Report | Question ID | Question | Discussion | Answer | Year |
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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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20041077 | CS Site Specific Factor 1--Colon: If the registrar did not support the CEA code recorded with the appropriate text documentation, should the central registry accept the registrars coding or change the value to 999? | 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.Accept your registrars' codes at your discretion. It is encouraged, but not required, to enter text for CS data elements. These cases do not automatically default to code 999. |
2004 | |
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20061005 | CS Reg LN Pos/Exam: Are lymph nodes coded as positive or negative when the pathology report for a lymph node dissection performed after radiation and chemo reveals that the nodes are negative but they demonstrated previous involvement by cancer? See Discussion. | Scenario: The patient was treated with radiation and chemotherapy prior to resection for esophageal cancer. The pathology report stated, "1/3 nodes c/w treated previous ca." | 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.Record lymph nodes that are pathologically confirmed as positive in Regional Nodes Positive. Evidence of previous involvement by cancer is not recorded in this data item. In the above scenario, the lymph nodes are negative according to pathology. Clinically positive lymph nodes are coded in CS Lymph Nodes. |
2006 |
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20091101 | CS Reg LN Pos/Exam--Melanoma: How should these fields be coded for a case that is an unknown primary site melanoma with liver involvement and a positive axillary lymph node? | 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.Code regional lymph nodes positive 01 [one positive lymph node] and regional lymph nodes examined 01 [one lymph node examined] (assuming the positive node was the only node examined). If the only lymph node involvement is the positive axillary lymph node, it is reasonable to conclude that this is a regional lymph node. When only one chain of lymph nodes is involved with metastatic melanoma, the metastatic cells had to come from skin with direct drainage to those lymph nodes. |
2009 | |
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20051044 | CS Reg LN Pos/Exam--Colon: For a patient with both a prostate and colon primary, if the pathology report indicates that 2 of the 3 regional lymph nodes to the colon are positive for a prostate malignancy, how should these fields be coded for the colon primary? | 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.For the colon primary, code Reg LN Pos 00 [all nodes negative]. Code Reg LN Exam 03 [three nodes examined]. Three lymph nodes were examined and found to be negative for metastatic colon cancer. |
2005 | |
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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 |
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20041079 | CS Mets at Dx/CS Mets Eval--Colon: Would the metastasis field be coded to 00 [No; none] and the evaluation field be coded to 1 [No path exam of metastatic tissue performed.] when the source of information is from the operative findings for the following 6 different cases? 1) Liver normal; 2) No evidence of metastatic disease; mesentery normal, 3) Small ascites; no liver metastasis, mass adherent to duodenum without obvious invasion, 4) No mets or local invasion, 5) No evidence of carcinomatosis, peritoneal studding or malignant effusion and 6) Tumor adherent to lateral sidewall (path negative); no evidence of metastatic 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. The CS Mets Eval code refers to the method used to evaluate the site farthest from the primary site. The correct code may not be the highest eval code. For example 1 above, if the liver is the site farthest from the colon primary that was evaluated for distant mets, code the CS Mets Eval code to the method used to evaluate liver. Code surgical evaluation as 1. Assuming this is all of the information about possible distant metastatic sites for the examples above, code CS Mets at DX as 00, and CS Mets Eval as 1 for each. Please note: imaging of farther sites should also be included when CS Mets at DX is coded. For example, if there was also a negative chest X-ray, the CS Mets at DX field would be 00 but the CS Mets Eval field would be 0 because the CXR documents that there are no mets beyond the immediate area of the tumor. |
2004 | |
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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 |
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20061125 | CS Lymph Nodes: Are positive right superficial inguinal lymph nodes coded to 30 (which is the case for anal canal primaries) or 31 (which is the case for anus primaries) if the primary is stated to be in the "cloacogenic zone" or is an anorectal primary? | 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 30 for positive unilateral superficial inguinal lymph nodes for cloacogenic primaries. The cloacogenic zone is part of the anal canal. |
2006 | |
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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 |