EOD v2.1 Review and Conversion:

  1. Histologies where AJCC eligibility has changed within a Schema:
    1. Schema ID/Histology combinations are now eligible for AJCC staging, manually review:
      Schema ID [3800] = 00150 (Cutaneous Squamous Cell Carcinoma of the Head and Neck) and Histology ICDO3 [522] = 8402
      Schema ID [3800] = 00170, 00180 (Stomach, Small Intestine) and Histology ICDO3 [522] = 8213
      Schema ID [3800] = 00180 (Small Intestine) and Histology ICDO3 [522] = 8144
      Schema ID [3800] = 00190, 00200, 00210 (Appendix, Colon and Rectum, Anus) and Histology ICDO3 [522] = 8033
      Schema ID [3800] = 00200 (Colon and Rectum) and Histology ICDO3 [522] = 8262
      Schema ID [3800] = 00400, 00410, 00421, 00422, 00440, 00450 (Soft Tissue Head and Neck, Soft Tissue Trunk and Extremities, Soft Tissue Abdomen and Thoracic, Heart, Mediastinum and Pleura, Retroperitoneum, Soft Tissue Rare) and Histology ICDO3 [522] = 9222
      Schema ID [3800] = 09520 (Cervix Version 9) and Histology ICDO3 [522] = 8045, 8054, 8085-8086, 8154, 8246, 8430, 8483-8484
      Schema ID [3800] = 00530 (Corpus Carcinoma and Carcinosarcoma) and Histology ICDO3 [522] = 8441 and Behavior ICDO3 [523] = 2
      Schema ID [3800] = 00790 (Lymphoma) and Histology ICD-O-3 [522] = 9715
      • Recalculate AJCC ID [995]
      • Recalculate TNM Edition Number [1060] (will go to 08; except for Schema ID = 09520 which will go to 09)
      • Manually review AJCC TNM fields [1001-1004, 1011-1014, 1021-1024, 1031-1036, 1062-1067] (if required by your standard setter – at a minimum, blank out the AJCC TNM fields)
      (These can always be applied. These histologies in the stated schemas are now eligible for AJCC staging.)
    2. Schema/Histology/Behavior combination is now eligible for AJCC staging, defaults provided:
      Schema ID [3800] = 00480 (Breast) and Histology ICDO3 [522] = 8509 and Behavior ICDO3 [523] = 2
      • Recalculate AJCC ID [995] (will go to 48.1)
      • Recalculate TNM Edition Number [1060] (will go to 08)
      • If TNM is required, set defaults:
        • If RX Summ—Surgery Prim Site [1290] = 20-45
          • Set AJCC TNM Path T [1011] = pTis(DCIS)
          • Set AJCC TNM Path N [1012] = cN0
          • Set AJCC TNM Path M [1013] = cM0
          • Set AJCC TNM Path Stage Group [1014] = 0
        • Else
          • Set AJCC TNM Path T [1011] = blank
          • Set AJCC TNM Path N [1012] = blank
          • Set AJCC TNM Path M [1013] = blank
          • Set AJCC TNM Path Stage Group [1014] = 99
        • Set AJCC TNM Clin T [1001] = cTis(DCIS)
        • Set AJCC TNM Clin N [1002] = cN0
        • Set AJCC TNM Clin M [1003] = cM0
        • Set AJCC TNM Clin Stage Group [1004] = 0
        • Blank out all AJCC TNM Post Therapy Path [1021-1024] and AJCC TNM Post Therapy Clin [1062-1067] fields and all Suffix [1031-1036] fields
      (This can always be applied. 8509/2 is now eligible for AJCC staging. No review necessary)
    3. Schema/Histology combinations are no longer eligible for AJCC staging:
      Schema ID [3800] = 00150 (Cutaneous Squamous Cell Carcinoma of the Head and Neck) and Histology ICDO3 [522] = 8400
      Schema ID [3800] = 09520 (Cervix Version 9) and Histology ICDO3 [522] = 8200, 8720
      • Recalculate AJCC ID [995] (will go to XX)
      • Recalculate TNM Edition Number [1060] (will go to 88)
      • Set AJCC TNM Clin T [1001] = blank or 88
      • Set AJCC TNM Clin N [1002] = blank or 88
      • Set AJCC TNM Clin M [1003] = blank or 88
      • Set AJCC TNM Clin Stage Group [1004] = 88
      • Set AJCC TNM Path T [1011] = blank or 88
      • Set AJCC TNM Path N [1012] = blank or 88
      • Set AJCC TNM Path M [1013] = blank or 88
      • Set AJCC TNM Path Stage Group [1014] = 88
      • Blank out all AJCC TNM Post Therapy Path [1021-1024] and AJCC TNM Post Therapy Clin [1062-1067] fields and all Suffix [1031-1036] fields
      (These can always be applied. These histologies are no longer eligible for AJCC staging. No review necessary)
  2. If Schema ID [3800] = 00421 (Soft Tissue Abdomen & Thoracic) and Primary Site [400] = C474 and Date of Diagnosis [390] is 2018-2020,
    • Recalculate Schema ID [3800] (will be changed to 00410)
    • Recalculate AJCC ID [995]
    • Manually review, as these have changed schemas
    (This can always be applied. C474 is changing schemas for 2018-2020)
