delmarva-dc - tumor registrars association of md · pdf file · 2015-10-06specific...

DelMarVa-DC

Regional Cancer Registrar’s

Educational Meeting

Doordan Conference Center

Anne Arundel Medical Center

Annapolis, MD

TNM Transition Updates &

News from SEER

Peggy Adamo, RHIT, CTR

NCI SEER

[email protected]

mailto:[email protected]

3

Outline

• CS TNM Transition Update

• SEER Summary Stage 2017

• 2017 Solid Tumor Rules

• ICD-O-3 Updates

• SEER Informatics Projects

• SEER Data Quality Projects

• New Registrar Tool

• 2016 SEER Workshop

Outline

CS TNM Transition update

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SEER Plans 2016

• ~Half of SEER registries continue CS

• All SEER registries collect TNM

oSEER API uses UICC TNM

CS TNM Transition Update

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What is UICC?

• Union for International

Cancer Control

• Published the UICC TNM

for over 50 years

• UICC TNM classification is

internationally accepted

standard for cancer

staging


http://www.uicc.org/resources/tnm/about

http://www.uicc.org/resources/tnm/about

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AJCC vs UICC TNM

• AJCC 7th edition is based on the UICC

7th edition

• Documenting differences between

AJCC and UICC (very few)

• Working with UICC TNM experts at

Princess Margaret Hospital (Canada),

including Dr. James Brierley


SEER Summary Stage 2017

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• Compatible with TNM 7th ed

oDerived from TNM elements or

oDirectly assigned

• Available through SEER staging API


2017 Solid Tumor Rules

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• 2007 MP/H rules 2017 Solid Tumor

rules

• On track for 2017 release

• Benign brain/CNS & malignant

brain/CNS ready for work group review

and/or beta testing


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2017 Solid Tumor Rules, cont.

• Next

oHead & Neck

oColon

oKidney

oMelanoma


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Table 3

Replaces Chart 1 (histology tree)

Histology Term Synonyms Variants Code

Angiocentric glioma 9431/1

Central neurocytoma Extraventricular neurocytoma

Cerebellar liponeurocytoma

9506/1

Chordoid glioma of the third

ventricle

Chordoid glioma 9444/1

Chondroma, NOS Chondroma

Enchondroma

9220/0

Chordoid plexus papilloma 9390/0

Atypical choroid

plexus papilloma

9390/1

Craniopharyngioma Rathke’s pouch tumor 9350/1

Adamantinomatous

craniopharyngioma

Craniopharyngioma,

adenomatous type

9351/1


Table 3: Reportable Histologies, NOS Terms. Synonyms, and Variants or

Subtypes of the NOS

Use this table to identify reportable histologies as well as the less

specific histology “NOS” and the variant or subtype of the NOS histology.

Use with rules M7, M8, M11, M12, and M13

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Table 4: Reportability of

Cranial Nerve (CN) Tumors

Name # Exits Cranium

Through

Function and Pathway

Cranial nerve,

NOS

Olfactory CNI

CN1

Cribriform plate Function: Taste, emotional function and memory. CNI is the

only cranial nerve to enter the cerebrum directly.

Pathway (Reportable): Reaches the surface of the brain by

traveling through the cribriform plate of the ethmoid bone.

Pathway: Sites not reportable: Originates on the olfactory

mucosa in the upper part of the nasal cavity, and then travels

through the cribriform plate of the ethmoid bone.

Optic CNII

CN2

Optic canal Function: Controls the pupillary light reflex and eye

movements.

Pathway (Reportable): CNII is unique because it is covered

with all three meningeal layers (dura, arachnoid, and pia.

Because CNII is intradural, it is reportable. It begins where

the retinal ganglion cells pierce the sclera and form the optic

disc. This nerve exits the optic canal and enters the middle

cranial fossa.

This table is used to determine reportability of cranial tumors. When cranial nerves exit the cranial or spinal meninges, they

become peripheral nerves. Benign tumors of peripheral nerves and meninges are not reportable.

Column 1: The proper name for the CN

Column 2: the number of the CN

Column 3: The point at which the nerve exits the cranium.

Column 4: Information on nerve function nerve and the pathways (reportable portions of nerve and non-reportable

portions of nerve.

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Table 5

Non-Reportable Neoplasms

Histology Code Site

Angiolipoma

Lipoma cavernosum

Telangiectatic lipoma

8861/0 A lipoma that contains an unusually large number or foci of

proliferated, neoplastic-like, frequently dilated vascular

channels. It is

a benign neoplasm of adipose tissue, composed of mature

fat cells.

