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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 tumor size as 999 [unknown]. Size of the focal noninvasive papillary carcinoma is not stated.

Non-genital skin primaries with a histology code equal to or less than 8110 are not reportable to SEER; therefore, the combination of C44_ and 8046/3 is not reportable.

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.Yes, the IPI score from the TNM form can be used to code SSF 3. Without further information, code "low" as 000 [0 points]. Code "high" as 004 [4 points].

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.

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].

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 prostate and other "inaccessible sites" with localized disease, code the regional lymph nodes as clinically negative when not mentioned on imaging or exploratory surgery.

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.

This submucosal metastasis does not affect CS extension. It is not part of CS or TNM staging.

According to the TNM supplement, "Multiple tumour foci in the mucosa or submucosa ("skip metastasis") are not part of the TNM classification and should not be classified as distant metastasis.

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.No, the EOD guidelines for coding apex involvement are not in effect for coding SSF4.

The codes for CS site specific factor 4 include code 2 [into prostatic apex/arising in prostatic apex, NOS]. When it cannot be determined if apical involvement is arising in, or extending to, the apex, use code 2.

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 tumors diagnosed prior to 2007:

Regression does not affect CS staging for cutaneous melanoma. "Malignant melanoma, regressing" [8723] is coded only when it is the final diagnosis. Do not use code 8723 for the examples above.

According to our pathologist consultant:

Melanoma can occasionally undergo "spontaneous" regression -- the tumor can become smaller, and in some cases even disappear. This phenomenon is likely due to an increased immune response on the part of the "host" (person with the melanoma). This is noted occasionally in patients with metastatic disease which gets smaller, or even disappears. We think this is also what has happened in patients who get diagnosed with metastatic melanoma, say in a lymph node, but have no primary tumor, though sometimes give a history of a skin lesion which came and then went away, or a skin lesion which was not submitted for pathological examination. In addition, we (pathologists) occasionally see biopsies which have melanoma as well as the presence of the immune reaction to it, and once in a while, the immune reaction with little or no evidence of residual melanoma.

The College of American Pathologists says that regression of 75% or more of the melanoma carries an adverse prognosis.

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.

Code site to C495 [connective tissue of pelvis, groin].

This was not called metastatic PNET and no other site of disease is noted. PNET is a broad classification of a group of tumors that usually occur in the CNS and can also occur in soft tissue (neuroblastoma, extra-osseous Ewing sarcoma).