Part V. Tumor Data

Section V.1, Primary Site

One of the major concerns of the CCR is the identification of the original (primary) site of a tumor -- not the metastatic (secondary) site. Identify the primary site by careful scrutiny of all reports in the patient's medical record. Where information in the record is conflicting, statements in the pathology report generally take precedence over other statements. If the record does not provide a clear answer, ask the patient's physician. If the only information available is the secondary site, then it should be reported in accordance with the instructions in Section V.1.3.

V.1.1 ICD-O Coding

The Primary Site field codes are found in the topography section of ICD-O*. In the ICD-O index, the site is indicated by a three-digit number preceded by a C. In the topography section, the first two digits stand for the part of the body and the third digit for a specific area in the part. Listings are arranged in the numerical order of the three digits. When entering the code, omit the period following the second digit.

*Beginning with cases diagnosed January 1, 2001, the ICD-O-3 (International Classification of Diseases for Oncology, Third Edition, 2000) must be used for coding primary site. For cases diagnosed prior to January 1, 2001, ICD-O-2 must be used. ICD-O-2 codes will not be allowed for cases diagnosed January 1, 2001 forward.

NOTE: For cases with unknown date of diagnosis collected 1/1/2001 and after, use ICD-O-3 to code site/histology/behavior/grade.

Examples

(1) All entries under lung have the first three characters C34, followed by a final digit indicating the subsite:

C34 BRONCHUS AND LUNG

C34.0 Main bronchus

Carina

Hilus of lung

C34.1 Upper lobe, lung

Lingula of lung

Upper lobe, bronchus

C34.2 Middle lobe, lung

Middle lobe, bronchus

C34.3 Lower lobe, lung

Lower lobe, bronchus

C34.8 Overlapping lesion of lung or bronchus

C34.9 Lung, NOS (not otherwise specified)

Bronchus, NOS

Bronchiole

Bronchogenic

Pulmonary, NOS

A computerized axial tomographic (CT or CAT) scan of a patient's chest revealed a large malignancy in the upper lobe of the left lung. The correct ICD-O-2 code is therefore C34.1, which should be entered C341.

(2) The site cardia of the stomach (the part of the stomach at the opening of the esophagus) is listed in the ICD-O-2 index under "cardia" or "stomach, cardia" as T-C16.0, which should be entered C160.

Co Code the last digit of the primary site code to '8' when a single tumor overlaps an adjacent subsite(s) of an organ and the point of origin cannot be determined.,

Examples

The patient has a 5 cm tumor that involves the dorsal surface and anterior 2/3 of the tongue. Code the primary site to C028 (overlapping lesion of tongue).

Code the last digit of the primary site code to '9' for single primaries, when multiple tumors arise in different subsites of the same anatomic site, unless the subsite is defined in one of the site groups listed in the SEER Site Grouping Table. Refer to the SEER Site Grouping Table in the section entitled "How to Determine Same vs Different Primary Site" to determine the primary site code for specified site groups. http://www.seer.cancer.gov/manuals/2004Revision 1/SPM_2004_maindoc.r1.doc

Examples

During a TURB, the physician describes multiple papillary tumors in the bladder neck (C675) and the lateral wall of the bladder (C672). Code the primary site as bladder, NOS (C679).

Examples

Patient has an infiltrating duct tumor in the upper outer quadrant (C504) of the right breast and another infiltrating duct carcinoma in the lower inner (C503) quadrant of the right breast. Code the primary site as breast, NOS (C509).

Part V. Tumor Data

Section V.1, Primary Site

V.1.1 ICD-O Coding

SEE ALSO the following topics for coding rules for Primary Site: