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20051066 | CS Site Specific Factor--Prostate: Explain the difference among SSF4 prostate codes 150 [No clinical involvement of prostatic apex & prostatectomy apex extension unknown], 510 [Clinical involvement of prostatic apex unknown & No prostatectomy apex extension], and 550 [Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown]. |
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.Site Specific Factor 4 captures the status of clinical apex involvement and prostatectomy apex involvement. The first digit in codes 110-550 indicates the clinical status of apex involvement. The second digit indicates apex involvement found at prostatectomy. The third digit is always zero. For both first and second digits, the codes and definitions are the same: 1 - No involvement of prostatic apex 2 - Into prostatic apex/arising in prostatic apex, NOS 3 - Arising into prostatic apex 4 - Extension into prostatic apex 5 - Apex extension unknown Code 150 = No clinical involvement of prostatic apex & prostatectomy apex extension unknown Code 510 = Clinical involvement of prostatic apex unknown & No prostatectomy apex extension Code 550 = Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown |
2005 | |
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20051011 | CS Lymph Nodes/CS Site Specific Factor--Breast: When there are no lymph nodes removed and none palpable for an inflammatory breast cancer and the physician stages the case Nx, is the CS Lymph Node field code to 00 [None, no regional lymph nodes involved] or 99 [Unknown, not stated] and would SSF 4 and 5 be coded to 000 [Regional lymph nodes negative...] or 888 [Not applicable]? | 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 CS Lymph Nodes 00 [clinically negative]. See note 3 for CS Lymph Nodes. Code SSF 4 and 5 000 [Nodes clinically negative]. |
2005 | |
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20051055 | CS Lymph Nodes/CS Mets at Dx--Lung: In which CS field is a focus of squamous cell carcinoma in the soft tissue coded for a lung primary? See Discussion. | Final Pathologic Diagnosis: 1. Right upper lobe mass, lobectomy: Extensive well differentiated squamous cell carcinoma 2. Right hilar lymph nodes: No tumor identified in nine hilar lymph nodes. A focus of squamous carcinoma is present in soft tissue |
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 a separate focus of squamous cell carcinoma in soft tissue in the CS Mets at DX field. Use this field to capture discontinuous metastasis. Code CS Mets at DX as 40 [Distant mets except distant lymph nodes] for the case described above. |
2005 |
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20051020 | CS Extension/CS Site Specific Factor--Breast: How is extension (localized or unknown) and SSF6 (entire tumor in situ or 888) coded for an in situ breast primary in which bone metastasis is diagnosed 4 months following the mastectomy? See Discussion. | In situ breast primary with bone mets. No mets work up prior to mastectomy done 2/04. Path: 2.5 cm mass: ductal carcinoma in situ, solid type, with comedonecrosis (no invasive carcinoma found in mastectomy specimen). Bone scan done 4/04 showed compression fractures. MRI 6/04 showed diffuse metastatic disease of the bones. | 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. First, determine whether the bone mets in this case are progression of disease. If the patient was asymptomatic at the time of the mastectomy, the bone mets are disease progression, not initial stage. If the initial stage includes the bone mets and they are not disease progression, extension must be coded to at least 10. Code site-Specific Factor 6 to 040 [Size of entire tumor coded, size of invasive component not stated]. |
2005 |
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20051048 | Multiple Primaries (Pre-2007)/Recurrence--Cervix: How many primaries should be abstracted if a patient had a diagnosis in 1998 of adenocarcinoma in situ of the cervix treated with a total hysterectomy and a July 2004 vaginal mass biopsy with a diagnosis of invasive adenocarcinoma that is consistent with an endocervical primary? | For tumors diagnosed prior to 2007:
Abstract the July 2004 diagnosis as a new endocervical primary. Abstract an invasive cancer in the same site more than two months after an in situ cancer as a new primary. Residual cervical tissue is present following a hysterectomy.
