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Yes, "consolidation" treatment is part of a planned treatment regimen. A treatment regimen may consist of the four following phases:

1. Induction (remission induction)

2. CNS preventive therapy

3. Consolidation/intensification

4. Maintenance

For cases diagnosed 1998-2002:

Code the Reason for No Cancer-Directed Surgery field to 1 [Cancer-directed surgery was not recommended] for patients who present with either a primary site or histology for which surgery is not a standard treatment. Also use code 1 for those patients who present with distant disease for a primary site that is typically treated surgically. Patients with distant metastasis typically do not have surgery performed as part of first course of treatment.

Code 2 [Contraindicated due to other conditions] is used when surgery would normally be recommended for the site (given the current stage of the tumor) but other medical conditions pose too much of a risk for the patient to undergo surgery.

Code the Grade, Differentiation field to 9 [cell type not determined, not stated or not applicable]. For lymphomas, do not code the descriptions "high grade," "low grade," and "intermediate grade" in the Grade, Differentiation field. These terms refer to categories in the Working Formulation and not to histologic grade for lymphoma histologies.

Generally, for histologies other than Non-Hodgkin lymphoma, the Grade, Differentiation field is coded to 2 [low grade], 3 [intermediate grade] and 4 [high grade] for most cancers.

For tumors diagnosed prior to 2007:

Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells."

Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy."

See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

For cases diagnosed 1998-2003:

If the physician used a term not on the clinically apparent/inapparent list, ignore that term and use the best information available from other sources to code the EOD-Extension field.

If clarifying stage information is missing and the term is in the maybe category or the term is not on the list, then code EOD-Extension as 30 [localized, NOS] for cases that appear localized.

Report this case as 8240/3. In this context, well differentiated neuroendocrine neoplasm seems to be a synonym for neuroendocrine tumor (NET) G1 (carcinoid). According to the WHO classification, "Neuroendocrine neoplasms of the duodenum comprise NETs..."

For cases diagnosed 1998 and later:

Code the Surgery of Primary Site field to 17 [Other method of local tumor destruction]. HIFU uses focused energy to destroy tissue. It is classified as a surgical procedure.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Per Rule M10, abstract two primaries. Per the Heme DB, polycythemia vera [9950/3] transforms to an acute myelogenous leukemia [9861/3]. According to Rule M10, one is to abstract multiple primaries when a neoplasm is originally diagnosed as a chronic neoplasm (e.g., polycythemia vera) AND there is a second diagnosis of an acute neoplasm (e.g., acute myelogenous leukemia) more than 21 days after the chronic diagnosis.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.