Report | Question ID | Question | Discussion | Answer | Year |
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20051003 | CS Tumor Size/CS Eval--Breast: How are these fields coded when there is a clinical size recorded but the tumor size is not specified on the pathology report associated with a subsequent resection? See Discussion. | 4/8/04 excisional biopsy of 1.5 cm palpable mass. Path: gives a specimen size only and states that there is a nodular firm area that correlates with the clustered microcalcification on radiograph. No pathologic tumor size is given. Would the size be coded to the clinical size of 1.5 cm? The patient did have surgery but the only size available is a clinical one. Because the size is clinical, is the CS Eval field coded to 0 [No surgical resection done. Evaluation based on PE...]? | 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. Clinical size can be coded when the patient has had surgery. For the case above, code the tumor size as 015 [1.5 cm] using the clinical information. The CS Tumor Size/Extent Eval field refers to both tumor size and extension. In this case, record the eval field as 0 or 1 (which ever is appropriate). The tumor size sets the T category unless the resection shows skin or chest wall or dermal lymphatic involvement. |
2005 |
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20051052 | CS Tumor Size/CS Extension--Brain and CNS: How are these fields coded for a glioblastoma multiforme occurring in a 3.5 cm tumor in the parietal lobe and a 3.0 cm tumor in the occipital lobe? | 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. CS Extension code is 10 [confined to cerebral hemisphere]. Record the size of the largest lesion in CS Tumor Size. Both the occipital and parietal lobes are supratentorial and confined to the cerebral hemisphere with no mention of crossing midline or involvement of ventricles. |
2005 | |
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20051086 | CS Site Specific Factor 4--Prostate: For apex involvement at prostatectomy, is only apical involvement found at prostatectomy included or is all histologically proven apical involvement documented in the second digit of Site Specific Factor 4? See Discussion. | Per note 1 for Site Specific Factor 3 - Pathologic Extension all histologic information is used. Biopsy information would be included when coding path extension. Would all histologic information be used for coding prostatectomy apex involvement in Site Specific Factor 4? Example 1: Prostate biopsies of the right and left apex and right and left mid gland show adenocarcinoma. Prostatectomy shows bilateral adenocarcinoma. Apex negative for tumor. Example 2: Prostate biopsies of right apex and mid gland show adenocarcinoma. There is no mention of apex on prostatectomy path. How is CS Site Specific Factor 4 Prostate Apex Involvement coded? |
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 second digit of CS SSF 4 based on prostatectomy only, do not include biopsy or other histologic information in the second digit. According to the CS Steering Committee, the clinical or biopsy of the prostate is included in the first number of the code and should not be combined with the prostatectomy code which is the second number. These were separated purposely. Example 1: Code the second digit of SSF 4 based on the prostatectomy, 1 [no involvement of prostatic apex]. Example 2: Code the second digit of SSF 4 based on the prostatectomy, 5 [apex extension unknown]. |
2005 |
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20041087 | CS Extension--Head of Pancreas: What code is used to represent extension to the superior mesenteric artery? See Discussion. | In the CS coding scheme for Head of Pancreas, superior mesenteric artery is listed under both code 54 (T3) and 60 (T4). | 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 code 60 for a primary in the head of the pancreas extending to the superior mesenteric artery. CS Extension code 54 should be Superior mesenteric VEIN and code 60 should be Superior mesenteric ARTERY. An errata will be issued by CS. In addition, extension 54 indicates resectable disease and code 60 is not resectable. |
2004 |
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20061056 | CS Lymph Nodes--Colon: Are positive paracecal lymph nodes for cecal primaries coded to 10 [paracolic] or code 20 [cecal: anterior (prececal), posterior (retrocecal); NOS]? | 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 code 20 [Regional lymph node(s) for specific subsites]. Paracecal means near the cecum. Paracecal lymph nodes are regional nodes for the cecum and not for other colon subsites. |
2006 | |