  3. Soft Tissue Rare and Soft Tissue Other: (Schema split and name modified)
    1. If Schema ID [3800] = 00450 and AJCC ID [995] = XX,
      • Set Schema ID [3800] = 00459 (Soft Tissue Other - new)
      (This can always be applied. The schema as split into Soft Tissue Other, containing the non-AJCC eligible combinations and Soft Tissue Rare, which matches Chapter 45. All field definitions within Soft Tissue Rare and Soft Tissue Other are the same. No review necessary)
    2. If Schema ID [3800] = 00450 and one of the following combinations:
      Primary Site [400] = C473, C475, C493-C495, Histology ICDO3 [522] = 8901, 8910-8920, 9120, 9133, 9180 and Schema Discriminator 2 [3927] = 9
      Primary Site [400] = C481-C488, Histology ICDO3 [522] = 8806, 8930-8931 and Sex [220] = 4
      Primary Site [400] = C696, C698 and Histology ICDO3 [522] = 8930-8931, 8991, 9020, 9180, 9231
      • Set Schema ID [3800] = 00459 (Soft Tissue Other - new)
      • Set AJCC ID [995] = XX
      (These can always be applied. These histologies are not eligible for AJCC staging. Since Soft Tissue Rare did not have T, N, M or Stage Group defined, there is no need to adjust those field values. No review necessary)
    3. If Schema ID [3800] = 00700 (Orbital Sarcoma) and Histology ICDO3 [522] = 9222
      • If Primary Site [400] = C690-C695, C699, C723
        • Set Schema ID [3800] = 00450 (Soft Tissue Rare)
        • Set AJCC ID [995] = 45
      • If Primary Site [400] = C696, C698
        • Set Schema ID [3800] = 00459 (Soft Tissue Other - new)
      • Manually review all cases, as these have changed schemas
      (These can always be applied. 9222 is a (relatively) new histology and is now part of chapter 45.)
  4. If Primary Site [400] = C530-C539 and Histology ICDO3 [522] = 8815, 8901, 8912, 8920, 9120, 9133, 9180, 9222, 9581 and Date of Diagnosis Year [390] >= 2021
    • Recalculate Schema ID [3800] (00450 – Soft Tissue Rare)
    • Recalculate AJCC ID [995] (45)
    • Recalculate TNM Edition Number [1060] (88)
       
    • Set AJCC TNM Clin T [1001] = blank or 88
    • Set AJCC TNM Clin N [1002] = blank or 88
    • Set AJCC TNM Clin M [1003] = blank or 88
    • Set AJCC TNM Clin Stage Group [1004] = 88
    • Set AJCC TNM Path T [1011] = blank or 88
    • Set AJCC TNM Path N [1012] = blank or 88
    • Set AJCC TNM Path M [1013] = blank or 88
    • Set AJCC TNM Path Stage Group [1014] = 88
    • Blank out all AJCC TNM Post Therapy Path [1021-1024] and AJCC TNM Post Therapy Clin [1062-1067] fields and all Suffix [1031-1036] fields
    • Manually review, as these have changed schemas
    (This can always be applied. These histologies have moved to Soft Tissue Rare for 2021 and later)
  5. If Primary Site [400] = C530-C539 and Histology ICDO3 [522] = 8710-8714, 8800-8803, 8805, 8810-8814, 8816-8858, 8860-8900, 8902-8910, 8921-8941, 8951-8976, 8981-8990, 8992-9016, 9030-9043, 9045-9105, 9111, 9121-9132, 9135-9138, 9141-9175, 9181-9221, 9230, 9240-9365, 9370-9580, 9582 and Date of Diagnosis Year [390] >= 2021
    • Recalculate Schema ID (00528 - Cervix Sarcoma)
    • Recalculate AJCC ID [995]
    • Recalculate TNM Edition Number [1060]
    • Blank out all existing SSDIs [may include 3815, 3836, 3865, 3871-3875, 3884]
    • Manually review, as these have changed schemas
    (This can always be applied. Cervix Sarcoma is a new Schema and histologies used to be in several different schemas including Cervix V9, GIST, Soft Tissue Abdomen and Thoracic, Soft Tissue Rare and Soft Tissue Other. If you do this AFTER the Lymph Node Status recode (8), those fields would be correctly recoded)
  6. If Schema ID [3800] = 00280 (Pancreas)
    • If you derived the EOD based T, N, M and Stage Group, re-calculate these values
    (This can always be applied. One of the calculation tables was updated. No review necessary)
  7. If Schema ID [3800] = 00370 (Pleural Mesothelioma)
    • If EOD Mets [776] = 00 and Pleural Effusion [3913] = 2 (Pleural effusion present, malignant), set EOD Mets = 05
    (This can always be applied. EOD Mets value of 05 is new. No review necessary)
  8. If Schema ID [3800] = 09520 (Cervix V9), 00520 (Cervix 8th), 00510 (Vagina), 00500 (Vulva)
    Summary Explanation
    Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic [3884] is being split into one item per node type.