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. |
2005 | |
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20051046 | Reportability/Diagnostic Confirmation--Leukemia: What is the diagnostic confirmation if a positive BCR/ABL result is diagnostic of a malignancy in a patient suspected to have chronic myelogenous leukemia? See Discussion. |
Example 1: Peripheral smear states: "No morphologic evidence of chronic myelogenous leukemia." Addendum: Molecular diagnostic studies showed a positive rearrangement for the BCR gene with the M-bcr (CML type) and of bcr-abl transcript expression". Example 2: Hematopathology is negative. Molecular diagnostic study: "fluorescent in situ hybridization (FISH) studies exceeded the limits established by the XXX Cytogenetics Laboratory for this probe set, and thus, demonstrated statistical evidence of BCR/ABL fusion." |
For cases diagnosed prior to 1/1/2010: Do not determine reportablility using cytogenetics or molecular studies alone. Since these are not routine screening tests, we suggest that you query the physician and review the medical record to see what prompted the study and what is being done with the result, but the test alone is not in and of itself sufficient to report the case. For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2005 |
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20051129 | Reportability/Behavior--Thyroid: Does the term "invasion" indicate the presence of a malignant tumor? See Discussion. | Left thyroid lobectomy showed microfollicular neoplasm with evidence of minimal invasion. Micro portion of path report stated, "The capsular contour is focally distorted by a finger of the microfollicular nodule which appears to penetrate into the adjacent capsular and thyroid tissue." | We recommend that you contact the pathologist for further information. If no further information is available, do not accession this case based on the information provided. There is no definitive statement of malignancy. If the case was sent to a consultant, there may be another opinion available. If there is information in the record, or the treating physician can be contacted, find out whether the tumor was benign or malignant and whether there was any further treatment. According to our pathologist consultant, based only on the information above and nothing else, do not report since there is no diagnosis of malignancy. |
2005 |
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20051034 | Date Therapy Initiated/Reason no treatment--Lymphoma: Is the date of the lymph node biopsy used as the date of treatment if the lymph node biopsy is the first treatment or the only treatment performed? Is the reason for no surgery coded to 0 [Surgery of the primary site was performed]? | For cases diagnosed prior to January 1, 2008, enter the date of the lymph node biopsy (excisional biopsy or biopsy NOS) as the Date Therapy Initiated for a lymphoma when the biopsy is the first or only therapy performed.
Code Reason for No Surgery of Primary Site as 0 [Surgery of the primary site was performed] and the biopsy of a lymph node is coded to 25 in Surgery to Primary Site.
Do not code a fine needle aspiration or core needle biopsy in Surgery of Primary Site. |
2005 | |
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20051112 | Collaborative Staging--Hematopoietic, NOS: Which Collaborative Staging schema is used for a connective, subcutaneous and soft tissue primary of the pelvis [C495] with the morphology of Langerhans cell sarcoma [9756/39]? See Discussion. | On page C-411 of the SEER manual for the connective, subcutaneous, and other soft tissues schema it lists exceptions for certain morphologies and the above is not listed as an exception. On the Hematopoietic scheme it lists the above morphology. | 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.Use the hematopoietic schema on page C-709 of the 2004 SEER manual. The histologically defined schemas have priority over the site schemas when both apply. See page 115 of the 2004 SEER manual.
The morphology codes listed on page C-411 pertain to the SEER Site Specific Guidelines. |
2005 |
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20051111 | Chemotherapy/Immunotherapy: Which drugs changed categories when SEER*Rx came out? | Please refer to http://seer.cancer.gov/tools/seerrx/ SEER*Rx is effective for cases diagnosed 1-1-2005 and forward. It replaces all previous references. It is neither required nor recommended that cases treated prior to 2005 be recoded.
The following drugs in the 5/17/02 Book 8 update changed from immunotherapy to cytostatic chemotherapy in SEER*Rx: alemtuzumab/Campath bexarotene/Targretin bevacizumab/Avastin bortezomib/Velcade pegaspargase/Oncaspar rituximab/Rituxan trastuzumab/Herceptin asparaginase The following drugs may have been coded as monoclonal antibodies but are radioisotopes in SEER*Rx: epratuzumab/LymphoCide ibrituzumab tiuxetan/Zevalin tositumomab/Bexxar Any other monoclonal antibodies either remained as monoclonal antibodies or it was a local decision to code them as immunotherapy. There were no drugs that changed from chemotherapy to immunotherapy. |
2005 |
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