· Site-specific codes for this data item are found in Surgery of the Primary Site Codes.
· If registry software allows only one procedure to be collected, document the most invasive surgical procedure for the primary site.
· If registry software allows multiple procedures to be recorded, this item refers to the most invasive surgical procedure of the primary site.
· For codes 00 through 79, the response positions are hierarchical by position (not necessarily numerically). Last-listed responses take precedence over responses written above. Code 98 takes precedence over code 00. Use codes 80 and 90 only if more precise information about the surgery is not available.
· Biopsies that remove all of the tumor and/or leave only microscopic margins are to be coded in this item.
· Surgery to remove regional tissue or organs is coded in this item only if the tissue/organs are removed in continuity with the primary site, except where noted in the site-specific Surgery of the Primary Site Codes.
· If a previous surgical procedure to remove a portion of the primary site is followed by surgery to remove the remainder of the primary site, then code the total or final results.
· If the procedure coded in this item was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record this surgery in the item Palliative Care (NAACCR Item #3270).
This item was abstracted using the FORDS manual for diagnosis years 2003 and later. For cases diagnosed on or before December 31, 2002, surgery of the primary site was originally abstracted using the ROADS manual, and converted by NCDB to the current version.
If multiple first course surgeries are performed on the primary site, the code represents the cumulative effect of all primary site surgeries. For example, if a breast cancer patient is treated with an excisional biopsy, then a lumpectomy, then a mastectomy, the mastectomy is coded in this field. The date of the mastectomy is represented in DX_DEFSURG_STARTED_DAYS.
CoC cancer programs are required to identify treatment their patients received from all sources. Surgical treatment may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file. This refers to the final surgery of the primary site, cumulative for all procedures, for the cancer by any facility.