    LN Status Femoral-Inguinal [3959]: (Vagina, Vulva)
    LN Status Para-aortic [3958]: (Cervix and Vagina)
    LN Status Pelvic [3957]: (Cervix, Vagina and Vulva)
    LN Assessment Method Femoral-Inguinal [3871] is being removed from Cervix
    LN Assessment Method Para-Aortic [3872] is being removed from Vulva

    Conversion
    • If Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic is 0, 8 or 9, set the new fields for the schema to the same value (0, 8 or 9 respectively)
    • Else
      • If Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic = 1, 4, 5, 7 and Schema ID = 00500, 00510, set LN Status Femoral-Inguinal = 1, else set LN Status Femoral-Inguinal = 0
      • If Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic = 2, 4, 6, 7 and Schema ID = 00510, 00520, 09520, set LN Status Para-aortic = 1, else set LN Status Para-aortic = 0
      • If Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic = 3, 5, 6, 7 and Schema ID = 00500, 00510, 00520, 09520, set LN Status Pelvic = 1, else set LN Status Pelvic = 0
    (These can always be applied. Lymph Node Status: Femoral-Inguinal, Para-aortic and Pelvic will not be reused. This data item will be retired in the future. No review necessary)

    • If Schema ID = 00520, 09520, set LN Assessment Method Femoral-Inguinal [3871] to blank
    • If Schema ID = 00500, set LN Assessment Method Para-Aortic [3872] to blank
    (These can always be applied. LN Assessment for the specific nodes is being removed from the indicated schemas. No review necessary)
  9. If Schema ID [3800] = 00530 (Corpus Carcinoma and Carcinosarcoma) and EOD Primary Tumor [772] = 070, 080
    • Set EOD Primary Tumor = 050
    (This can always be applied. These codes are being removed. No review necessary)
  10. If Schema ID [3800] = 09520 (Cervix Version 9) and Date of Diagnosis Year [390] >= 2021
    • Manually review to set p16 [3956] if required by your standard setter
  11. If Schema ID [3800] = 00795 (Lymphoma-CLL/SLL)
    1. If Schema ID [3800] = 00795 (Lymphoma-CLL/SLL) and Primary Site [400] is NOT C421
      • Set Lymphocytosis [3885] = 5
      • Set Adenopathy [3804] = 5
      • Set Organomegaly [3907] = 5
      • Set Anemia [3811] = 5
      • Set Thrombocytopenia [3933] = 5
      (This can always be applied. 5 is a new code for these fields. These will cause Derived Rai Stage [3955] to be set to 8. No review necessary)
    2. If Schema ID [3800] = 00795 (Lymphoma-CLL/SLL)
      • Calculate Derived Rai Stage [3955]
      (This can always be applied. No review necessary)
  12. If Schema ID [3800] = 00821 (Plasma Cell Myeloma) and Schema Discriminator 1 [3926] = 1 or 9
    • Set Serum Beta-2 Microglobulin Pretreatment Level [3931] = 5
    • Set Serum Albumin Pretreatment Level [3930] = 5
    • Set High Risk Cytogenetics [3857] = 5
    • Set LDH Level [3869] = 5
    (This can always be applied. 5 is a new code for these fields. No review necessary)

AFTER the updated version (SEER Staging API version 2.1) has been run across the database:

  1. If Schema ID [3800] = 00811 (Mycosis Fungoides) and Primary Site [400] is not C000-C002, C006, C440-C449, C510-C512, C518-C519, C600-C602, C608-C609, C632)
    • Set EOD Primary Tumor [772] = 999
    • Set EOD Regional Nodes [774] = 999
    • Set EOD Mets [776] = 99
    • Set Summary Stage 2018 [764] = 9
    • Set Grade Clinical [3843] = 8
    • Set Grade Pathological [3844] = 8
    • Set Peripheral Blood Involv [3910] = 9
    (This should only happen as part of the v2.1 update. Many Site codes were moved into the Mycosis Fungoides schema. With the defaults, no review is necessary.)
    Alternately: If Schema ID [3800] is NOT 00811 and Histology ICD-O-3 [522] = 9700-9701, Recalculate and then set the defaults as described.
  2. If Schema ID [3800] = 99999 (Ill-Defined Other) and Primary Site [400] = C760
    • Set Schema Discriminator 1 [3926] = blank
    • Set EOD Primary Tumor [772] = 888
    • Set EOD Regional Nodes [774] = 888
    • Set EOD Mets [776] = 88
    • Set Summary Stage 2018 [764] = 9
    • Set Grade Clinical [3843] = 9
    • Set Grade Pathological [3844] = 9
    (This should only happen as part of the v2.1 update. Histologies that are not eligible for AJCC Staging in Schema ID = 00060 (Cervical Lymph Nodes, Unknown Primary of Head and Neck) were moved into the Ill-Defined schema. With the defaults, no review is necessary.)
    Alternately: If Schema ID [3800] = 00060 and Histology ICD-O-3 [522] is not 8010, 8046, 8051-8052, 8070-8074, 8082-8084, 8121, 8140, 8147, 8200, 8310, 8430, 8450, 8480, 8525, 8550, 8562, 8941, 9700, 9701, Recalculate and then set the defaults as described
  3. If AJCC ID [995] is NOT XX and TNM Edition Number [1060] = 88
    • Set TNM Edition Number = 08
    (This was a misunderstanding about site/hist combinations that are part of a chapter which does not have T, N, M or Stage Group defined should be handled. This affects Brain, CNS Other, HemeRetic, Intracranial Gland, Kaposi Sarcoma, Plasma Cell Disorders, Plasma Cell Myeloma, and Soft Tissue Rare schemas. No review is necessary.)

