Neoadjuvant Therapy

See the current version of the SEER Program Coding Manual under Reporting Guidelines, Section VII: First Course of Therapy, for complete coding instructions for the neoadjuvant data items. See also Appendix C.

For Prostate cancer, the role of neoadjuvant hormonal therapy has not been established, although hormonal therapy done prior to prostatectomy is commonly done. For many patients, hormonal therapy may be done for 2-4 months prior to prostatectomy, which does not meet the definition of neoadjuvant therapy.

• If a prostate patient receives hormonal therapy for a limited duration of time PRIOR to prostatectomy, code the hormonal therapy and the prostatectomy as regular treatment. The hormonal therapy would not be counted as neoadjuvant therapy unless the patient is receiving the therapy as part of a clinical trial for neoadjuvant therapy purposes.
• Clinical trials are currently being done to determine if hormonal therapy given for neoadjuvant therapy purposes is beneficial for patients. If you have a patient who is in a clinical trial receiving neoadjuvant hormonal therapy, this would be counted as neoadjuvant therapy.

Neoadjuvant therapy is systemic therapy that is administered prior to surgical resection. This may include chemotherapy, hormone, immunotherapy and/or radiation. For a treatment to be noted as neoadjuvant therapy, it must meet the treatment guidelines. (See the Prostate NCCN Guidelines to determine the appropriate guidelines for neoadjuvant therapy.)

If only systemic therapy (chemo, hormone, immune) or radiation are given (no surgical resection), then this is adjuvant therapy.

If neoadjuvant therapy is followed by surgery, do not record the size from the pathologic specimen. Code the largest size of tumor prior to neoadjuvant treatment; if unknown code size as 999.

Document neoadjuvant therapy details in NAACCR Item #’s (as applicable)

• 1632: Neoadjuvant Therapy
• 1633: Neoadjuvant Therapy-Clinical Response
• 1634: Neoadjuvant Therapy-Treatment Effect
• 2620: Text-Dx Proc-Radiation (Beam)
• 2630: Text-Dx Proc-Radiation Other
• 2640: Text-Chemo
• 2650: Text-Hormones
• 2660: Text-BRM
• 2670: Text-Other

See Additional Resources for Prostate Cancer Treatment.

Updated: June 15, 2026