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Report Produced: 05/11/2025 23:15 PM

Report Question ID Question Discussion Answer Year
20000421 Surgery of Primary Site/Reconstruction-First Course--Breast: If the plan is to "reconstruct" the breast 6 months after an ipsilateral modified radical mastectomy, is the time span a problem or should it be coded in the Surgery of Primary Site field because it was planned? For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 55 [Modified radical mastectomy WITHOUT removal of uninvolved contralateral breast, Implant]. The time span is not a problem as long as the reconstruction was planned as first course, which is indicated by tissue expander insertion at the time of the original surgery. 2000
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
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
20000485 EOD-Extension--Lung: Should the phrase "some pleural fluid in both posterior gutters" be interpreted as pleural effusion for lung primaries? See discussion. CT scan: "3 cm mass left upper lobe of lung. Some pleural fluid in both posterior gutters. Large matted hilar lymph nodes, left. Some narrowing left upper bronchus by this adenopathy. Squamous cell ca lung with mets to left hilar lymph nodes, most likely possibility." Would you code extension to 72 [malignant pleural effusion; pleural effusion, NOS]?

For cases diagnosed 1998-2003:

Yes. Code the EOD-Extension field to 72 [malignant pleural effusion, pleural effusion, NOS]. Pleural effusion is mentioned as being present.

 2000
20000272 Grade, Differentiation: Are anaplastic tumors always coded to grade 4, even for anaplastic brain primaries? Yes. Always code the Grade, Differentiation field to for 4 [Grade IV] for "anaplastic" tumors. Anaplastic is synonymous with undifferentiated. Refer to the example in the SEER Program Code Manual, 3rd Ed. 2000
20000248 Date of Diagnosis: When doing follow-back at nursing homes on DCO cases, we find it difficult to code diagnosis date because the nursing home records are often vague or incomplete. Should the diagnosis date be coded as unknown (excluded from SEER database), the date of death, or the approximate date of diagnosis as reported on the death certificate?

If the nursing home record indicates that the patient had cancer, use the best approximation for date of diagnosis.

If the record says the patient had cancer when admitted, but it does not provide a date of diagnosis, use the date of admission as the date of diagnosis.

If there is no mention of cancer in the nursing home record and/or all work-up in the record is negative, assume the cancer was discovered at autopsy. Use the date of death as the date of diagnosis, and leave as a Death Certificate Only case.

 2000
20000515

Multiple Primaries (Pre-2007)--Ovary/Endometrium: Is endometrioid adenocarcinoma occuring simultaneously in the left ovary and the endometrium one primary or two? See discussion.

Pathology Final Diagnosis:

Left Ovary: Moderately differentiated endometrioid adenocarcinoma squamous differentiation grade 2 (scale of 3)

Uterus: Moderately differentiated endometrioid adenocarcinoma with squamous differentiation, grade II (scale of III). Focal, very superficial invasion to inner third myometrium with extension to lower uterine segment. Endocervix, cervix, right ovary and fallopian tubes negative for tumor.

For tumors diagnosed prior to 2007:

Code the case you describe as two primaries. The endometrioid adenocarcinoma can arise in the endometrium without a concomitant ovarian carcinoma.

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.

 2000
20000483 EOD-Extension--Corpus Uteri: What code is used to represent this field for a corpus primary (sounding 8 cm or less in length) treated with radiation prior to a hysterectomy that pathologically showed superficial myometrial invasion? Is it possible that the invasion could have been more extensive prior to the radiation treatment?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 12 [Myometrium, inner half] which represents the extension you know. In this particular case, there was no clinical evidence of extension outside the corpus. As long as the surgery was not performed because of disease progression, use information from the surgery to code EOD extension.

 2000
20000512 EOD-Extension/EOD-Lymph Nodes--Kaposi Sarcoma: What code is used to represent this field for a Kaposi sarcoma with no skin lesions but positive lymph node and bone marrow biopsies?

Code the EOD-Extension field to 13 [Visceral (e.g., pulmonary, gastrointestinal tract, spleen, other)], because of the positive bone marrow. Code the EOD-Lymph Nodes field to 3 [Both clinically enlarged palpable lymph nodes (adenopathy) and pathologically positive lymph nodes], for the pathologically positive node.

Note: Potential revision of the extension scheme will be referred to SEER Medical Advisory Group (SMAG).

 2000
20000843 Place of Birth: When there is conflicting information, which record takes precedence in coding this field, the medical record or the death certificate? If there is a discrepancy, use the information from the medical record to code the Place of Birth field. The information from the medical record is provided by the patient, the information on the death certificate is provided by others. If the medical record does not contain birth information, use the information from the death certificate. 2000