EOD v2.1 changes:

EOD and SS2018

includes changes to schema definitions, EOD fields and SS2018

  • Formal Schema Name: The formal name for the Cervix and Corpus schemas were revised to include Uteri:
    Cervix Uteri [8th: 2018-2020]
    Cervix Uteri [9th: 2021+]
    Corpus Uteri Adenosarcoma
    Corpus Uteri Carcinoma and Carcinosarcoma
    Corpus Uteri Sarcoma
  • General Change EOD fields:
    EOD Primary Tumor, EOD Regional Nodes, EOD Mets, EOD Prostate Pathological Extension: for the unknown code, the phrase 'not documented in patient record' was changed to be 'not documented in medical record'
    EOD Regional Nodes: Note was added (the # differs by schema) specifying to code 800 if regional lymph nodes are involved but which node isn’t specified. This was not added to
    Colon and Rectum (already had note)
    Kaposi Sarcoma, Mycosis Fungoides
    Brain, CNS Other, Intracranial Gland, Lymphoma, Lymphoma CLL/SLL, HemeRetic (Lymph nodes not applicable)
    Soft Tissue Rare, Soft Tissue Other, Soft Tissue Abdomen and Thoracic (800 is only positive node code)
  • Histology:
    8444, 8473 and 8965 were removed in v2.0 and should not have been. They were re-added.
    8455, 8483, 8484, 8859, 8976, 9111, 9366-9368 were added for 2022.
    9700-9701 were moved from all other schemas into Mycosis Fungoides (Schema ID = 00811). The only exceptions are Brain, CNS Other and Intracranial Gland for /0 and /1. **(See ‘EOD v2.1 Review and Conversion’)**
  • TNM Edition Number [1060]: If the AJCC ID is defined (is not XX), even if none of T, N, M or Stage Group are defined, the TNM Edition Number is now being set to 08. This affects Brain, CNS Other, HemeRetic, Intracranial Gland, Kaposi Sarcoma, Plasma Cell Disorders, Plasma Cell Myeloma, and Soft Tissue Rare schemas.
  • Appendix, Anus
    AJCC ID: 8033 is now considered AJCC eligible and will have an AJCC ID of 19 or 21 **(See ‘EOD v2.1 Review and Conversion’)**
  • Appendix
    EOD Primary Tumor; Code 000 was modified to include High-grade appendiceal mucinous neoplasm (HAMN)
    SS2018: Code 0 modified to include Low-grade appendical mucinous neoplasm (LAMN) and High-grade appendiceal mucinous neoplasm (HAMN)
  • Bladder
    EOD Primary Tumor: Note 3 had bullet added describing when to use Code 050, existing bullet for Code 000 revised
  • Bladder, Kidney Renal Pelvis, Urethra, Urethra-Prostatic
    SS2018: Code 0 has 'In situ, intraepithelial, noninvasive' replaced as the first line
  • Bone Appendicular Skeleton, Bone Pelvis, Bone Spine
    SS2018: Spinal Canal was moved from Code 7 to Code 2 for Spine (C412)
  • Brain, CNS Other, Intracranial Gland
    Schema and AJCC ID: Schema selection and AJCC ID calculation were restructured to show 8000-9993 for Beh=0, 1 to simplify the logic
  • Breast
    AJCC ID: 8509/2 is now considered AJCC eligible and will have an AJCC ID of 48.1 (Breast DCIS) **(See ‘EOD v2.1 Review and Conversion’)**
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Buccal Mucosa, Floor of Mouth
    EOD Primary Tumor: Note 4 modified to specify Invasion, rather than involvement, of cortical bone; Code 600 changed to be "Invasion through cortical bone"
  • Buccal Mucosa
    SS2018: Note 4 about cortical bone modified to specify Invasion rather than involvement and to assign Code 7
  • Buccal Mucosa, Floor of Mouth, Gum, Lip, Mouth Other, Palate Hard, Tongue Anterior
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Cervical Lymph Nodes and Unknown Primary (of Head and Neck), Ill-Defined Other
    Schema: Cervical Lymph Nodes and Unknown Primary was revised to only include those histologies that are eligible for AJCC staging. The other histologies were moved to Ill-Defined Sites **(See ‘EOD v2.1 Review and Conversion’)**
  • Cervical Lymph Nodes and Unknown Primary (of Head and Neck)
    EOD Regional Nodes: Note 3 Clinical assessment had an exception added related to neoadjuvant therapy
  • Cervix [8th]
    EOD Primary Tumor: Code 550 text was corrected (copy/paste error introduced in v2.0)
  • Cervix [V9]
    AJCC ID: Histologies 8045, 8054, 8085-8086, 8154, 8246, 8430, 8483-8484 will now return AJCC ID of 52; Histologies 8200, 8720 will now return AJCC ID of XX **(See ‘EOD v2.1 Review and Conversion’)**
  • Cervix [8th], Cervix [V9], Vagina, Vulva
    EOD Regional Nodes: Lymph nodes have been restructured, but no change to codes or meaning
    SS2018: Codes 3 and 7 had the lymph nodes restructured, but no changes to codes.