Colloid cyst No code III ventricle

Epidermoid tumor/cyst No code

Epithelioid hemangioepithelioma 9133/1 Tumor that originates in blood vessels

Fibermoma No code A variant of lipoma

Glomus tympanicum, glomus

jugulare

8690/1 /0 and /1 tumors are not reportable because they occur in

the inner ear, the aortic body and other paraganglia

respectively; sites in which /0 and /1 tumors are not

reportable

Hemangioblastoma 9161/1 Primary site is the blood vessel. Even though the blood

vessel may be in the brain, the primary site is coded to

blood vessel.

Either the histology OR site is not reportable. For some neoplasms, there is no ICD-O-3 code for the

histology and/or the primary site. Use this table to determine non-reportable tumors.

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Table 6

Histology Code Site Code

Angiocentric glioma 9431/1 Cerebrum C710

Choroid plexus papilloma 9390/0 Intraventricular site (lateral and IV

ventricle), third ventricle

C713, C717,

C715

(Capillary) hemangioblastoma 9161/1 Cerebellum, spinal cord, cerebrum

(rare)

C716, C720,

C710

Craniopharyngioma 9350/1 Pituitary gland, sella turcica C751

Dermoid cyst 9084/0 Pineal gland, suprasellar C752, C719

Desmoplastic infantile ganglioglioma 9412/1 Supratentorial brain, NOS C710

Dysembryoplastic neuroepithelial

tumor (DNET)

9413/0 Cerebrum, temporal lobe C710, C712


Histologic types of Benign and Borderline Tumors that Occur within the

Brain

Code the primary site listed in the medical record or other relevant

documentation. Use this table to aid in making decisions about primary site

when the documentation is discrepant or not clear.

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New M Rules

Benign Brain/CNS

• Transformation from /0 to /1

• Transformation from /1 to /3

• Bilateral acoustic neuromas

• Multiple meningiomas

oNon-contiguous

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New H Rules

Benign Brain/CNS

• Priority order using source documents

to code histology

• Rule for coding NF1 and NF2

• Histology “trees” converted to tables

ICD-O-3 Updates

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ICD-O-3 Updates

• Reconvene NAACCR ICD-O-3

workgroup

• New codes, terms/synonyms in 4th

edition WHO Classification of Tumors*

o11 newly defined neoplasms & codes

o11 existing codes with new behaviors

o8 new terms/synonyms for existing

neoplasms *Not a complete list

ICD-O-3 Updates

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NAACCR Guidelines for

ICD-O-3 Update Implementation

• Table 2

o ICD-O-3 Changes Effective for January 1,

2015 also for 2016

oNo 2016 changes http://www.naaccr.org/StandardsandRegistryOperations/ImplementationGuidelines.aspx

ICD-O-3 Updates

http://www.naaccr.org/StandardsandRegistryOperations/ImplementationGuidelines.aspx

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New Version of ICD-O-3 Manual

• First revision

• Published 2013

• Includes some

terms/codes not

implemented in

US!!

• Use the 2001

version for now

ICD-O-3 Updates

SEER Informatics Projects

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Linkage Studies

• CS SSF 22 & 23

• Multigene Signature Method & Results

oOncotype DX

• 21 gene assay


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Linkage Studies, cont.

• IMS Health

oOrally administered chemotherapy


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Other Linkages in the Works

• Clinical data

oSerologic biomarkers

• Discussion data feed from clinical labs

– LabCorp

– Quest

• Longitudinal CEA, PSA, CA19


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Other Linkages in the Works, cont.

• Clinical data, cont.

oSpecific Tumor Characterization

• BRCA mutations

– Demonstration project to collect and link BRCA for

CA and GA

• Retrospective data from Myriad for Ovarian

and Breast

• 3 other companies participating with more

recent data


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Other Linkages in the Works, cont.

• Reaching out to pharmacy chains

oe.g. Walgreens

• Already report to state entities

– Controlled substances

• Potential to supplement treatment data

& case finding


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Future Linkages?

• Direct reporting into registry by patients?

• Linking with other sources

oPatient status & QOL

• Social media (with consent)

• Public data files


SEER Data Quality Projects

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Melanoma

SSF 1: Measured thickness

• Implied decimal point

• Similar to PSA issue

• Plan

oReview 7-8 thousand cases


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Neoadjuvant Therapy

• Data discrepancies

oSystemic treatment/surgery sequence

oCS tumor size/extent eval

oSurgery of primary site


New Registrar Tool

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Glossary for Registrars

• Released July 2015

• Update regularly

• Includes

oDefinition

oResource

oAlternate names

oAbstractor notes

oHistology & primary site (when applicable)

New Registrar Tool

seer.cancer.gov/seertools/glossary/

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Glossary Example

New Registrar Tool

2016 SEER Workshop

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2016 SEER Workshop

• Vegas Baby!

• Pre-NCRA

oSat & Sun, April 9-10, 2016

• Saturday: Central registry topics

• Sunday: General registry topics

SEER Workshop

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Questions?

• Thank you!!

Thank you!

delmarva-dc - tumor registrars association of md · pdf file · 2015-10-06specific...

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