2016 DATA CHANGES ___________________________________ - PDF document

___________________________________ 1 ___________________________________ ___________________________________ 2016 DATA CHANGES ___________________________________ ___________________________________ ___________________________________ ___________________________________ CALIFORNIA CANCER REGISTRY ___________________________________ Outline ___________________________________ 2  New Data Items ___________________________________  3 New Tumor Size Fields  Mets at Diagnosis Fields  Collaborative Stage ___________________________________  What’s discontinued  Data items remaining  Revised Data items  New AJCC categories ___________________________________  Examples TNM data entry 2015 vs 2016  TNM Edits ___________________________________  CCR Updates/Reminders  ICD-O-3  Reportability update for CCR  Visually Edited Data Items for 2016 ___________________________________  2016 Staging Requirements ___________________________________ New Data Item – Tumor Size Clinical ___________________________________ 3  Tumor Size Clinical (SEER) ___________________________________  Record largest clinical tumor size prior to any treatment , i.e., neoadjuvant therapy, or surgery, etc. ___________________________________  Code the largest TS from PE, imaging, Bx, or other diagnostic procedure ___________________________________ Example:  Patient has a palpable 2.2 cm mass in the right breast. Bx ___________________________________ confirms invasive ductal ca. Pathologic tumor size from surgical resection is 2.8 cm.  Record Tumor Size Clinical as 022 (2.2cm=22mm) ___________________________________  If pretreatment clinical tumor size is not known, use code 999

___________________________________ New Data Item – Tumor Size Pathologic ___________________________________ 4  Tumor Size Pathologic (SEER) ___________________________________  Record largest pathologic TS from surgical resection  Even if patient received neoadjuvant therapy ___________________________________ Example:  Patient with 2.2 cm mass in right breast. Bx confirms invasive ___________________________________ ductal ca. Patient receives preoperative combination chemo followed by surgical resection. Pathologic resection tumor size is 1.8 cm. ___________________________________  Record Tumor Size Pathologic as 018 (18mm)  Information from a PE or imaging/radiographic techniques ___________________________________ cannot be used to code Tumor size pathologic ___________________________________ New Data Item – Tumor Size Summary ___________________________________ 5  Tumor Size Summary (NPCR/CoC) ___________________________________  When surgery is first definitive treatment  And NO neoadjuvant treatment received ___________________________________  Record TS from surgical resection  If neoadjuvant therapy preceded surgery ___________________________________  Record largest pretreatment tumor size(i.e., clinical tumor size)  Do not code size from pathologic specimen  If pretreatment tumor size is unknown, code 999 ___________________________________  If no surgical resection performed  Code TS from PE, imaging or other diagnostic workup (i.e., clinical ___________________________________ tumor size) ___________________________________ New Data Item – Tumor Size Summary ___________________________________ 6 Example 1: ___________________________________  Patient with 2.2 cm mass right breast. Bx confirms invasive ductal ca. Patient undergoes lobectomy and pathologic tumor is 2.8 cm. ___________________________________  Record Tumor Size Summary as 028 (28mm)  Pathologic tumor size ___________________________________ Example 2 :  Patient with 2.2 cm mass right breast. FNA/bx confirms invasive ductal ca. Patient receives neoadjuvant chemo ___________________________________ followed by lobectomy. Surgical resection pathologic tumor size is 2.8 cm.  Record Tumor Size Summary as 022 (22mm) ___________________________________  Clinical TS

___________________________________ New Data Items – Tumor Size ___________________________________ 7  Reminder: Document information in text to support Tumor ___________________________________ Size codes  For Complete Coding Guidelines refer to CCR Volume 1: ___________________________________  Tumor Size Clinical Section V.4.1.1 – placeholder for finalized SEER coding guidelines  ___________________________________  Tumor Size Pathologic Section V.4.1.2 – placeholder for finalized SEER coding guidelines  ___________________________________  Tumor Size Summary Section V.4.1.3 – Complete coding guidelines available ___________________________________  Additional reference 2016 FORDS Manual  ___________________________________ New Data Items – Mets at Diagnosis ___________________________________ 8  Replace similarly named CS Mets at Dx data items. ___________________________________  Mets at Diagnosis- Bone Codes:  Mets at Diagnosis- Brain 0= None, no involvement ___________________________________ 1=Yes, mets in this site  Mets at Diagnosis- Liver 8=Not Applicable  Mets at Diagnosis- Lung 9=Unknown ___________________________________  Mets at Diagnosis- Other  Mets at Diagnosis- Distant Lymph Node(s) ___________________________________  Mets may be clinical or pathologic  Mets may be solitary or multiple ___________________________________  Code all fields whether or not patient had preoperative systemic therapy. ___________________________________ New Data Items – Mets at Diagnosis ___________________________________ 9  Mets at Diagnosis- Other ___________________________________ Some Examples :  Carcinomatosis  Bone marrow ___________________________________  Malignant pleural effusion  Peritoneum ___________________________________  Skin  Adrenal gland  The “Mets at DX” fields are coded for all solid tumors, Kaposi ___________________________________ sarcoma, Unknown Primary and Other and Ill-Defined primary sites. ___________________________________  Refer to CCR Volume 1, Section V.4.2 for coding guidelines

___________________________________ ___________________________________ Collaborative Stage ___________________________________ 10 Discontinued CS Items ___________________________________ Continuing Data Items ___________________________________ ___________________________________ ___________________________________ ___________________________________ Discontinued CS Data Items for 2016 ___________________________________ 11 ___________________________________  CS Tumor Size  CS Extension  CS Tumor Size/Ext Eval ___________________________________  CS Lymph Nodes  CS Lymph Nodes Eval ___________________________________  CS Mets at DX  CS Mets Eval ___________________________________  CS Mets at DX Data Items  Bone, Brain, Liver, Lung  Still required for cases Dx 2004-2015 ___________________________________ ___________________________________ Continuing Data Items for 2016 ___________________________________ 12 ___________________________________  Regional Nodes Examined  Regional Nodes Positive ___________________________________  If definition difference for “regional” lymph nodes ___________________________________ between AJCC and SEER ___________________________________ AJCC definition takes precedence  ___________________________________

___________________________________ Continuing Data Items for 2016 ___________________________________ 13  Lymph-Vascular Invasion (presence or absence) ___________________________________  Required for ALL sites 2016 forward when available  Previously required for all Testis and Penis 2010 forward ___________________________________  Surgical Margins ___________________________________  Required from all reporting sources when available  Previously only required for CoC Codes: ___________________________________ 0-No residual  VE item for 2016 1-Residual tumor, NOS 2-Microscopic residual tumor 3-Macroscopic residual tumor 7-Margins not evaluable ___________________________________ 8-No primary surgery 9-Unknown not applicable ___________________________________ CS Site Specific Factors 2016 ___________________________________ 14 ___________________________________  SSFs used to determine directly assigned AJCC TNM Stage  Example: Gleason score and PSA value ___________________________________  SSFs with Prognostic significance  Example: ER/PR, HER2 for breast ___________________________________  CoC requires same SSF’s as collected in 2015 ___________________________________  Refer to Appendix “Y” in Volume 1 for CCR required SSF’s by primary site for 2016 ___________________________________ ___________________________________ Appendix Y-Site Specific Factors 2016 ___________________________________ 15 Navigate to CCR Volume 1: ___________________________________ http://www.ccrcal.org/Cancer_Reporting/Registrar_Resources/Reporting_Cancer_Cal.shtml  1.) Open Volume 1 2.) Note Appendices in Table of contents ___________________________________ 3.) Open Appendix “Y” ___________________________________ ___________________________________ Click on ___________________________________