clarification be added?
Answer:
Assign code 8574/3 only when there is
A history of androgen-deprivation therapy or
No history of previous prostate adenocarcinoma
Prostate cancer with neuroendocrine differentiation (PCND) can present as untreated primary pathology (i.e., a new primary) or more commonly as a post ADT and androgen receptor inhibition resistance phenomenon. PCND is either a newly diagnosed prostate cancer or a result of ADT indicated for treatment of other prostate cancers or other non-cancer diagnoses (e.g., benign prostatic hyperplasia) but not for the PCND diagnosis.
We will edit the notes to make them more clear.
