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Report Produced: 10/07/2026 17:14 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20071005 EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?

For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.

Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.

 Prostate N/A 2007
20000247 EOD-Pathologic Extension--Prostate: If there is residual tumor in the distal urethra on prostatectomy, does that mean there is distal urethral margin involvement? See discussion.

2/98 Prostate bx: Right apex, right mid and right base positive for adenocarcinoma.

6/1/98 Radical retropubic prostatectomy w/ bilateral pelvic lymph node dissection. Pathology: Residual adenocarcinoma in distal urethra, right lateral sections and posterior lobe. Right apical margin, other margins, seminal vesicles, and 7 pelvic LN negative for malignancy.

For cases diagnosed 1998-2003:

For the example above, code the EOD-Pathologic Extension field to 34 [extending to apex] because most of the right side is involved.

The pathology report says all margins are free. The comment on residual tumor in the urethra, meant the first surgery did not completely remove tumor tissue from the urethra, it does not mean that tissue is at the margin.

 Prostate N/A 2000
20071084 MP/H Rules/Histology--Prostate: How is an "acinar adenocarcinoma with focal large duct adenocarcinoma" coded?

For cases diagnosed 2007 or later:

As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10.

Do not code histologies designated as "focal."

 Prostate Histology 2007
20071096 Multiplicity Counter--Prostate: How is multiplicity counter to be coded for a clinically inapparent prostate cancer for which sextant needle biopsy cores on left and right sides are positive for adenocarcinoma? See Discussion.

Prostate cancer typically presents as multifocal diffuse disease. The coding exercise in the MPH rules presentations coded prostate cancer as one tumor.

Reference: SEER Training Web Casts - Other Sites Rules Practicum

 Code the number of tumors present if known. This information can be taken from any part of the record, including imaging and prostatectomy. If the only information available is "diffuse," or "multifocal," assign code 99. Do not assume there are multiple tumors just beacause there are multiple biopsies. When there is no information about the number of tumors, code Multiplicity Counter to 99 and Type of Multiple Tumors to 99. Prostate N/A 2007
20100032 First course treatment--Prostate: Is Degarelix coded as hormonal treatment for prostate cancer? Code the administration of Degarelix in the "Hormone Therapy" field. Assign code 01 [Hormone therapy administered as first course therapy]. This drug will be added to the next update of SEER*Rx. Prostate First course treatment 2010
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.

 Prostate N/A 2003
20260009

SEER Manual/Reportability/Date of Diagnosis--Prostate: How is the diagnosis date coded when a Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesion is identified on imaging and therefore reportable, but further work-up or biopsy does not follow for 6 months or more? See Discussion.

2026 SEER Manual Appendix E states PI-RADS (4 and 5) are reportable; they can be used to code the diagnosis date.

The Date of Diagnosis Coding Instruction 3 in the SEER Manual states:The first diagnosis of cancer may be clinical (i.e., based on clinical findings or physician’s documentation) Note: Do not change the date of diagnosis when a clinical diagnosis is subsequently confirmed by positive histology or cytology.

2026 STORE Manual states:

PI-RADS, BI-RADS, LI-RADs alone are not reportable for CoC. PI-RADS, BI-RADS, L-RADS confirmed with biopsy or physician statement are reportable to CoC. Date of diagnosis is the date of the positive biopsy or definitive statement from physician.

Example: 01/04/2023 MRI identified both PI-RADS 4 and 5 lesions bilaterally. No work-up immediately followed and there is no chart information to account for the delay. The patient was seen again by urology and a 05/20/2024 biopsy proved adenocarcinoma. The patient underwent a prostatectomy approximately 6 months after biopsy on 01/13/2025. Biopsy diagnosis followed MRI diagnosis more than 16 months later and the plan was for active treatment.

When further work-up does not shortly follow the MRI, and no information is available to the central registry to account for the delay, should the date of the biopsy be used to code diagnosis date?