  • Cervix Sarcoma – New schema
    Schema: Cervix Sarcoma was added as Schema ID = 00528 and the histologies were removed from other schemas including Cervix, GIST, Soft Tissue Abdomen and Thoracic, Soft Tissue Rare, and Soft Tissue Other **(See ‘EOD v2.1 Review and Conversion’)**
  • Colon and Rectum
    AJCC ID: 8033, 8262 are now considered AJCC eligible and will have an AJCC ID of 20 **(See ‘EOD v2.1 Review and Conversion’)**
    EOD Regional Nodes: Note 3 added specifying when to use Code 200; 'PATHOLOGICIAL assessment only' was added to Code 200
  • Corpus Carcinoma and Carcinosarcoma
    AJCC ID: 8441/2 is now considered AJCC eligible and will have an AJCC ID of 53 **(See ‘EOD v2.1 Review and Conversion’)**
    EOD Primary Tumor: Codes 070 and 080 were removed; Code 000 was updated for EIN; Code 050 was updated for SEIC; Note 2 modified to only refer to Code 050 **(See ‘EOD v2.1 Review and Conversion’)**
    EOD Regional Nodes: Code 600 was updated to include ‘Size of lymph node metastasis unknown’
    SS2018: Code 0 modified to include SEIC
  • Cutaneous Squamous Cell Carcinoma of the Head and Neck
    AJCC ID: 8400 is no longer AJCC eligible, while 8402 is now an AJCC eligible histology **(See ‘EOD v2.1 Review and Conversion’)**
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Fallopian Tube, Ovary
    EOD Primary Tumor: Note 2 was restructured; Code 000 modified to include Low Grade and No grade STIC
  • Gallbladder
    EOD Regional Nodes: Code 300 had Portacaval added
    SS2018: Code 3 had Portacaval added
  • Gum, Lip, Mouth Other, Palate Hard, Tongue Anterior
    EOD Primary Tumor: Note 4 modified to specify Invasion, rather than involvement, of cortical bone;
  • Heart, Mediastinum and Pleura, Retroperitoneum, Soft Tissue Abdomen and Thoracic, Soft Tissue Head and Neck, Soft Tissue Trunk and Extremities, Soft Tissue Rare
    AJCC ID: 9222 is now considered AJCC eligible and will have an AJCC ID of 42, 44, 42, 40, 41 or 45**(See ‘EOD v2.1 Review and Conversion’)**
  • HemeRetic
    Regional Nodes Positive, Regional Nodes Examined: These had been limited to 99, but are now using the standard validate tables for these fields
  • Hypopharynx
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Kaposi Sarcoma
    EOD Primary Tumor: Note 2: had bullets added describing when to use Codes 100, 200 and 300
  • Larynx Glottic, Larynx Other, Larynx Subglottic, Larynx Supraglottic
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Liver
    EOD Primary Tumor: Note 3 was added describing the lobes of the liver
  • Lymphoma
    AJCC ID: 9715 is now AJCC eligible and will return AJCC ID = 79.0 **(See ‘EOD v2.1 Review and Conversion’)**
  • Lymphoma, Lymphoma CLL/SLL
    EOD Primary Tumor: Code 700 modified to include multiple extra-lymphatic organs/sites
    SS2018: Code 7 modified to include multiple extra-lymphatic organs/sites
  • Major Salivary Glands, Maxillary Sinus, Nasal Cavity and Ethmoid Sinus
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Merkel Cell
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Mouth Other
    SS2018: Note 4 about cortical bone modified to specify Invasion rather than involvement and to assign Code 7
  • Oropharynx HPV-Mediated (p16+), Oropharynx (p16-)
    EOD Primary Tumor: Base of Tongue for Lingual Tonsil moved from Code 200 to Code 100
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
    SS2018: Base of Tongue for Lingual Tonsil moved from Code 2 to Code 1
  • Ovary, Primary Peritoneal Carcinoma
    SS2018: Code 0 restructured, changed to ovarian mucosa, and STIC was added; Code 2, Adjacent (pelvic) peritoneum), remove extra parenthesis
  • Orbital Sarcoma
    Schema: Additional review by AJCC cause the following adjustment related to Soft Tissue Other/Soft Tissue Rare
    C690-C695, C699, C723 with 9222 were moved to Soft Tissue Rare (Schema ID = 00450, AJCC ID = 45)
    C696, C698 with 9222 were moved to Soft Tissue Other (Schema ID = 00459, AJCC ID = XX)
  • Penis
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
  • Pleural Mesothelioma
    EOD Mets: Notes were revised and expanded; Code 05 was added (Malignant pleural effusion) **(See ‘EOD v2.1 Review and Conversion’)**
  • Prostate
    EOD Primary Tumor: Note 2 added to code field based on DRE
    EOD Prostate Path Extension: Note 1 had bullet added to code TURP and simple prostatectomies in EOD Primary Tumor and the phrase about simple prostatectomy with negative margins was removed; Note 7 about when to use Code 950 was added
  • Skin Other
