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Report Produced: 10/07/2026 11:40 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20230061

EOD 2018/EOD Primary Tumor--Prostate: How is Extent of Disease (EOD) Prostate Pathologic Extension coded when no residual cancer is found? See Discussion.

Patient was diagnosed with a pT1c prostate cancer in 2022. Patient was then treated with radical prostatectomy. No residual disease was found. Would the correct EOD prostate path extension code be 999 based on Note 8 (code 999 when radical prostatectomy is performed, but there is no information on the extension); or, would we use code 300 (confined to prostate) because the data item "...is used to assign pT category for prostate cancer based on radical prostatectomy specimens" and we know it was limited to the prostate because no residual was found?

Assign code 300 for EOD Prostate Pathologic Extension.

In this scenario, the patient has a localized cancer confirmed by radical prostatectomy; the needle core biopsies likely removed all the cancer. Unlike prostate, other sites’ extension information is collected in EOD Primary Tumor, as seen commonly with breast tumors where the results from the surgical resection are recorded with tumor confined to primary site.

Prostate EOD Primary Tumor 2023
20031076 EOD-Size of Primary Tumor--Prostate: Is this field coded to the size of a hypoechoic mass identified on a TRUS when there is no tumor size from the prostatectomy specimen? For cases diagnosed 1998-2003: Ultrasound measurement of a malignancy can be used to code EOD-Size of Primary Tumor. Information on tumor size taken from imaging/radiographic techniques has low priority, just above physical examination. Prostate N/A 2003
20160057

MP/H Rules/Histology--Prostate: What is the histology code for a prostate case whose histology reads “adenoca with mixed ductal and acinar variants?

Assign 8523/3.

The 2013 revision to ICD-O-3 has a new code for mixed acinar ductal carcinoma; however, this new code will not be implemented in the U.S. until 2018 or later. Page 7 of the Guidelines for ICD-O-3 Update Implementation document released by NAACCR 1/1/2014 instructs us to use 8523/3 in the meantime.

Prostate Histology 2016
20000516 Diagnostic Confirmation--Prostate: How do we code this field when there is an elevated PSA, no other work-up and there is a clinical diagnosis of adenocarcinoma? Code the Diagnostic Confirmation field to 5 [positive laboratory test/marker study] to indicate the diagnosis is based upon an abnormal PSA tumor marker if the physician uses the PSA as a basis for diagnosing prostate cancer. Prostate Diagnostic confirmation 2000
20091103 Reportability/Ambiguous Terminology--Prostate: Is a prostate biopsy that states "highly suspicious for, but not diagnostic of adenocarcinoma, suggest another biopsy" reportable? Do not report. "Not diagnostic of" means that while the pathologist is seeing some features that resemble cancer, there are not enough features to feel comfortable making an unquestionable diagnosis. Watch for another biopsy of the patient in the next 3-6 months. The statement "not diagnostic of" overrules the "highly suspicious" statement. Prostate N/A 2009
20010158 EOD-Pathologic Extension--Prostate: Does capsular invasion (code 32) take priority over apex extension (code 34) on prostate primaries? See discussion. On prostatectomy, adenocarcinoma involves left apex and also left mid lobe where it focally invades capsule. Do we code extension to 34 - the highest numerical code, or to 32 to capture the capsular invasion? Do codes 33 and 34 represent a subset of code 31, and would code 32 represent greater tumor involvement?

For cases diagnosed 1998-2003:

Code the EOD-Pathologic Extension field to 32 [Invasion into (but not beyond)prostatic capsule] when there is both capsular and apex invasion of the prostate.

Although numerically lower, code 32 takes precedence over codes 33 [arising in the apex] and 34 [extending to the apex]. Codes 33 and 34 are "subsets" of code 31 [Into prostatic apex/arising in prostatic apex].

 Prostate N/A 2001
20240045

Reportability/Ambiguous Terminology--Prostate: Should cases be reported and abstracted based on ambiguous terminology, e.g., suspicious for prostate cancer, when the physician is not treating the case as malignant? See Discussion.

Please comment on these specific scenarios.

