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Report Produced: 08/26/2025 07:08 AM

Report Question ID Question Discussion Answer Year
20031086 EOD-Clinical Extension--Prostate: Must all three criteria be met (an elevated PSA; documentation that the physical exam was negative; and, if a TRUS was done, there is documentation that the findings were negative) in order to code this field to 15 [Tumor identified by needle by elevated PSA]?

For cases diagnosed 1998-2003:

Refer to the Prostate EOD Coding Guidelines, Final version distributed to SEER Registries 6/20/2001.

Prostate clinical EOD extension code 15 is used when all three criteria are met as listed on page 3 of the Prostate EOD Coding Guidelines. Meeting 1 or 2 of the 3 criteria is not sufficient for code 15. PE must be done and documented as negative. TRUS may or may not be done, but if done, must be documented as negative. PSA must either be elevated or there is no documentation about the PSA.

Codes 20 and 23-24 would be used with positive physical exam or positive TRUS.

Use codes 30-34 when there is no documentation that the physical exam was negative, or no documentation that the TRUS was negative, or when the prostatic apex is involved.

 2003
20021053 EOD-Extension--Pancreas: How would you code extension for the following non-surgically treated pancreas primaries? None of these cases has TNM staging to assist with classifying the extent of disease. See discussion.

1) CT scan: Cystic lesion in body of pancreas. Discharge dx: pancreas ca.

2) Discharge dx: CBD obstruction due to probable early ca in head of pancreas.

3) CT scan: mass involves the head and body of the pancreas. No evidence of abdominal mets. Discharge dx: Locally advanced pancreatic ca.

4) H&P: Pt with splenomegaly probably secondary to splenic vein thrombosis and a large ca of the tail of pancreas. Imp: Advanced pancreatic ca of the tail of pancreas. Would you code extension to splenic vein [56]?

5) H&P: Pancreatic ca with extension or mets into porta hepatis. (Would you assume direct extension or mets?)

6) CT scan: Pancreas ca. Significant peritoneal implants. (Would you assume the implants to be related to the pancreas primary and code as involvement?)

For cases diagnosed 1998-2003:

The information provided for these pancreatic primary examples is very limited. Additional information should be sought. If not available, code the EOD-Extension field to:

1) 10

2) 10

3) 10

4) 99

5) Assuming primary in head, body or tail of pancreas, 76

6) 85

 2002
20000561 EOD-Pathologic Extension--Prostate: Can a pathological extension code be assigned when a retropubic prostatectomy is done? See discussion. The TNM manual states, "Total prostatoseminalvesiculectomy and pelvic lymph node dissection are required for pathologic staging."

For cases diagnosed 1998-2003:

The pathology report from a retropubic prostatectomy should be used to code the Pathologic Extension field. This field is coded using pathology report information from the prostatectomy operation regardless of the surgical approach and regardless of whether or not a pelvic lymph node dissection was performed. This is one area in which TNM rules for pathologic staging and SEER rules for EOD are slightly different.

 2000
20021063 EOD-Pathologic Review of Number of Regional Lymph Nodes Examined: What code is used to represent this field when a path report from a lymph node biopsy or dissection describes lymph node "portions" or "fragments"? See discussion.

1) Lymph nodes, right pelvic dissection: No evidence of malignancy in 4 portions of lymph node examined. (Should we code the number examined as 01, 04, or 97?)

2) Lymph nodes, left pelvic dissection: 5 fragments of lymph nodes show no evidence of malignancy. (Should we code the number examined as 05 or 97?)

3) Biopsy of right neck mass: Malignancy in fragments of lymph nodes. The following month, pt had a right modified lymph node dissection: 16/32 lymph nodes are positive for malignancy. (Should we code the number examined as 32, 33, 97, 98?)

For cases diagnosed 1998-2003:

The total number of lymph nodes examined is recorded in EOD-Num of Reg LN Examined. If the number of actual lymph nodes represented by the "fragments" or "portions" cannot be determined, assign code 96, 97, or 98 as appropriate.

1) Based on the terminology "four portions of lymph node (singular)" code to 01 despite "dissection" terminology.

2) Code to 97 based on "fragments of lymph nodes (pleural)" terminology and procedure identified as dissection.