    EOD Primary Tumor: Code 200 was revised to include Bone and Cartilage
  • Small Intestine
    AJCC ID: 8144, 8213 are now considered AJCC eligible and will have an AJCC ID of 18.1 **(See ‘EOD v2.1 Review and Conversion’)**
  • Soft Tissue Abdomen and Thoracic, Soft Tissue Trunk and Extremities
    Schema: C474 was moved from Soft Tissue Abdomen and Thoracic into Soft Tissue Trunk and Extremities for diagnosis years 2018-2020. (This change was made for diagnosis years 2021 and later in version 2.0) **(See ‘EOD v2.1 Review and Conversion’)**
  • Soft Tissue Other and Soft Tissue Rare
    Schema: Soft Tissue Other was split into Soft Tissue Rare with Schema ID = 00450 which includes all combinations where AJCC ID = 45 and Soft Tissue Other with Schema ID = 00459 which includes all combinations where AJCC ID = XX. **(See ‘EOD v2.1 Review and Conversion’)**
    Schema: Additional review by AJCC caused the following additional adjustments where the listed combinations are moving to Soft Tissue Other (00459) and AJCC ID = XX:
    C473, C475, C493-C495 with 8901, 8910-8920, 9120, 9133, 9180 and Schema Discriminator 2 = 9
    C481-C488 with 8806, 8930-8931 and Sex = 4
    C696, C698 with 8930-8931, 8991, 9020, 9180, 9231
    Schema: Additional review by AJCC cause the following adjustment related to Orbital Sarcoma (00700)
    C690-C695, C699, C723 with 9222 are included in Soft Tissue Rare (Schema ID = 00450, AJCC ID = 45)
    C696, C698 with 9222 are included in Soft Tissue Other (Schema ID = 00459, AJCC ID = XX)
  • Stomach
    AJCC ID: 8213 is now considered AJCC eligible and will have an AJCC ID of 17 **(See ‘EOD v2.1 Review and Conversion’)**
    Schema Notes: Note 3 discussing EGJ was modified
  • Testis
    EOD Primary Tumor: Code 300 is now contributing an L to Summary Stage instead of RE
    EOD Regional Nodes: Note 2 Clinical assessment had an exception added related to neoadjuvant therapy
    SS2018: Code 1 modified to be with or without LVI, confined to testis, NOS also added; Code 2 had with LVI and limited to testis removed.
  • Thyroid, Thyroid Medullary
    EOD Regional Nodes: Code 000 revised to specify Microscopic assessment only; Code 050 revised to specify Clinical assessment only
  • Vagina
    EOD Regional Nodes: Note 4 was added related to code 800; Code 300 was restructured and para-aortic nodes were moved to the new Code 400
    EOD Mets: Code 10 was restructured and para-aortic was moved from the all sites category into the lower third category

SSDI and Grade

NAACCR is the custodian of these fields, changes are listed here for convenience. See Change Log on https://apps.naaccr.org/ssdi/list/ for complete information.

  • Metadata changes: These are changes to information available about the SSDIs
    Year Ranges: there is now a start and end year associated with SSDI and with each standard setter who requires the SSDI. If Start is blank, the default is 2018. If End is blank, the default is through the present. If the SSDI was implemented after 2018, the SSDI start will have a value.
    SEER (RC): a new tag has been added to track specifically when an SSDI is required by SEER if the incident cancer was collected as an analytic case from a CoC Facility (CoC Accredited Flag [2152] = 1) This is noted in NAACCR Volume II, Chapter VIII as RC. The underlying tag is 'SEER_REQUIRED_WHEN_COC_ANALYTIC'
  • General
    Grade Pathological [3844]: Note about when clinical workup should be used revised – last bullet under Surgical Resection was moved to its own category of No Surgical Resection
    Grade Post Therapy Clin (yc) [1068]: Note 1 regarding when to leave field blank had bullet added for when neoadjuvant therapy completed but no microscopic exam was done; Not required for CCCR
    Grade Post Therapy Path (yp) [3845]: Note 1 regarding when to leave field blank had bullet added for when neoadjuvant therapy completed but no surgery was performed; Note 2 regarding how to code when preferred grading system not available for yPath was added to those schemas with a preferred grading system; Note added (number varies) detailing when the grade from clinical work up can be used
    SSDIs effective AFTER 2018: Note 1 was added to all new SSDIs indicating the start year. A ‘blank’ code was added to the possible code list for years prior to the effect start date. P16
    SSDIs no longer required by any standard setters: Note 1 was added to SSDIs indicating the year after which no standard setter is collecting the code. A ‘blank’ code was added to the possible code list for years after the last required year.
