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Report Produced: 02/12/2026 16:49 PM

Report Question ID Question Discussion Answer Year
20071058

CS Tumor Size: Is a measured "area" equivalent to a tumor, mass or lesion size? See Discussion.

Collaborative Stage manual, page 26

Rule 4a: "always code size of the primary tumor, not size of the polyp, ulcer, cyst or distant metastasis."

Rule 4e: Additional rule for breast primaries: Example: Duct carcinoma in situ covering a 1.9 cm area with focal areas of invasive ductal carcinoma. Record the tumor size as 1.9 cm.

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.In general, a measured area is not equivalent to a tumor size.

Do not apply the rule related to the breast example to other primary sites. This example in the CS manual pertains to coding tumor size for breast primaries when the size of the invasive component is not stated. In the example, the area involved with duct carcinoma in situ is the only measurement available. The size of the invasive component was not given.

 2007
20091036 CS Mets at DX/CS Extension--Ovary: Is carcinomatosis always captured in the CS Mets field? Can the term carcinomatosis be used to describe peritoneal implants as well? See Discussion.

1/18/06 CT guided biopsy of abdominal mass & ant peritoneum nodule: Extensive carcinomatosis affecting the paracolic gutters, liver surface & pelvis. 6 cm tumor mass was visibly engulfing the small bowel & tube; poorly differentiated adenoca, mullerian derived, shows attributes of clear cell carcinoma, high grade (FIGO III), 2.5 cm size, does not involve fallopian tube. R&L abdominal wall & mesentery, mets adenoca.

5/31/06: tumor debulking with right salpingo-oophorectomy. Final DX: Poorly differentiated adenocarcinoma, clear cell type, right ovary (FIGO III), stage IV per MD.

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.In the case of ovarian cancer, the term carcinomatosis may refer to peritoneal implants, especially when the implants are numerous. It does not refer to distant metastases in this context.

This issue has been forwarded to the CS version 2 committee.

 2009
20051140 CS Reg LN Pos/Exam--Breast: How are nodes positive/examined coded for a positive FNA of a lymph node followed by a subsequent lymph node dissection? See Discussion.

A breast cancer patient had an FNA of an axillary lymph node positive for metastases. A modified radical mastectomy with lymph node dissection showed six lymph nodes negative for metastases.

Example 1: Patient received neoadjuvant chemotherapy prior to mastectomy and lymph node dissection.

Example 2: Patient received no neoadjuvant therapy.

This question is answered for EOD in SINQ 20031059. What is the answer for Collaborative Stage?

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.Include all nodes examined by the pathologist in Regional lymph nodes positive and Regional lymph nodes examined, unless there is disease progression. These fields are cumulative -- record the total number of regional nodes positive and examined during first course of treatment. Preoperative treatment does not affect the coding of these fields.

An FNA alone, positive for regional lymph node metastasis is coded as 95 for number positive and 95 for number examined.

For the case examples above, assuming there has been no disease progression, include all nodes positive and all nodes examined from both the FNA and the lymph node dissection in the counts. Code number of regional nodes positive as 01, number examined as 07 for both examples.

 2005
20051144 CS Lymph Nodes: Are lymphatic channels/vessels within an organ coded as regional lymph nodes?

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.Lymphatic channels/vessels carry lymph fluid throughout the organs and tissues of the body. Lymph channels/vessels within an organ are not nodes. Lymph channels/vessels outside an organ are not nodes.

 2005
20071098 Multiplicity Counter/Date of Multiple Tumors/CS Tumor Size--Lung: How are these fields to be coded when work-up of a malignancy spans a couple of months and reveals developing nodules? See Discussion. Example: Chest CT on 4-26-07 reveals 2.2 cm mass in lingula, left lung, consistent with lung malignancy. Biopsy on 5-18-07 shows non-small cell carcinoma. PET scan on 6-6-07 shows left upper lobe mass consistent with known non-small cell lung carcinoma. Second developing mass increasing in prominence since 4-07 in periphery of left upper lobe, approximately 3.6 cm which may represent intrapulmonary mets or second primary neoplasm. At least 3 additional intrapulmonary nodules have developed since 4-07, two in the left upper lobe and one in the right upper lobe, suspicious for mets.

