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SEER Extent of Disease (EOD) coding has gone through several
revisions and now includes schemes for all sites of cancer.
The EOD coding scheme consists of a ten-digit code. It incorporates
three digits for the size and/or involvement of the primary
tumor, two for the extension of the tumor, and one more as
a general code for lymph node involvement. Four more digits
are used after these six: two for the number of pathologically
positive regional lymph nodes and two more for the number
of regional lymph nodes that are pathologically examined.
The code is based on clinical, operative, and pathological
diagnoses of the cancer. The size of tumor recorded is the
size before systemic (i.e., chemotherapy) or radiation therapy.
Examples for tumor extension codes for the colon are shown
in the table below.
Extent of Disease Codes for Colon Cancer as Classified by
the Surveillance, Epidemiology and End Results (SEER) Program
| Description of
Tumor Extent |
Codes |
| Noninvasive tumor |
00 |
| Polyp, noninvasive |
05 |
| Localized tumor in colon |
10-30 |
| Tumor invasive through bowel wall or adjacent
structures |
40-66 |
| Tumor with distant involvement |
70-85 |
| Unknown extension |
99 |
As depth of invasion increases in a site the extension code
increases. It is important to review the extent of disease (EOD)
codes and coding instructions at the time of abstracting in
order to ensure accuracy. Each site has a different scheme.
Regional lymph nodes are listed for each applicable site.
Regional lymph nodes do not apply to sites such as the brain,
lymphoma, and the hematopoietic system. These cancers induce
leukemia, multiple myeloma, and other hemoatopoietic and reticuloendothelial
neoplasms. The lymphoma scheme reflects systemic symptoms
at diagnosis. Positive and examined regional nodes are not
applicable to these sites.
The EOD coding scheme provides a value, or code, for the
lymph node field for all sites. Adjacent (regional) lymph
nodes may be classified by size, laterality, number of nodes
involved, and the distance of the nodes from the organ of
origin. Lymph node involvement is also a hierarchical code.
When lymph nodes are described as fixed, matted, or mass,
they are considered to be involved with tumor. Terms such
as palpable, enlarged, or lymphadenopathy
do not indicate involvement in solid tumors. A clinical or
pathological statement must verify the presence of tumor.
When staging lymphomas, however, any of these terms indicate
involvement. Nodes that are part of a resected primary site
specimen should be considered regional nodes.
The extent of disease coding scheme records the number of
regional nodes found positive for cancer at pathological examination.
The number of regional lymph nodes pathologically examined
must also be recorded.
The EOD coding system also includes schemes for Kaposi's
sarcoma and mycosis
fungoides and Sezary
disease . There is no staging system for this disease
in the American Joint Committee on Cancer staging system.
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