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Report Produced: 03/01/2026 14:25 PM

Report Question ID Question Discussion Answer Year
20000431

Surgery Fields--Multiple sites: What code is used to represent these fields for the following surgical procedures?

1. Tongue, NOS - Hemiglossectomy with lymph node dissection

2. Choroid - Eye enucleation

3. Vulva, NOS - Vulvectomy with bilateral lymph node dissection

4. Gallbladder - Cholecystectomy

5. Lung - Laminectomy with partial removal of tumor

For cases diagnosed 1/1/03 and later:

1. Code Surgery of Primary Site to 30 and Scope of Regional Lymph Node Surgery to 3.

2. Code Surgery of Primary Site to 41.

3. Code Surgery of Primary Site to 40 and Scope of Regional Lymph Node Surgery to 3.

4. Code Surgery of Primary Site to 40.

5. Code Surgical Procedure of Other Site to 4.

 2000
20000454

First Course Treatment: If the patient receives no treatment at the time of diagnosis (either because it is not recommended or because the patient refused treatment at that time) but treatment is later instituted after disease progression, should this treatment be coded as part of the first course of treatment?

The SEER rules changed in 1998 regarding what constitutes First Course of Cancer-Directed Therapy.

For cases diagnosed on or after 1/1/98: The First Course of Cancer-Directed Therapy fields will all be coded to 0 [None] for these types of cases. The documented disease progression would stop the timeframe for inclusion of any treatment to be part of first course of therapy.

 2000
20000542 EOD-Lymph Nodes/TNM--Breast: Do we code these lymph nodes fields for a breast primary that describes ipsilateral axillary lymph node involvement as "extending through the lymph node capsule and into perinodal soft tissue/fat" as "fixed/matted"?

For cases diagnosed 1998-2003:

Code the EOD-Lymph Nodes field to 6 [Axillary regional lymph nodes, NOS], if the size of the metastasis within the lymph node is not known. "Extension into perinodal soft tissue" does not imply that the lymph nodes are fixed to one another or to other structures. AJCC stage for lymph nodes is coded to N1 [Metastasis to moveable ipsilateral axillary lymph nodes].

In order to code the EOD-Lymph Nodes field to 5 [Fixed/matted ipsilateral axillary nodes] which is the equivalent to AJCC equivalent N2, there must be some clinical or pathologic statement of fixation or matting. There can be extension through the capsule without fixation or matting. "Fixation" is a clinical term and "matting" can be either clinical or pathologic. A pathologist can recognize two or more lymph nodes stuck together by tumor.

 2000
20000554 EOD-Extension--Stomach: What code is used to represent this field for a stomach primary described as linitis plastica?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 30 [Localized, NOS], unless more information is known about the extent of tumor involvement. Coding the Histology field to 8142/3 [Linitis plastica] and the Size of Primary Tumor field to 998 [Diffuse; widespread; 3/4 or more: Linitis plastica] identifies this diagnosis.

In the EOD-Extension field, the depth of invasion is the important characteristic to be coded. The 10 digit EOD corresponds to the AJCC Staging Manual in which the "T" is based on level of invasion. While a diagnosis of linitis plastica indicates a worse prognosis, it does not define the extent of infiltration. There is no luminal mass with linitis plastica. Instead, the entire gastric wall is thickened by tumor.

 2000
20000486 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined/Surgical Procedure of Other Site--Kaposi Sarcoma: How do you code these fields for a groin mass excision containing 4 lymph nodes for a Kaposi sarcoma case that presented with multiple skin lesions?

Code the EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined fields to 99 99 for Kaposi cases that present systemically and for those that present in more than one site (which includes cases with more than one skin subsite involved at diagnosis). There are no "regional" lymph nodes for such cases. This represents a majority of currently diagnosed Kaposi cases. However, for localized Kaposi cases, you can count the number of regional lymph nodes positive and examined if the primary site selected has a regional lymph node chain(s) associated with it (e.g., soft palate, hard palate, or a skin subsite).

For cases diagnosed 1/1/2003 and after: Code the groin mass excision in the Surgical Procedure of Other Site field to 1 [Non-primary surgical procedure performed; Non-primary surgical resection to other site(s), unknown if whether the site(s) is regional or distant].

 2000
20000433 Diagnostic Confirmation: Is it appropriate to code this field to "radiography" confirmation when a CT scan does not actually contain a diagnosis of malignancy, however, the discharge diagnosis in the medical record of "probable malignancy" is likely based on the abnormal CT findings? See discussion.

10/1/02 CT of Chest: 1) Huge (left) suprahilar mass. 2) Moderate volume loss, left lung. Appearance suspicious of LLL collapse. An infiltrate is seen in the aerated upper lobe as well as pleural effusion. 3) Streaky and nodular changes are noted at the right base that may represent possible lymphangetic spread of tumor.

10/23/02 Discharge Dx: Lung mass, probably carcinoma.

 Code the Diagnostic Confirmation field to 7 [Radiography]. This is appropriate because it was the scan evidence that was used to make the clinical diagnosis. 2000
20000535 EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the following phrases: "case staged as C" and "case staged as T3a"? See discussion.

Example: A prostatectomy was done on 6/29. The physician staged the case as a "C" on 7/2 and as T3a on 8/6. It appears the physician is interpreting the following pathology information as unilateral extracapsular extension: "The tumor on the right extends to the inked surface of the gland. In this area the capsule appears absent." Should pathologic extension be coded to unilateral extracapsular extension [42]?

For cases diagnosed 1998-2003:

Yes. Use the best information available to stage this case. In this case, the best information is the physician's statement that the case is stage T3a. Without any additional information, the EOD-Extension field is coded to 42 [Unilateral extracapsular extension (pT3a)] on the basis of the T3a stage by the MD. When there is a conflict between different staging systems, default to the AJCC stage.

 2000
20000511 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: What codes are used to represent these fields when only a regional lymph node (positive) aspiration is performed?

For cases diagnosed 1998-2003:

With the exception of those sites/histologies that require 99 in these fields, code the Number of Regional Lymph Nodes Positive field to 97 [Positive nodes but number of positive nodes not specified]. Code the Number of Regional Lymph nodes Examined field to 95 [No regional Lymph nodes removed, but aspiration of regional Lymph nodes was performed].

 2000
20000452 Other Therapy: What code is used to represent "gene" therapy? See discussion.

The following form of gene therapy has been described as treatment for malignant brain tumors.

Patients undergo surgery to remove as much of the tumor as possible. After surgery, the patients are infused with a virus that has been genetically altered so that it is not infectious and so that it contains a gene from the herpes simplex virus. The herpes gene is sensitive to a drug called ganciclovir. Once inside the brain, the genetically altered virus infects any remaining tumor cells. When this occurs, the herpes gene is established inside the cancer cells. After the virus infects the cancer cells, the patients are given ganciclovir. This drug would kill both the virus and the brain tumor cells.

 Code the Other Cancer-Directed Therapy field to 2 [Other experimental cancer-directed therapy (not included elsewhere)]. 2000
20000419 EOD-Extension--Corpus Uteri: How do you code myometrial involvement described as 1) "to the level of the middle one-third" or 2) "superficial"?

For cases diagnosed 1998-2003:

Evaluate each case carefully.

1. Code the EOD-Extension field to 12 [Myometrium-inner half] because the pathology report indicates involvement of the myometrium "to the level of." However, if you feel that you cannot make that determination with certainty and you cannot ask a pathologist for clarification, then code the EOD-Extension field to 14 [Myometrium, NOS].

2. Code the EOD-Extension field to 12 [Myometrium-inner half] for cases with "superficial" myometrial invasion.

 2000