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.Multiplicity Counter/Date of Multiple Tumors

Apply the multiple primary rules first and record the number of tumors determined to be a single primary in Multiplicity Counter. Record the corresponding date in Date of Multiple Tumors. These data items may be updated once if future tumors are determined to be the same primary as the initial diagnosis.

CS Tumor Size

Include information gathered through

  • completion of surgery(ies) in first course of treatment OR

  • all information available within four months of the date of diagnosis in the absence of disease progression

    • WHICHEVER IS LONGER.

    Metastasis known to have developed after the diagnosis was established should be excluded.

    		 2007
    		20071089 CS Extension--Ovary: Are "non-invasive implants" identified per pathology coded differently than "invasive implants"?

    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, non-invasive and invasive implants are not handled differently in collaborative staging for ovary.

    		 2007
    		20051124 CS Site Specific Factor--Prostate: Are the EOD guidelines developed for coding apex involvement still in effect for determining the code for apical involvement in SSF 4? See Discussion. How do the old prostate codes 31, 33, and 34 correspond to the new SSF 4 field? Because "arising in" or "extending into" apex is rarely, if ever, stated, previous SEER guidelines instructed us to use code 33 for "apex only" involvement, and code 34 for "apex and any other area of prostate". Code 31 [into/arising, NOS] was to be avoided.

    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 EOD guidelines for coding apex involvement are not in effect for coding SSF4.

    The codes for CS site specific factor 4 include code 2 [into prostatic apex/arising in prostatic apex, NOS]. When it cannot be determined if apical involvement is arising in, or extending to, the apex, use code 2.

    		 2005
    		20041046

    CS Tumor Size--Breast: When the diagnosis is inflammatory carcinoma of the breast, must the CS tumor size always be 998? See Discussion.

    		I have no specific example of a situation; I am writing an edit check and wondering if there would be any exceptions to this rule.

    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. For inflammatory carcinoma, code the size of the tumor in CS tumor size. Use code 998 [diffuse] when the tumor is stated to be "diffuse."

    Page 27 in Part I of the CS manual will be corrected to define code 998 for breast as only "diffuse." The errata should be distributed in July 2004.

    		 2004
    		20091107

    CS Extension--Lymphoma: Does peripheral blood involvement affect the stage for lymphoma? See Discussion.

    2009 Diagnostic Year

    Lymph node bx is positive for Mantle Cell lymphoma. Flow cytometry on lymph node tissue shows CD+ pos B cell lymphoproliferative disorder. IHC findings support Mantle Cell lymphoma. Flow cytometry on peripheral blood shows CD+ B cell lymphoproliferative disorder. Because the lymph node is positive for Mantle Cell lymphoma and the flow cytometry findings are the same on the lymph node tissue and peripheral blood, is the peripheral blood involved (Stage IV disease)?

    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. Peripheral blood is not the same as bone marrow involvement which is what would be required for stage IV.

    Lymphomas can arise in lymph nodes which are connected by lymphatic vessels. Both lymphatic vessels and blood vessels travel through lymph nodes and malignant cells can travel between the vessels. Cells in peripheral blood do not prove Stage IV.

    		 2009
    		20091041

    CS Lymph Nodes--Ovary: Are positive lymph nodes removed from "colon tissue" during a modified posterior pelvic debulking regional or distant? If regional, what is the appropriate CS LN code?

    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.Pericolonic lymph nodes are "regional" lymph nodes for an ovarian primary. If you do not have enough information to assign codes 12-30, assign code 50 [Regional lymph nodes, NOS].

    		 2009