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20051087 | CS Site Specific Factor 3--Prostate: When a prostatectomy specimen shows tumor focally penetrating through the capsule into periprostatic striated muscle tissue, is the involvement coded to 041 [periprostatic tissue] or 052 [skeletal muscle, NOS]? | 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 code 052 [Levator muscle, Skeletal muscle, NOS, Ureter]. The description for this case states periprostatic "striated" muscle tissue. According to our pathologist consultant, "striated muscle in this context is skeletal muscle and the term is being used to differentiate the muscle from smooth (non-striated) muscle." Smooth muscle involvement would be most likely be coded 050 [Extension to bladder neck...] because smooth muscle in a prostatectomy or TURP specimen is usually from the urinary bladder neck. |
2005 | |
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20051030 | CS Eval--All Sites: If any of the CS fields (TS/Extension, LN, or Mets) are based on the TNM and there is no text documenting the basis for the evaluation, are the evaluation fields coded to 0 instead of 1? | 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 code 0 [No surgical resection done...based on physical exam...or other non-invasive clinical evidence] to the corresponding eval fields when CS Extension, Lymph Nodes or Mets at Diagnosis are coded based only on the TNM and no further information is available. |
2005 | |
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20081115 | CS Extension--Brain and CNS: How is this field coded for a malignant tumor presenting as a confluent lesion over right parietal, posterior frontal and thalamic regions? | 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 40 [Tumor crosses the midline; Tumor involves contralateral hemisphere; Tumor involves corpus callosum (including splenium)] The thalamus is located between the corpus callosum and the cerebellum and brain stem. A supratentorial tumor extending to the thalamus involves the corpus callosum (extension code 40) but has not yet reached the cerebellum or brain stem. Code 40 applies, but code 50 or any higher code is not applicable in this case. |
2008 | |
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20091007 | CS Extension--Lung: How is this field coded for a tumor in the right middle lobe with extension to the bronchus intermedius? | 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 20 [Extension from other parts of lung to main stem bronchus, NOS (EXCLUDES superficial tumor as described in code 11) Tumor involving main stem bronchus greater than or equal to 2.0 cm from carina (primary in lung or main stem bronchus)].
A right middle lobe tumor that extends to the bronchus intermedius is one that is extending to the main stem bronchus from another part of the lung. The bronchus intermedius is the lower part of the main stem bronchus on the right. It is more than 2.0 cm away from the carina. |
2009 | |
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20061061 | CS Lymph Nodes--Breast: Clarify the use of code 25 [Movable axillary lymph node(s), ipsilateral, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm)] vs code 60 [Axillary/regional lymph node(s), NOS; Lymph nodes NOS] when surgically removed lymph nodes are positive but the size of the metastasis is not stated. See Discussion. | Note 2 in CS manual states: "If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2mm and code LNs as positive in this field. Use code 60 in the absence of other information about regional nodes." 1. If the LNs are known to be axillary LNs, note 2 seems to imply the size can be assumed to be greater than 0.2mm. Would you code 25 or 60? 2. Both codes 25 and 60 map to N1, node involvement. Do they each mean something else in the evaluation process? 3. What would constitute "absence of other information"? 4. Is the use of 60 over 25 specific to SEER registries or all users? 5. Abstractors are trained to assume LNs are mobile if there is no contrary information. Is this appropriate? |
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 Lymph Nodes code 25 for breast when there are positive axillary nodes without internal mammary nodes. Code 25 is used in a couple of situations: a. when you know the lymph nodes are clinically movable and only the axillary nodes are involved; b. when you know the size of the metastasis in an axillary lymph node is more than a micrometastasis (i.e., > 2 mm). Code 60 can be used for any regional lymph node (internal mammary, infra- or supraclavicular, as well as axillary. So you can code to 25 if you have "regular" metastases in axillary lymph nodes only. If you don't know whether the mets are micro or regular, use code 60. Assign code 60 when there are positive regional nodes not further described. 1. Assign code 25 for positive axillary lymph nodes. 2. Codes 25 and 60 may map to N1, N1a, N2a or N3a depending on the coding of SSF3. 3. Assign code 60 when there is not enough information to assign a code from 13 to 50. 4. CS instructions are the same for all users. There are no CS instructions specific to SEER registries. 5. Yes, assume lymph nodes are moveable (not matted, not fixed) when there is no information to the contrary. |
2006 |