Multiple Reportable Tumors

Generally, a separate abstract is prepared for each independent tumor. However, specific rules may apply for some primary sites. The Solid Tumor Rules provide instructions on how to determine multiple primaries and tumor histologies https://seer.cancer.gov/tools/solidtumor/. The Hematopoietic Database provides instructions on how to determine multiple primaries and tumor histologies for hematopoietic primaries (lymphoma and leukemia) https://seer.cancer.gov/tools/heme/. It is important to follow the reporting guidelines for each primary site.

When a patient is initially entered into the registry database, they are given a local registry number, or accession number (this is a method recommended by the American College of Surgeons) and their initial tumor is given a sequence number. Subsequent primaries are given higher sequence numbers in order. For example, the sequence number for the first malignant/in-situ primary tumor is always 00. If another malignant/in-situ primary is entered into the registry database for that patient, the sequence number of the second primary is 02 and the first primary becomes 01. Subsequent malignant/in-situ primaries become 03, 04 and so on. The patient’s accession number never changes, but each primary is recorded on a separate abstract with a separate sequence number. Benign tumor sequence number start at 60 and follow a similar process. The first benign tumor is 60, the second is 62 (the first becomes 61), the third benign tumor is 63, fourth is 64 and so on.

Updated: December 28, 2023