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SEER Inquiry System - Report
Produced: 11/29/2024 9:45 PM
Question 20240073
Inquiry Details
References:
#1: Solid Tumor Rules. Urinary, 2024 Update
#2: 2021 ICD-O-3.2 Update
Question:
Solid Tumor Rules/Multiple Primaries--Bladder: Urinary Sites Solid Tumor Rules (STRs), Rule M6, says to abstract multiple primaries when an invasive tumor occurs more than 60 days after an in situ tumor. Does that 60-day interval apply to the original diagnosis date, or to the latest recurrence? See Discussion.
Discussion:
10/2017 Bladder cancer diagnosed as invasive papillary urothelial bladder carcinoma (8130/3) (submucosal invasion).
12/2017 Surveillance scope and transurethral resection of bladder tumor (TURBT) finds “recurrent” bladder tumor, non-invasive papillary urothelial bladder carcinoma (8130/2) - same primary per 2007 Multiple Primaries/Histology, Rule M6, (both papillary urothelial bladder carcinomas).
4/2018 Radical nephrectomy found focally invasive urothelial carcinoma (8120/3) in the renal pelvis.
Is this a new primary per 2018 and forward STR, Rule M6, because it was more than 60 days since the 12/2017 in situ bladder recurrence? Or would one compare the 2018 diagnosis to the original invasive bladder tumor in 10/2017, and continue on to Rule M11, which says to abstract a single primary for urothelial carcinomas in multiple organs, regardless of behavior?
SINQ #20120080 said to compare to the original diagnosis and disregard intervening recurrences, but that pertained to the 2007 MP/H rules. Does this still apply for 2018 forward? STR, Rule M10, Note 3, states when there is a recurrence within three years of diagnosis, the “clock” starts over. The time interval is calculated from the date of last recurrence. Comparing each recurrence for urothelial carcinomas using Rule M6 could result in over-counting them. Can the instructions on how to calculate the 60-day interval be clarified in Rule M6?
Answer:
Abstract a single primary for this scenario based on Urinary Sites STRs.
10/2017 and 12/2017 bladder diagnoses: Single primary (Rule M15: Abstract a single primary when synchronous, separate/non-contiguous tumors are on the same row in Table 2 in the Equivalent Terms and Definitions). This interval is not indicative of recurrence as there is no clinically disease free period on follow-up.
Use the Multiple Primary Rules as written to determine whether a subsequent tumor is a new primary or a recurrence as stated in the General Instructions. The only exception is when a pathologist compares slides from the subsequent tumor to the “original” tumor and documents the subsequent tumor is a recurrence of the previous primary. Never code multiple primaries based only on a physician’s statement of “recurrence” or “recurrent.”
12/2017 (bladder) and 4/2018 diagnoses (renal pelvis): Single primary (Rule M11: Abstract a single primary when there are urothelial carcinomas in multiple urinary organs; behavior is irrelevant.)
