System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 03/02/2026 07:18 AM

Report Question ID Question Discussion Answer Year
20091024

MP/H Rules/Multiple primaries--Urinary: Are diagnoses in bladder, ureter, renal pelvis, and other urinary made prior to 2007 used in determining multiple primaries? See Discussion.

Per the General Information for MPH, Rule #3, the rules are effective for cases diagnosed January 1, 2007 and after. Do not use these rules to abstract cases diagnosed prior to January 1, 2007.

Example: Is a 2006 diagnosis of a renal pelvis primary with the histology 8130/3 and a 2007 diagnosis of a bladder primary with histology 8130/3 "multiple tumors" or is the bladder tumor a new primary because it is a single tumor at the time of diagnosis in 2007?

For cases diagnosed 2007 or later:

Use the 2007 MP/H rules for urinary sites to assess tumors diagnosed in 2007 or later.

For the example above, use the 2007 rules to determine whether or not the bladder tumor diagnosed in 2007 is a new primary. Use the Multiple Tumors module when comparing a 2007 or later diagnosis to an earlier diagnosis. Start with rule M3. Stop at rule M8. The 2007 bladder urothelial tumor is not a new primary since there is an existing 2006 renal pelvis urothelial primary.

 2009
20091096 MP/H Rules/Multiple primaries--Breast: How many primaries should be reported when an in situ diagnosis is followed by an invasive diagnosis in the same breast 1.5 years later? See Discussion. Patient had a core biopsy 1/07 that showed DCIS and PE showed no adenopathy. Patient refused resection, and adjuvant treatment. In 6/08, the pt returned for a modified radical mastectomy which showed infiltrating duct carcinoma and positive lymph nodes. A comment in the Correction Record stated "Per MD, patient did not see any urgency and delayed surgery 1.5 years after diagnosis." The patient did not have any treatment in that time period and there is no statement that there was progression. For cases diagnosed 2007 or later, abstract the 6/08 invasive diagnosis as a separate primary according to rule M8. Rule M8 applies whether or not the later diagnosis in this case is progression of disease. 2009
20091001 CS Lymph Nodes/CS Mets at DX--Ovary: Are lymph nodes in the pericolic mesentery of the sigmoid that are removed during ovarian cancer debulking surgery, coded as regional or distant? See Discussion. Debulking surgery found tumor in both ovaries and in lymph nodes of pericolic mesentery, which was removed en bloc with a segment of sigmoid colon (colon had tumor implants involving serosa). Pericolic nodes are not listed as regional for ovary. However Note 2 in the CS manual for Extension states "sigmoid mesentery" is a regional pelvic organ, and that metastatic deposits here should be coded in the extension field, not as distant mets. Should lymph nodes from this same area be coded as regional or distant?

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.

Lymph nodes in the mesentery of the sigmoid colon are regional for an ovarian primary. Code involved sigmoid mesenteric nodes under CS Lymph Nodes.

 2009
20091046 CS Lymph Nodes/CS Site Specific Factor--Melanoma: When CS Lymph Nodes is coded 13, 14 or 15 (codes used when satellite nodule(s) or in-transit metastases are present), why must CS SSF 3 be coded 000 (No lymph node metastasis)? See Discussion.

3/11/05 Consult - PE: huge exophytic lesion right lower leg (mushroom-type lesion), 6cm. Below that lesion is another ulcerative lesion 2cm. Right upper arm lesion w/ satellite nodule. Note from physician states malignant melanoma on right lower leg metastatic to the left arm/shoulder. No scans done so there is no assessment of the lymph nodes.

We coded CS LNS to 13, which captures the satellite nodule, CS SSF3 = 999 and CS Reg Nodes Eval = 0. SEER Edit 216 requires the SSF3 to be 000. SSF 3 is coded 999 as there is no information about the clinical status of 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.When CS lymph nodes is coded 13-15, SSF 3 must be coded 000. Follow the instruction in the SSF 3 Note: Use code 000, No lymph node metastases, if ... there are satellite nodules or in-transit metastases, but no regional lymph node metastases, i.e., CS Lymph Nodes is coded 13-15.

For this case, assign CS lymph node code 15 [Satellite nodule(s) or in-transit metastases greater than 2cm from primary tumor WITHOUT regional lymph node involvement or involvement of regional nodes not stated]. The arm lesion is more than 2cm from the leg lesion.

 2009
20091045 CS Tumor Size/CS Site Specific Factor--Breast: When tumor size is unknown, but it is known that both in situ and invasive components are present, how should CS Tumor Size and SSF6 be coded? See Discussion. We coded CS Tumor Size 990 and SSF 6 to 060 for a case in which no tumor size was mentioned and the breast core biopsy identified microinvasive infiltrating lobular carcinoma and lobular carcinoma insitu. The lumpectomy identified no residual tumor. SEER edit 218 states we must have CS Tumor Size as 999 if the CS SSF 6 is 060. Yet the tumor size code of 990 (Microinvasion; microscopic focus or foci only, no size given; described as less than 1 mm) would more accurately reflect this case. Even in a situation where there was microinvasion described as less than 1mm, the edit will not allow one to code CS Tumor Size to 990 with the CS SSF 6 as 060. Should these types of cases have CS Tumor Size coded 999 or should the edit be adjusted to allow for this combination?

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 990 [Microinvasion; microscopic focus or foci only, no size given; described as less than 1 mm] and CS SSF6 050 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated AND proportions of in situ and invasive not known].

This combination of codes captures the information available for this case.

 2009
20091044 Radiation Therapy: Would tomotherapy, described as targeted IMRT, be coded as external beam?

Code tomotherapy as 1 [Beam radiation].

Tomotherapy is external beam radiation therapy. It is a type of IMRT. Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy that utilizes computer-controlled x-ray accelerators to deliver radiation. Tomotherapy is a CT image guided IMRT.

2009
20091025

MP/H Rules/Multiple primaries--Urinary: How should we handle urinary tract tumors diagnosed before the MP rules went into effect when determining the number of primaries to report primaries? How do you apply rules M5, M6 and M8 when an invasive bladder tumor and other urinary site tumors occur before and after the effective date of these rules? See Discussion.

Example: Patient with a prior in situ carcinoma of the bladder in 11/89, left ureter papillary transition cell carcinoma in situ diagnosed in 5/05, left renal pelvis papillary transition cell carcinoma in situ diagnosed in 8/07 and invasive bladder carcinoma diagnosed in 3/08. When an invasive bladder tumor and other urinary site tumors occur, do you stop with the bladder at rule M5 and M6 never reaching M8?

For cases diagnosed 2007 or later:

Use the 2007 MP/H rules for urinary sites to assess diagnoses made in 2007-2014. Use the multiple tumors module to compare a diagnosis in 2007-2014 to an earlier diagnosis.

For the example above, start by comparing the left renal pelvis diagnosis in 8/07 to the earlier left ureter primary diagnosed 5/05. Start with rule M3. Stop at rule M8. The 8/07 renal pelvis diagnosis is not a new primary. Next, compare the 3/08 bladder tumor to the earlier left ureter primary diagnosed 5/05. Start with rule M3. Stop at rule M5. The 3/08 bladder tumor is a new primary because it is an invasive diagnosis following an in situ diagnosis. Use only the more recent of the two earlier urinary diagnoses for comparison. Do not compare the 2007 and later diagnoses to the 11/89 in situ bladder primary in this case.

 2009
20091016 CS Extension--Pancreas: How do you code this field for a head of pancreas primary with involvement of portal and splenic veins? See Discussion. The splenic artery/vein is only mentioned in the body and tail scheme; no mention is made of this site in the pancreatic head scheme.

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 54 [major blood vessels]. The portal vein is listed under code 54 for head of pancreas. The splenic vein branches from the portal vein.

 2009
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
20091033 CS Tumor Size--Ovary: Can the size of a tumor mass shadow seen on a CT scan be used to code CS Tumor Size? See Discussion. Ovarian primary: No surgery performed. CT abd/pelvis states "Bilateral pleural effusions, ascites. Right appendix region with tumor mass shadow 3 x 8 x 3.9cm"

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 999 [Unknown; size not stated]. The size of the tumor is not known in this case.

Note that tumor size is not used for AJCC staging for ovary.

 2009