Survival Status

Field Length:  1

Enter the one digit code which describes the patient and tumor status at last contact.

If a patient is recorded as dead (codes 4-9), then none of the seven "Reason No Therapy" fields can be coded 8.  Review and update this code, if applicable. 

Code 1 - Alive, no evidence of disease (NED)

Appropriate Scenarios for Code 1 include:

• The physician documents that the patient is without disease following treatment (i.e., complete remission).

• The patient had localized disease that was fully excised with negative surgical margins.

• In rare cases, patients with regional disease may qualify if:

  • The primary site was surgically removed with negative margins, and

  • Any metastatic regional lymph nodes were also removed, with no evidence of residual disease.

  • The physician has documented a complete response to therapy, with no evidence of disease or recurrence.

• In rare cases, patients diagnosed with metastatic disease may be coded as NED if the following conditions are met:

  • Additional clinical information is required to confirm NED status. Please consult the treating physician for clarification.

  • The physician has documented a complete response to therapy, with no evidence of disease or recurrence.

  • Follow the Solid Tumor Rules to determine whether a new primary should be assigned.

    • Source: https://cancerbulletin.facs.org/forums/node/156247

Code 2 – Alive, Tumor Present

Code 3 - Alive, cancer unknown

Code 4 – Dead, Unrelated to This Cancer

Code 5 – Dead, Due to This Cancer

• The patient was never rendered disease-free by treatment:

  • Positive surgical margins without additional treatment.

  • Metastatic or persistent disease post-treatment.

  • No documentation indicating complete remission.

• The patient’s cancer recurred after initially being disease-free.

• If the patient is coded as “Alive, disease-free” (Code 1), and a death certificate lists this cancer as the primary cause of death (line 1):

  • Review the record for any documentation of recurrence.

  • If recurrence is confirmed or likely, update:

    • Survival status to Code 5.

    • Recurrence date to the date of death (unless a more accurate date is available in the record).

    • Recurrence status to 88 (unless a more accurate status is found).

Code 6 – Dead, Due to Complications of This Cancer
Use code 6 when the patient was disease-free after therapy but died due to treatment-related complications, such as:

• Radiation pneumonitis.

• Myocardial infarction (MI) after chemotherapy.

If the death certificate lists the cancer in lines 2–4 (contributing causes of death) and the patient was disease-free:

• Use Code 6.

• Do not change recurrence status or recurrence date, as the cancer was not the primary cause of death.

[instructions before 8/27/25]

Code 1  Alive, no evidence of tumor present.  Should be used for the following conditions:

• Physician states that the patient is without disease after treatment

• Patient has localized disease completely removed at surgery with negative margins

Code 4 Dead, unrelated to this cancer.  Should be used for the following conditions:

• Patient expires of non-cancer related cause per physician or death certificate

• Patient expires of a cancer different than the primary you are updating per physician or death certificate

Code 5 Dead, due to this cancer.  Should be used for the following conditions:

• Patient expires and has not been rendered disease free by treatment (positive margins after surgery without additional treatment, patient has metastatic disease and has persistent disease after treatment)(no documentation by physician that treatment has resulted in complete remission), patient’s cancer has recurred

• If a patient has a cancer sequenced, is noted to have survival status coded to 1 (disease free) and you receive death certificate information that lists the cancer you have in the database in the first spot on the certificate, which is the primary cause of death, look for information regarding recurrence in your record. You can update survival status to 5 and update recurrence date to the date of death (unless you find more accurate information in the record, which you would us) and update recurrence status to 88 (unless you find more accurate information in the record, which you would use). 

Code 6, Dead, due to complications of this cancer.  Should be used for the following conditions:

• Patient rendered disease free after therapy, expires of therapy-induced side effects or complications (like radiation pneumonitis or MI after chemotherapy)

• If you receive death certificate information and the cancer listed in the 2^nd, 3^rd, or 4^th spot matches the reportable case you have in your database, and you have patient as disease free, you can use code 6, as lines 2-4 are contributing factors in death, not the primary cause. In this case, you would not change the recurrence status or date.

Cases diagnosed year 2018 and forward:

Cases diagnosis year prior to 2018: