CS Tumor Size/CS Extension--Brain and CNS: How are these fields coded for a glioblastoma multiforme occurring in a 3.5 cm tumor in the parietal lobe and a 3.0 cm tumor in the occipital lobe?
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.
CS Extension code is 10 [confined to cerebral hemisphere]. Record the size of the largest lesion in CS Tumor Size. Both the occipital and parietal lobes are supratentorial and confined to the cerebral hemisphere with no mention of crossing midline or involvement of ventricles.
CS Eval--Colon: Should 1 [No surgical resection done...] or 3 [Surgical resection performed...] be used to correctly reflect this field when a surgical observation is "adherent to duodenum" but the extension per the pathology is stated to be to the "subserosal tissue"? See Discussion.
7/2/04 Op Findings 5 cm mass in mid transverse colon involving also the right colon; mass was adherent to duodenum without obvious invasion. 7/2/04 Path: Rt & Transverse Colon: 6x5 cm mass, micro: MD Adenoca with invasion of subserosal tissue; margins neg. 17/17 colic LNs negative.
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 case described above, code extension as 46 [Adherent to other organ...no microscopic tumor found in adhesion]. Code CS TS/Ext eval as 3 [Surgical resection performed...].
Surgery was performed for this case. The fact that the adherence to the duodenum was proven not to be tumor involvement should be coded as 3 in CS TS/Ext Eval. By using eval code 3, the case will map to a pathologic T indicating that the patient had resective surgery. Eval code 1 would map to a clinical T, incorrect for this case.
Reportability/AmbiguousTerminology: Because there is a caveat in the SEER PCM, 3rd edition to ignore adverbs such as "strongly" when assessing reportability, should a term such as "likely" cancerous be reportable given than the expression "most likely" cancerous is reportable?
"Likely cancerous" is NOT reportable.
The CoC, NPCR and SEER have agreed to a strict interpretation of the ambiguous terms list. Terms that do not appear on the list are not diagnostic of cancer.
Primary Site--Soft Tissue: How is the primary site coded for a PNET found in the groin when the Tumor Board states the primary is unknown but the SEER site/histology validation table does not allow a site of C809 or C76x to be coded in combination with the histology of 9473/3?
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).
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.
Histology (Pre-2007)--Melanoma: How is histology coded if the final diagnosis is "melanoma" and only in the comment section of the pathology report is there an indication of "Type: Lentigo Maligna. Cell Type: Small Cell"?
For tumors diagnosed prior to 2007:
Code the histology as 8742 [lentigo maligna melanoma]. Code the specific histologic type, even if stated only in the comment section.
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.
2004 SEER Manual Errata/CS Tumor Size--Can the Determining Descriptive Tumor Size information, on page 6 in the SEER EOD Manual, January 1998, be used to code descriptive tumor size in 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.
Use the instructions in the CS Manual, Appendix 1, page 62. This information will be added to the 2004 SEER manual in the next update.
Do not use the Determining Descriptive Tumor Size information from EOD for CS Tumor Size.
Surgery of Primary Site--Colon: In the absence of detailed operative or pathology report descriptions of the specific segment(s) of the colon removed, should a hemicolectomy be coded if stated by the surgeon to be such?
Yes, code hemicolectomy as stated by the surgeon when there is no conflicting or additional information avaliable.
CS Lymph Nodes/Scope of Regional Lymph Node Surgery--Prostate: When prostate cancer is an incidental finding at cystoprostatectomy for bladder cancer, is the pelvic lymph node dissection coded for the prostate as well as the bladder?
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 pelvic lymph node dissection is coded as regional lymph node surgery for both primaries and the nodes are counted in collaborative staging for both primaries. The examination of the pelvic lymph nodes is relevant to both the bladder and the prostatic primaries.
CS Site Specific Factor--Lymphoma: Can the International Prognostic Index (IPI) score be taken from a TNM form in the record? If so, what score would we code for "low" (0-1 points) and "high" (4-5 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.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].
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