Question: 20200047




#1:   Ovary


Source 1:   2018 STORE Manual
pgs:   152
Notes:   LVI
Source 2:   2016 SEER Manual
pgs:   72
Notes:   Section V: LVI


Stage-related Data Item/Lymphovascular Invasion--Ovary:  The 2018 SEER Program Coding and Staging Manual states that LVI is coded 8 (Not applicable) for Ovary (Schema 00551). What is the reason for having lymphovascular invasion (LVI) coded "8" for Ovary?  See Discussion.


This direction is also in SEER*RSA for Ovary. Researching a possible explanation for this, we found that LVI is an independent predictor of progression and survival in patients with primary epithelial ovarian cancer at early stage but not at advanced stage. However, studies also recommend that routine evaluation of LVI in ovarian cancer is highly recommended in daily practice.


The coding instructions were developed and implemented in concert with the AJCC Cancer Staging Manual, 7th  edition, and updated with the 8th edition as per the 2018 STORE Manual and were based on sites where distinguishing between lymphatic/small vessel invasion and venous/large vessel invasion was not medically appropriate. 

SEER required LVI for penis and testis cases only beginning in 2016; sites other than penis or testis are coded 8 unless required by state or central registries.  The list for use of code 8 has been changed for 2021 and will no longer include Ovary.


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