SEER Inquiry System - Search

Instructions for First Course of Therapy include using the documented first course of therapy (treatment plan) from the medical record. While a patient may weigh in on the treatment decision, the physician is responsible for developing and managing the treatment plan including closely watching a patient’s condition but not giving treatment unless symptoms appear or change.

We can add language to a future manual to clarify.

Abstract two primaries and assign

Primary 1: C772, 9699/3

Primary 2: C162, 9699/3

Per Rule M7, you would change the first case to histology 9699/3 based on Note 4 under Rule M7, Note 4: Change the histology code on the original abstract to the more specific histology when the original diagnosis is in your registry database. Use previous editions of ICD-O (i.e., ICD-O-1, ICD-O-2) or the Hematopoietic Database to assign the code applicable to the year of diagnosis for the more specific histology.

Per Rule M2 this would be the same primary based on both being the same histology; however, there is an exception for MALT lymphomas (9699/3), which states: Abstract multiple primaries when a nodal MALT (C770-779, 9699/3) occurs before or after an extranodal MALT (all other sites, 9699/3).

Code histology as squamous cell carcinoma, NOS (8070/3) using Lung Solid Tumor Rules, Rule H3 if no other information is available.  Rule H3 states:  If the case is accessioned (added to your database) based on a single histology described by ambiguous terminology and no other histology information is available/documented, code that histology.

This is a correction to the SEER manual. Lymphomas originating in lymph nodes (C77) could have distant metastases to any site except lymph nodes. The following corrections to the manual apply now and will appear in the next version of the manual.

Remove C770-C779 from the instruction for assigning code 8 on the following pages.

Page 135 Mets at Dx--Bone

Page 137 Mets at Dx--Brain

Page 139 Mets at Dx--Liver

Page 141 Mets at Dx--Lung

Page 145 Mets at Dx--Other

Example

Biopsy of axillary lymph node: Diffuse Large B-Cell lymphoma. Lymph nodes involved above and below the diaphragm, multiple nodules seen in lung, lesions in liver. Bone marrow biopsy positive for DLBLC. Per Hematopoietic manual, primary site would be C778 for multiple lymph node regions involved.

Mets at Dx--Bone-0

Mets at Dx--Brain-0

Mets at Dx--Liver-1

Mets at Dx--Lung-1

Mets at Dx--Distant Lymph Nodes-8

Mets at Dx--Other-1

The following cancer cases are reportable unless there is information to the contrary.

–Liver cases with an LI-RADS category LR-4 (reportable since 2021) or LR-5 (reportable since 2016)

–Prostate cases with a PI-RADS category 4 or 5 (reportable since 2017)

The following are not reportable without additional information.

–Breast cases designated BI-RADS 4, 4A, 4B, 4C or BI-RADS 5

–Lung cases designated Lung-RADS 4A," 4B, or 4X

–Liver cases based only on an LI-RADS category of LR-3

–Colon cases with only C-RADS information (C-RADS category C4 is not reportable by itself)

–Head and Neck cases with only NI-RADS information (NI-RADS category 3 is not reportable by itself)

–Ovarian or fallopian tube cases with only O-RADS information (none of the O-RADS categories are reportable without additional information)

–Thyroid cases with only TI-RADS information (none of the TI-RADS categories are reportable without additional information)

Assign the neoadjuvant therapy data items as if the patient had neoadjuvant therapy.  Neoadjuvant Therapy data item would be coded either code 1 or 2 depending on whether the chemotherapy was completed or not. In this case, they are a surgical candidate by having the chemotherapy with the plan from the beginning to evaluate the chemotherapy after X cycles to see if surgery can be performed. After the patient is evaluated, update the abstract as needed.

Assign code 999 for Tumor Size--Pathologic when there is no surgery of the primary site. Code 999 includes "No excisional biopsy or tumor resection done."

Assign primary site code C473 for this case based on the information provided (peripheral nerves and autonomic nervous system of thorax).

From our expert pathologist consultant: The origin of neuroblastomas is generally in the adrenal medulla or one of the sympathetic ganglia on either side of the vertebral column (although they have been reported in many other locations given the migration of the neural crest cells embryologically).

Spinal cord tumors (including lipomas) are reportable when they arise in the spinal dura or nerve root. The tumor must be of the spinal cord itself or within the spinal cord dura. Spinal cord tumors are reportable when they arise in the intradural space. A reportable intradural tumor can be either intramedullary or extramedullary. Extramedullary intradural spinal tumors are reportable. A spinal tumor originating in the extradural space is not reportable. If it is outside the dura, it is not reportable because it would be outside the CNS. They are not reportable when they arise in the peripheral nerves.

Endometrial hyperplasia with atypia is equivalent to atypical hyperplasia of the endometrium (8380/2) and thus reportable for cases diagnosed 2021 and later. Our expert pathologist consultant confirmed this for us.