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Report Produced: 11/16/2025 05:42 AM

Report Question ID Question Discussion Answer Year
20091016 CS Extension--Pancreas: How do you code this field for a head of pancreas primary with involvement of portal and splenic veins? See Discussion. The splenic artery/vein is only mentioned in the body and tail scheme; no mention is made of this site in the pancreatic head scheme.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign CS extension code 54 [major blood vessels]. The portal vein is listed under code 54 for head of pancreas. The splenic vein branches from the portal vein.

 2009
20081108 CS Extension--Pancreas: How is this field coded for a head of pancreas primary with involvement of the inferior vena cava?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign CS extension code 54 [Blood vessel(s) major]. The inferior vena cava is one of the major blood vessels.

The inferior vena cava is located just behind the head of the pancreas. The hepatic artery, the superior mesenteric vessels and the portal vein are nearby.

 2008
20051143 CS Extension--Prostate: Can the EOD Manual clarifications regarding apparent and inapparent tumors be used to determine CS clinical extension for prostate primaries?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Do not use the EOD information to determine apparent and inapparent when coding Collaborative Stage for tumors diagnosed 1/1/2004 or later.

The August 2007 CoC Flash stated that "After consultation with the AJCC curators for genitourinary disease, the CS Steering Committee has determined that the SEER list of terms for apparent and inapparent in the SEER Extent of Disease Manual is NOT to be used for interpreting reports for Collaborative Staging. While it was a convenient tool for registrars, the curators are of the opinion that the use of the list will lead to misinterpretation of reports. Rather, the curators recommend that registrars rely on a direct physician statement of apparent or inapparent disease for Collaborative Staging."

August 2007 CoC Flash: http://www.facs.org/cancer/cocflash/august07.pdf, Coding Prostate Cancer: A Message from the Collaborative Staging Steering Committee.

 2005
20071017 CS Extension--Prostate: Can the phrase "hard, fixed prostate" be interpreted as clinical extracapsular extension and coded to 50 [extension or fixation to other structures]? See Discussion.

Patient had a "hard, fixed prostate" with needle core bx positive for Gleason grade 4+5=9 adenocarcinoma extensively involving gland. PSA was 87.5. Lymphadenectomy showed 3 positive pelvic/obturator lymph nodes. No prostatectomy was done and no physician TNM staging documented.

Do we need a specific clinical description of other organs to which the prostate is fixed in order to code CS Clinical Extension 50, or does the statement "hard, fixed prostate" qualify? If not, how would we code extension for this seemingly advanced cancer?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign extension code 50 [extension or fixation to adjacent structures] based on the term "fixed." Fixation to a particular structure(s) does not have to be specified in order to use code 50.

Do not use the statement "hard" to determine CS extension.

 2007
20061090 CS Extension--Prostate: Does the term "activity" in a Prostascint report indicate a clinically apparent tumor, tumor extension or tumor involvement for this primary site? (http://www.rtrurology.com/prostascint.htm)

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

No, the term "activity" alone does not indicate clinically apparent tumor or involvement.

 2006
20041054 CS Extension--Prostate: For a tumor that is clinically inapparent, but a biopsy from the prostatic apex is positive, is this field coded to 15 [Tumor identified by needle biopsy, e.g., for elevated PSA (clinically inapparent)]?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Yes. Code CS Extension-Clinical Extension to 15 [Tumor identified by needle biopsy, e.g., for elevated PSA (clinically inapparent)] for clinically inapparent prostate cancer with positive apex biopsy.

 2004
20000539 CS Extension--Prostate: How do you code clinical extension for prostate primaries diagnosed at autopsy? See discussion.

A patient was not diagnosed prior to autopsy. The autopsy diagnosis states that this is adenocarcinoma of the prostate without capsular invasion.

Should clinical extension be coded to clinically inapparent, NOS (10) and pathologic extension be coded to no prostatectomy done within first course of treatment (97)?

 Code CS Extension (clinical) to 99 [Unknown]. Code SSF 3 according to the amount of tumor found using the information from the autopsy. 2000
20071035 CS Extension--Prostate: Should CS Clinical Extension always be coded to 99 [Extension unknown] for prostatic adenocarcinoma found incidentally during surgery for another primary or at autopsy? See Discussion.

Patient had a cystoprostatectomy for bladder cancer. Pathology report states only 2 microscopic foci of prostate adenocarcinoma found on LEFT side of gland. Physician notes state patient has been followed for 4 years with a nodule in the RIGHT prostate and has refused biopsy despite rising PSA. There was no definite statement of suspected cancer.

Should CS Clinical Extension be coded 99 because prostate cancer wasn't clearly stated to have been suspected until cystoprostatectomy? Or could we code the right-sided "nodule" as clinically apparent (CS Extension 20), even though path found tumor only on the left (which is how we would code a standard prostate case)?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Code CS extension 99 [Extension unknown]. This prostate cancer was not clinically evident; it cannot be clinically assessed based on the information provided.

Note: This is an unusual case. A DRE was performed and a nodule was palpated on the right that was not cancer. The other lobe is presumed to have been negative because it was not mentioned.

 2007
20051068 CS Extension--Retinoblastoma: When the degree of extension differs between the retinas, how is extension coded for simultaneous bilateral retinoblastoma?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign the CS extension code that corresponds to the greatest level of extension seen in either eye, excluding information from enucleation.

Record extension based on enucleation in Site Specific Factor 1.

Record bilateral disease under laterality. For retinoblastomas, bilaterality is not a component or consideration for staging.

 2005
20021070 CS Extension/CS Lymph Nodes--Breast: How would you interpret the phrase "axillary lymph node tissue, not clearly a lymph node" or the phrase "satellite nodule of invasive tumor, left axillary lymph node or chest wall tissue"? See discussion. A lumpectomy with axillary lymph node dissection and removal of nodule in anterior axillary line revealed negative lymph nodes. The nodule specimen was labeled "axillary lymph tissue, not clearly a lymph node". The microscopic description for that specimen stated "Fibroadipose tissue. A fragment of a lymph node is incidentally sampled in block 4 and it is free of tumor". The final path dx stated "Satellite nodule of invasive tumor, left axillary lymph node, or chest wall tissue. Comment: If the tissue is considered chest wall this would be a stage IIIB. If it is considered an intramammary satellite nodule, this is a stage I". The clinician repeated what the comment said, and added "If lymph node mets, this is a stage II." Code the invasive tumor in the axillary area as a regional lymph node metastasis. According to the AJCC, cancerous nodules in the axillary fat adjacent to the breast, without histologic evidence of residual lymph node tissue, are classified as regional lymph node metastases. 2002