    Unknown code (XX9, 99, etc): the phrase 'not documented in patient record' was changed to be 'not documented in medical record'
  • Bile Duct Intrahepatic
    Tumor Growth Patterns [3935]: not required by SEER after 2021
  • Bile Duct Intrahepatic, Bile Duct Perihilar
    Primary Scleros Cholangitis [3917]: not required by SEER after 2021
  • Bladder, Kidney Renal Pelvis, Urethra, Urethra-Prostatic
    Grade Post Therapy Pathological [3845]: Note 7 specifying that TURB does not qualify for Surgical resection of bladder was added
  • Brain, CNS Other, Intracranial Gland
    Brain Molecular Markers [3816]: Note 1 modified to clarify priority of 85 and 99 if both seem to apply
    Grade Clinical [3843]: Note 2 added to indicate that Grade Clinical can be assigned without histologic confirmation if histology is based on imaging
  • Breast
    ER Summary [3827], PR Summary [3915], HER2 Summary [3855]: Note 3 revised to specify evidence of in situ or invasive carcinoma; Note 4 revised to specify the invasive and in situ components described are in the primary tumor
    ER Percent Positive [3826], PR Percent Positive [3914]: Note 6 added describing how to code ranges other than the ones given in the codes
    HER2 IHC Summary [3850], HER2 ISH Summary [3854]: These are no longer required by CCCR, CoC or SEER (No standard setters are requiring these)
    HER2 ISH DP Copy Ratio [3852], HER2 ISH DP Copy No [3851], HER2 ISH SP Copy No [3853]: These are no longer required by CoC or SEER (No standard setters are requiring these)
    Lymph Nodes Positive Axillary Level I-II [3882]: Note 4 was revised, ‘removed’ changed to ‘positive’ and examples were added
    Grade Clinical [3843], Grade Pathological [3844], Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: Codes 1-3 modified to include Nottingham/Scarff Bloom-Richardson grade
    Grade Post Therapy Pathological [3845]: Note 5 related to priority order was added; Note 8 describing when nodal tissue can be used was added
  • Cervix V9
    p16[3956]: added for 2021 and later
  • Cervix 8th, Cervix V9, Vagina, Vulva
    LN Status Femoral-Inguinal, Para-Aortic, Pelvic [3884]: Retired (It will be removed from all schemas next year); it is replaced by the related SSDIs. Note 1 added stating this field should no longer be coded and indicating the replacement fields; blank added to code list for cases collected after new fields are available
    LN Status: Femoral-Inguinal [3959]: added to Vagina and Vulva
    LN Status: Para-aortic [3958]: added to Cervix 8th, Cervix V9 and Vagina
    LN Status: Pelvic [3957]: added to Cervix 8th, Cervix V9, Vagina, and Vulva **(See ‘EOD v2.1 Review and Conversion’)**
    LN Assessment: Femoral-Inguinal [3871]: Note 2 added to list applicable lymph nodes; Note 4 added to not include ITCs; Notes updated to indicate LN Status, Femoral-Inguinal; Code 2 had 'Sentinel node biopsy' added; Codes 7 and 9 had Regional replaced with 'Femoral-inguinal'; Removed from Cervix 8th and Cervix V9.
    LN Assessment: Para-Aortic [3872]: Note 2 added to list applicable lymph nodes; Note 4 added to not include ITCs; Notes updated to indicate LN Status: Para-Aortic; Code 2 had 'Sentinel node biopsy' added; Codes 7 and 9 had Regional replaced with 'Para-Aortic'; Removed from Vulva.
    LN Assessment: Pelvic [3873]: Note 2 added for Vulva that pelvic nodes are distant; Note added to list applicable lymph nodes; Note added to not include ITCs; Notes updated to indicate LN Status: Pelvic; Code 2 had 'Sentinel node biopsy' added; Codes 7 and 9 had Regional replaced with 'Pelvic'
  • Colon and Rectum
    BRAF Mutational Analysis [3940], NRAS Mutational Analysis [3941]: these are now required by CoC
    Microsatellite Instability [3890]: Note 3 added indicating results from nodal and metastatic tissue may be used; Code 9 updated to include MSI-equivocal
  • Corpus Adenosarcoma, Corpus Carcinoma and Carcinosarcoma, Corpus Sarcoma, Cervix Sarcoma
    Number of Examined Para-aortic Nodes [3899], Number of Examined Pelvic Nodes [3900]: Note 2 added to list applicable lymph nodes; Note 3 excluding ITCs was removed; Note 4 describing when to code X9 was modified to clarify dissection and when 00, X6 and X9 should be used
    Number of Positive Para-aortic Nodes [3901], Number of Positive Pelvic Nodes [3902]: Note 2 added to list applicable lymph nodes; Note 5 describing when to code X9 was modified to clarify dissection and when X6 should be used
  • Corpus Carcinoma and Carcinosarcoma
    FIGO Stage [3936]: Note 5 was added to describe how to code EIC and SEIC
  • Esophagus, Esophagus Squamous, Stomach
    HER2 Overall Summary [3855]: added Code 8 for not applicable/not collected
  • Fallopian Tube, Ovary
    CA-125 PreTX Interpretation [3818]: CA-125 changed to CA-125 II in all notes, this is the next generation test
    FIGO Stage [3936]: Note 5 was added to describe how to code High-grade STIC and LGSC
  • Fallopian Tube, Ovary, Primary Peritoneal Carcinoma
    Residual Tumor Volume Post Cytoreduction [3921]: Note 2 added describing where the information can be found
  • GIST
    KIT Gene Immunohistochemistry [3865]: Note 4 added indicating results from nodal and metastatic tissue may be used
  • Heart Mediastinum and Pleura, Kaposi Sarcoma, Orbital Sarcoma, Retroperitoneum, Soft Tissue Abdomen and Thoracic, Soft Tissue Head and Neck, Soft Tissue Other, Soft Tissue Rare, Soft Tissue Trunk and Extremities
    Grade Clinical [3843], Grade Pathological [3844], Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: Codes 1-3 modified to include FNCLCC Grade
  • Ill-Defined Other
    Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: fixed typos in notes referred to the incorrect field or using the old field name
  • Kidney Parenchyma
    Grade Clinical [3843], Grade Pathological [3844], Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: Note about Fuhrman grade was removed; Codes 1-4 modified to include WHO/ISUP Grade value; Code 9 modified to include only Fuhrman grade documented
    Sarcomatoid Features [3925]: Note 5 and Code XX5 were added to handle when sarcomatoid features are only present from a metastatic site
  • Lung
    ALK Rearrangement [3938], EGFR Mutational Analysis [3939]: these are now required by CoC
  • Lymphoma, Lymphoma CLL/SLL
    HIV Status [3859]: This is no longer required by CoC; Note 5 was added indicating how to code a history of HIV
  • Lymphoma CLL/SLL
    Derived Rai Stage [3955]: added for 2018 and later as an output, value will be derived based on Lymphocytosis [3885], Adenopathy [3804], Organomegaly [3907], Anemia [3811] and Thrombocytopenia [3933]
    Lymphocytosis [3885], Adenopathy [3804], Organomegaly [3907], Anemia [3811] and Thrombocytopenia [3933]: Note 2 added specifying Code 5 should be used if primary site is not C421; Code 5 was added
    Lymphocytosis [3885]: Old Note 4 indicating lab value takes precedence was removed; Note 5 was revised to indicate that physician statement of Rai stage should take priority when conflicting information exists and it was moved to the end; Code 6 was modified to include a physician statement of Rai stage; Code 9 was modified to clarify that no Rai stage or lymphocytosis were documented
    Adenopathy [3804], Organomegaly [3907]: Note 7 was added indicating that physician statement of Rai stage should take priority when conflicting information exists; Codes 0 and 1 were revised to indicate the corresponding Rai stage; Code 9 was revised to modified to clarify that no Rai stage or the SSDI were document OR Rai stage was II/III-IV without documentation of the SSDI
    Anemia [3811] and Thrombocytopenia [3933]: ; Note 4 was revised to indicate that physician statement of Rai stage should take priority when conflicting information exists and it was moved to the end; Codes 0 and 6 were revised to indicate the corresponding Rai stage; Code 9 was revised to modified to clarify that no Rai state or the SSDI were document OR (for Anemia) Rai stage was IV without documentation of the SSDI
  • Lymphoma Ocular Adnexa
    Grade Clinical [3843], Grade Pathological [3844], Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: Code 1 and 2 modified to specify 10 HPF
  • NET Ampulla of Vater, NET Appendix, NET Colon and Rectum, NET Duodenum, NET Jejunum and Ileum, NET Pancreas, NET Stomach
    Grade Clinical [3843], Grade Pathological [3844], Grade Post Therapy Clinical [1068], Grade Post Therapy Pathological [3845]: 'or 2mm2' added to the mitotic count descriptor; Stated as WHO Grade added to grades 1 through 3
  • Melanoma Skin
    Ulceration [3836]: bullet added to Note 2 indicating ulcerated lesions on PE and ulceration on microscopic exam differ; bullets added to Note 3 describing when to use Codes 0 and 1 and that ulceration must be caused by the melanoma
  • Pancreas
    CA 19-9 PreTX Lab Value [3942]: this is now required by CoC; Note 4 about known lab values was added; Codes XXXX.2 and XXXX.3 for lab value not available were added
  • Plasma Cell Myeloma
    LDH (Lactate Dehydrogenase) Level [3869]: 'Pretreatment' removed from the name and 'pretx_' removed from the data item tag; this change was carried through the notes for this data item
    High Risk Cytogenetics [3857], LDH Level [3869], Serum Albumin Pretreatment Level [3930], Serum Beta-2 Microglobulin Pretreatment Level [3931]: Note 4 changed to indicate Code 5 should be used that if Schema Discriminator 1 = 1 or 9; Code 5 was added **(See ‘EOD v2.1 Review and Conversion’)**
  • Pleura Mesothelioma
    Pleural Effusion: [3913]: Notes were reorganized and information about when to use Codes 2 and 3 was added; Code 2 had text for physician statement added.
  • Prostate
    PSA Lab Value [3920]: Note 4 about known lab values was added; Codes XXX.2 and XXX.3 for lab value not available were added
    Gleason Patterns Clinical [3838], Gleason Score Clinical [3840]: Note 2 was revised to include TRUS and simple prostatectomy as valid procedures; Note 5 was added to Patterns to describe how to code when only the Score is available; Note 7 (old note 6) was revised to include TRUS and simple prostatectomy; these were required by NPCR since 2021
    Gleason Patterns Pathological [3889]: Note 2 had a bullet added indicating TURP and simple prostatectomy are coded in the Clinical field; Note 4 and 5 were added describing how to code when only the score is known and when different patterns are documented; Code X7 and X9 had ‘radical’ added before prostatectomy; these were required by NPCR since 2021
    Gleason Score Pathological [3841]: Note 2 was modified to specify radical prostatectomy and to indicate that TURP and simple prostatectomy results are coded in clinical; Code X7 and X9 were revised to specify radical prostatectomy; these were required by NPCR since 2021
    Gleason Tertiary Pattern [3842]: Note 3 was modified to specify radical prostatectomy; Code X7 was revised to specify radical prostatectomy
    Grade Clinical [3843], Grade Post Therapy Clinical [1068]: Note 5 modified to specify that simple prostatectomy are clinical
    Grade Pathological [3844], Grade Post Therapy Pathological [3845]: Note 6 modified to specify that simple prostatectomy are clinical and radical prostatectomy are pathological