SEER Inquiry System - Report
Produced: 06/02/2025 3:25 PM
Question 20250017
Inquiry Details
References:
#1: 2025 SEER Manual, 246-247; Appendix C-Site-specific codes for NT Treatment Effect-All Other Schemas. Neoadjuvant Therapy--Treatment Effect
#2: College of American Pathologists (CAP). https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates
Question:
SEER Manual/First Course Therapy--Neoadjuvant Therapy: How is Neoadjuvant Therapy--Treatment Effect coded for bladder cancers? The College of American Pathologists (CAP) Protocol for the Examination of Cystectomy Specimens From Patients With Carcinoma of the Urinary Bladder does not provide a clear distinction between the SEER site-specific codes for Neoadjuvant Therapy Treatment Effect for All Other Schemas, codes 2, 3, and 4, as compared to the CAP Treatment Effect Post Neoadjuvant Chemotherapy (BCG not included) categories. See Discussion.
Discussion:
CAP Protocol for the Examination of Cystectomy Specimens From Patients With Carcinoma of the Urinary Bladder/Treatment Effect Post Neoadjuvant Chemotherapy (BCG not included) selections
o No known presurgical neoadjuvant therapy
o Complete response: Absence of histologically identifiable residual cancer cells and extensive fibrosis of the tumor bed after presurgical neoadjuvant therapy (TRG1)
o Strong response: Predominant fibrosis of the tumor bed, with residual cancer cells occupying less than 50% of this area (TRG2)
o Weak or no response: Residual cancer cells occupying ≥50% of the tumor bed or absence of regressive changes (TRG3)
o Other (specify): _________________
SEER Coding Instruction for Site-Specific Codes for Neoadjuvant Therapy Treatment Effect - Schemas: All Other Schemas selections
0 Neoadjuvant therapy not given/no known presurgical therapy
1 Complete pathological response
Present: No viable cancer cells/no residual invasive carcinoma identified
Residual in situ carcinoma only
2 Near complete pathological response
Present: Single cells or rare small groups of invasive cancer cells
3 Partial or minimal pathological response
Present: Residual invasive cancer with evident tumor regression, but more than single cells or rare small groups of cancer cells
4 Poor or no pathological response
Absent: Extensive residual cancer with no evident tumor regression
6 Neoadjuvant therapy completed and surgical resection performed, response not documented or unknown
Cannot be determined
7 Neoadjuvant therapy completed and planned surgical resection not performed
9 Unknown if neoadjuvant therapy performed
Unknown if planned surgical procedure performed after completion of neoadjuvant therapy
Death Certificate only (DCO)
Answer:
Code Neoadjuvant Therapy--Treatment Effect using the surgical pathology report only. Carefully review the pathology report gross description and comments to assist with assignment of codes.
Review of neoadjuvant therapy data items is currently underway.