DelMarVa-DC Regional Cancer Registrar s Educational Meeting. Doordan Conference Center Anne Arundel Medical Center Annapolis, MD

Transcription

1 DelMarVa-DC Regional Cancer Registrar s Educational Meeting Doordan Conference Center Anne Arundel Medical Center Annapolis, MD

2 TNM Transition Updates & News from SEER Peggy Adamo, RHIT, CTR NCI SEER

3 Outline CS TNM Transition Update SEER Summary Stage Solid Tumor Rules ICD-O-3 Updates SEER Informatics Projects SEER Data Quality Projects New Registrar Tool 2016 SEER Workshop Outline 3

4 CS TNM Transition update

5 SEER Plans 2016 ~Half of SEER registries continue CS All SEER registries collect TNM o SEER API uses UICC TNM CS TNM Transition Update 5

6 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 CS TNM Transition Update 6

7 AJCC vs UICC TNM AJCC 7 th edition is based on the UICC 7 th edition Documenting differences between AJCC and UICC (very few) Working with UICC TNM experts at Princess Margaret Hospital (Canada), including Dr. James Brierley CS TNM Transition Update 7

8 SEER Summary Stage 2017

9 SEER Summary Stage 2017 Compatible with TNM 7 th ed o Derived from TNM elements or o Directly assigned Available through SEER staging API SEER Summary Stage

10 2017 Solid Tumor Rules

11 2017 Solid Tumor Rules 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 2017 Solid Tumor Rules 11

12 2017 Solid Tumor Rules, cont. Next o Head & Neck o Colon o Kidney o Melanoma 2017 Solid Tumor Rules 12

13 Table 3 Replaces Chart 1 (histology tree) 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 Histology Term Synonyms Variants Code Angiocentric glioma 9431/1 Central neurocytoma Extraventricular neurocytoma 9506/1 Cerebellar liponeurocytoma Chordoid glioma of the third Chordoid glioma 9444/1 ventricle Chondroma, NOS Chondroma 9220/0 Enchondroma Chordoid plexus papilloma 9390/0 Atypical choroid 9390/1 plexus papilloma Craniopharyngioma Rathke s pouch tumor 9350/1 Adamantinomatous craniopharyngioma Craniopharyngioma, adenomatous type 9351/ Solid Tumor Rules 13

14 Table 4: Reportability of Cranial Nerve (CN) Tumors 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. Name # Exits Cranium Through Cranial nerve, NOS Olfactory Optic CNI CN1 CNII CN2 Cribriform plate Optic canal Function and Pathway 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. 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 14 cranial fossa.

15 Table 5 Non-Reportable Neoplasms 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. 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 Epidermoid tumor/cyst No code III ventricle No code Epithelioid hemangioepithelioma 9133/1 Tumor that originates in blood vessels Fibermoma No code A variant of lipoma Glomus tympanicum, glomus 8690/1 /0 and /1 tumors are not reportable because they occur in jugulare 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 15 blood vessel.

16 Table 6 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. 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, C Solid Tumor Rules 16

17 New M Rules Benign Brain/CNS Transformation from /0 to /1 Transformation from /1 to /3 Bilateral acoustic neuromas Multiple meningiomas o Non-contiguous 17

18 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 18

19 ICD-O-3 Updates

20 ICD-O-3 Updates Reconvene NAACCR ICD-O-3 workgroup New codes, terms/synonyms in 4 th edition WHO Classification of Tumors* o 11 newly defined neoplasms & codes o 11 existing codes with new behaviors o 8 new terms/synonyms for existing neoplasms *Not a complete list ICD-O-3 Updates 20

21 NAACCR Guidelines for ICD-O-3 Update Implementation Table 2 o ICD-O-3 Changes Effective for January 1, 2015 also for 2016 o No 2016 changes ICD-O-3 Updates 21

22 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 22

23 SEER Informatics Projects

24 Linkage Studies CS SSF 22 & 23 Multigene Signature Method & Results o Oncotype DX 21 gene assay SEER Informatics Projects 24

25 Linkage Studies, cont. IMS Health o Orally administered chemotherapy SEER Informatics Projects 25

26 Other Linkages in the Works Clinical data o Serologic biomarkers Discussion data feed from clinical labs LabCorp Quest Longitudinal CEA, PSA, CA19 SEER Informatics Projects 26

27 Other Linkages in the Works, cont. Clinical data, cont. o Specific 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 SEER Informatics Projects 27

28 Other Linkages in the Works, cont. Reaching out to pharmacy chains o e.g. Walgreens Already report to state entities Controlled substances Potential to supplement treatment data & case finding SEER Informatics Projects 28

29 Future Linkages? Direct reporting into registry by patients? Linking with other sources o Patient status & QOL Social media (with consent) Public data files SEER Informatics Projects 29

30 SEER Data Quality Projects

31 Melanoma SSF 1: Measured thickness Implied decimal point Similar to PSA issue Plan o Review 7-8 thousand cases SEER Data Quality Projects 31

32 Neoadjuvant Therapy Data discrepancies o Systemic treatment/surgery sequence o CS tumor size/extent eval o Surgery of primary site SEER Data Quality Projects 32

33 New Registrar Tool

34 Glossary for Registrars Released July 2015 Update regularly Includes o Definition o Resource o Alternate names o Abstractor notes o Histology & primary site (when applicable) New Registrar Tool 34

35 seer.cancer.gov/seertools/glossary/

36 Glossary Example New Registrar Tool 36

37 2016 SEER Workshop

38 2016 SEER Workshop Vegas Baby! Pre-NCRA o Sat & Sun, April 9-10, 2016 Saturday: Central registry topics Sunday: General registry topics SEER Workshop 38

39 Questions? Thank you!! Thank you! 39

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