  1. A prostate biopsy is suspicious for adenocarcinoma, but the urologist is not considering this malignant, nor is the urologist treating for malignancy, but there is no clear statement from the physician that this is not reportable.  Should this case be abstracted?
  2. A prostate biopsy is suspicious for adenocarcinoma, and there is a statement by the physician that this is not yet malignant. Should this case be abstracted?
  3. Prostate MRI with PIRADS 4 or 5; however, the treating urologist does not call this malignant and is not treating patient for prostate cancer.  [Example: 2024 Prostate MRI - PI-RADS 4. Follow up with Urologist states patient to repeat Prostate MRI in 1 year and continue with yearly PSA levels and there is no mention of prostate cancer other than the PI-RADS score]. Should this case be abstracted?

For each of your scenarios, the medical record information indicates that the case is not reportable based on physician opinion. Do not abstract these cases.

Remember that the ambiguous terms list is to be used as a last resort. The ideal way to approach abstracting situations when the medical record is not clear is to follow up with the physician. If the physician is not available, the medical record, and any other pertinent reports (e.g., pathology, etc.) should be read closely for the required information. See page 19 in the SEER Manual, https://seer.cancer.gov/manuals/2024/SPCSM_2024_MainDoc.pdf

 Prostate N/A 2024
20230076

Solid Tumor Rules/Histology--Prostate: How is histology coded and what rule applies to a diagnosis of “prostatic adenocarcinoma with neuroendocrine differentiation” with reference to the Comment: Immunohistochemical findings are consistent with amphicrine carcinoma for a patient with no prior androgen-deprivation therapy. See Discussion.

The case in question represents an adenocarcinoma with neuroendocrine differentiation that arises in the absence of androgen-deprivation therapy. A 2023 journal article states, “We show that amphicrine prostate cancer is a unique entity and differs in clinical and molecular features from high-grade neuroendocrine carcinomas of the prostate. Our study highlights the need to recognize AMPC as a unique molecularly defined subgroup of prostate cancer.”

Should we be coding this with histology 8140 (Adenocarcinoma, NOS) because we have no specific code for an amphicrine carcinoma? Should we code this as 8045 (Mixed small cell carcinoma) because this is possibly the only way to capture both the adenocarcinoma and neuroendocrine components in a patient without previous treatment?

Our concern about using histology code 8574 (Adenocarcinoma with neuroendocrine differentiation) is that, while a valid histology code, this might confound the data if researchers are trying to separate the truly treatment-related tumors from other histologies captured under 8574.

Assign 8140/3 (adenocarcinoma, NOS). WHO has not yet recognized the variant amphicrine prostate carcinoma and have not proposed an ICD-O code for this neoplasm. Document information in a related text field.

 Prostate Histology 2023
20020044

Terminology/EOD-Extension--Prostate: How does SEER define the prostatic "apex"? See discussion.

Some pathologists define the prostatic apex as including the bottom third of the prostate whereas others regard only the bottom-most portion of the gland to be the apex.

SEER defines the apex as being the bottom-most portion of the gland. Apex means "narrowest part," which in the prostate would be the bottom-most portion of the gland.

 Prostate N/A 2002
20210054

EOD 2018/EOD Primary Tumor/Tumor Size--Clinical--Prostate: How is Tumor Size--Clinical coded when there is an incidental finding of prostate cancer on prostatectomy for another reason? See Discussion.

SEER*RSA states EOD Primary Tumor should be coded to 800 for an incidental finding of prostate cancer on prostatectomy for other reasons.

The SEER Manual states to assign code 000 for Tumor Size--Clinical when EOD Primary Tumor is coded to 800; however, the definition for Tumor Size--Clinical indicates clinical classification is composed only of diagnostic workup prior to treatment.

If there is no clinical workup for an incidental finding of prostate cancer, code 000 does not seem appropriate (does not meet criteria for clinical classification). Code 999 seems more appropriate for incidental findings during surgery for other reasons. The SEER Manual does not provide this exception in the current instruction.

Assign code 000 for Tumor Size--Clinical when EOD Primary Tumor is coded 800 (No evidence of primary tumor). Code 000 indicates no tumor was found since there was no clinical workup to identify this incidentally found cancer. This is a special instruction for cases coded 800 in EOD Primary Tumor. Text fields can be used to record details.

 Prostate EOD Primary Tumor, Tumor size 2021