3) Code to 97 based on statement of "fragments of lymph nodes (pleural)" for biopsy plus dissection.

 2002
20021209 EOD-Extension/EOD-Lymph Nodes--Rectosigmoid: How do you code these fields for a scan-based clinically staged T3 N1 rectosigmoid primary in a patient who received chemotherapy and radiation prior to a resection that demonstrated invasion only into the muscularis and no positive lymph nodes?

For cases diagnosed 1998-2003:

Use the best information available, in this case, the clinical staging, to code EOD. Code the EOD-Extension field to 40 [Invasion through muscularis propria or muscularis, NOS] and the EOD Lymph Node field to 3 [Regional lymph node(s) NOS] because the case had a clinical stage of T3 N1. EOD is coded using the most extensive clinical or pathologic stage.

 2002
20031012 EOD-Lymph Nodes/Extension: How does one code these fields if the clinical level of disease extension prior to neoadjuvant treatment is greater than demonstrated on pathology at time of resection? See discussion. Breast case described clinically as a "breast mass and nodal metastases" which is treated with neoadjuvant chemotherapy and at surgery the lymph nodes are pathologically negative.

For cases diagnosed 1998-2003:

Use the combination of clinical and pathologic information to code EOD for primary site, extension and lymph nodes. Code the more extensive disease. If lymph nodes are positive clinically and not positive after neoadjuvant treatment, code lymph node involvement. If lymph nodes are negative clinically and positive on path, code lymph node involvement. When neoadjuvant treatment is administered because of a clinical statement of stage or involvement, code EOD based on this clinical information, even if later pathologic information would lead to a lesser EOD. General guideline number 6 (page 1 of SEER EOD-88 3rd ed.) points out that clinical information must be considered when coding EOD. However, do not code EOD based on clinical information disproved by pathologic findings in the absence of intervening treatment. The scenario above: The clinical involvement of the nodes justifies the neoadjuvant chemotherapy. Therefore, code EOD based on the clinical lymph node involvement.

 2003
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
20000502 EOD-Extension/EOD-Lymph Nodes: Can the AJCC TNM/Stage be used to help code these fields when there is limited text information in the medical record that describes the tumor involvement?

For cases diagnosed 1998-2003:

Yes, this staging information can be used to help code the SEER EOD fields but only if a physician does the TNM/Stage at the time of diagnosis and there is limited text information that describes tumor involvement.

 2000
20010164 EOD-Size of Primary Tumor--Prostate: If you only have a biopsy and not a resection of the primary site, can you code the size of the prostate nodule demonstrated on digital rectal exam? See discussion.

Example 1: Digital rectal exam reveals 1 cm left side prostate nodule. TRUS-guided biopsy of left side of prostate shows adenocarcinoma. Right side biopsy is negative. Is size coded to 010 or 999?

Example 2: Digital rectal exam reveals 1 cm left side prostate nodule. Bone scan was positive for metastatic disease. Is size coded to 010 or 999?

For cases diagnosed 1998-2003:

You need path confirmation that a malignancy exists in the prostate before you can code the size of the nodule seen clinically.

Example 1: Code the EOD-Size of Primary Tumor to 010 [1 cm], because the nodule in the prostate is confirmed as cancer by needle biopsy.

Example 2: Code the EOD-Size of Primary Tumor to 999 because there was no pathologic confirmation of malignancy.

 2001
20020030 EOD-Size of Primary Tumor: 1) Can we add "Imaging studies" to those EOD schemes that currently do not include this on their priority list for coding size? 2) When an EOD scheme already lists specific types of imaging studies, are we limited to only those types of procedures or can any imaging study be used to code size? See discussion. How do we determine where to add "imaging studies" to the priority listing? Currently the hierarchy differs for primaries that currently include imaging studies on their EOD schemes. For example, on the breast EOD imaging ranks lower than the physical exam while on the thyroid EOD imaging ranks higher than the physical exam.

For cases diagnosed 1998-2003:

1) You may add "Imaging" to the size priority list for all EOD schemes that currently do not include it. Prioritize it just above the physical exam for these sites.

2) You may use the information from any imaging technique to code tumor size, even for those sites such as breast and bladder where specific imaging tests are mentioned.

 2002