Using the SEER PI-RADS diagnosis in these cases makes it appear as if any first course treatment is often greater than 1 year after "diagnosis," when it is really only approximately 6 months after the biopsy.

Which source should be used to code diagnosis date in these cases?

Case 1: 01/04/2023 MRI identified both PI-RADS 4 and 5 lesions bilaterally. No work-up immediately followed and there is no chart information to account for the delay. The patient was seen again by urology and a 05/20/2024 biopsy proved adenocarcinoma. The patient underwent a prostatectomy approximately 6 months after biopsy on 01/13/2025. Biopsy diagnosis followed MRI diagnosis more than 16 months later and the plan was for active treatment.

Case 2: 02/05/2024 MRI identified a PI-RADS 5 lesion. No work-up immediately followed and there is no chart information to account for the delay. The patient was seen again by urology and a 08/29/2024 biopsy proved adenocarcinoma. After consultation with the urologist, active surveillance was recommended on 01/27/2025. Biopsy diagnosis followed MRI diagnosis more than 6 months later and the plan was for active surveillance.

Updated June 2026

Report PI-RADS 4 or 5 PI-RADS only when confirmed with biopsy or when based on a recognized medical practitioner statement. Use the date of diagnosis as the date of the positive biopsy or the definitive statement from the recognized medical practitioner, whichever is earlier.

Use the date of biopsy in the two case scenarios based on the revised guidance.

We will include this update in the next release of the SEER Manual.

 Prostate Date of diagnosis 2026
20100017 MP/H Rules/Multiple primaries--Prostate: Does adenosquamous carcinoma found in the prostate represent a second primary in a patient previously diagnosed with adenocarcinoma of the prostate? See Discussion.

Patient was diagnosed many years ago with adenocarcinoma of the prostate and treated with hormonal and radiation therapy. The patient recently underwent a TURP and is found to have adenosquamous carcinoma of the prostate. The pathology report comment states squamous carcinoma of the prostate is rare and is often associated with a history of hormonal or radiation therapy. There is no information indicating a history of a squamous carcinoma in the urinary system that could have involved the prostatic urethra.

Would the MP/H rules make this a second primary with the histology of 8560/3 [adenosquamous carcinoma]?

 For cases diagnosed 2007 or later, based on the limited information available for this unusual case, abstract a second prostate primary and code the histology as adenosquamous carcinoma. Rule M3 does not apply in this case. Apply rule M10. Prostate N/A 2010
20071125 Radiation Therapy--Prostate: Is the regional treatment modality XRT best coded to 50 (brachytherapy, NOS), 53 (LDR) or 54 (HDR) when the documentation indicates only "I-125 seeds" to the prostate? Assign code 53 [Brachytherapy, interstitial, LDR] for seeds to the prostate. Seeds are always low dose because they are left in place and the radioactivity decays over time. Prostate Radiation Therapy 2007
20071068 MP/H Rules/Multiple Primaries/Histology--Prostate: How many primaries should be abstracted and how should the histology field(s) be coded for a case in which the pathology specimen showed adenocarcinoma in 20% of the tissue and sarcoma in 50% of the tissue? See Discussion.

Patient has TURP. The final path diagnosis is adenocarcinoma in 20% of tissue and sarcoma in 50% of tissue.

Because it is unknown whether there is a single or multiple tumors, rule M1 (Other Sites) is used which states the case is to be abstracted as a single primary.

Single invasive histology rules are followed to rule H16, but table 2 does not contain a mixed code for this situation, even though ICD-O-3 has a code 8933/3 for "adenosarcoma". Therefore, rule H17 is applied that states to use the highest code, which in this case would be 8800/3 [Sarcoma, NOS]. Is this correct?

For cases diagnosed 2007-2014, code as two primaries, one adenocarcinoma and the other sarcoma.

This is two tumors (adenocarcinoma and separate sarcoma) until proven otherwise. Do not code as adenosarcoma, as this is a gyn-specific diagnosis. Adenosarcoma of the prostate is not a recognized entity in the WHO classification of prostate tumors.

 Prostate N/A 2007