Appendix H 2018 FCDS Required Site Specific Data Items (SSDIs)

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1 Below is the short list of Site Specific Data Items (SSDI) Required by FCDS for The list may be subject to changes. FCDS requires only a subset of the 136 total SSDIs available to be reported as compared to the Commission on Cancer Requirements. FCDS will accept and monitor data from these 48 new data items for missing data and unknown values for any analytic case reported. SSDI data should be available for every analytic case meeting AJCC Schema Criteria. Please refer to the Site Specific Data Items Manual for more information and specific coding instructions for each item. FCDS Required Item Number Item Name Start C 3804 Adenopathy 2018 C 3806 AFP Post-Orchiectomy Range 2018 C 3808 AFP Pre-Orchiectomy Range 2018 C 3809 AFP Pretreatment Interpretation 2018 C 3811 Anemia 2018 C 3812 B symptoms 2018 C 3816 Brain Molecular Markers 2018 C 3817 Breslow Tumor Thickness 2018 C 3826 Estrogen Receptor Percent Positive or Range 2018 C 3827 Estrogen Receptor Summary 2018 C 3828 Estrogen Receptor Total Allred Score 2018 C 3829 Esophagus and EGJ Tumor Epicenter 2018 C 3835 Fibrosis Score 2018 C 3837 Gestational Trophoblastic Prognostic Scoring Index 2018 C 3838 Gleason Patterns Clinical 2018 C 3839 Gleason Patterns Pathological 2018 C 3840 Gleason Score Clinical 2018 C 3841 Gleason Score Pathological 2018 C 3842 Gleason Tertiary Pattern 2018 C 3843 Grade Clinical 2018 C 3844 Grade Pathological 2018 C 3845 Grade Post Therapy 2018 C 3847 hcg Post-orchiectomy Range 2018 C 3849 hcg Pre-orchiectomy Range 2018 C 3855 HER2 Overall Summary 2018 C 3856 Heritable Trait 2018 C 3857 High Risk Cytogenetics 2018 C 3865 KIT Gene Immunohistochemistry 2018 C 3867 LDH Post-Orchiectomy Range 2018 C 3868 LDH Pre-Orchiectomy Range 2018 C 3869 LDH Pretreatment Level 2018 C 3870 LDH Upper Limits of Normal 2018 C 3882 LN Positive Axillary Level I-II 2018 C 3883 LN Size 2018 C 3885 Lymphocytosis 2018 C 3887 Measured Basal Diameter 2018 C 3888 Measured Thickness 2018 C 3890 Microsatellite Instability (MSI) 2018 C 3895 Multigene Signature Results 2018 C 3904 Oncotype Dx Recurrence Score-Invasive 2018 C 3906 Oncotype Dx Risk Level-Invasive 2018 C 3907 Organomegaly 2018 C 3910 Peripheral Blood Involvement 2018 C 3911 Peritoneal Cytology 2018 C 3914 Progesterone Receptor Percent Positive or Range 2018 C 3915 Progesterone Receptor Summary 2018 C 3916 Progesterone Receptor Total Allred Score 2018 C 3917 Primary Sclerosing Cholangitis 2018 C 3920 PSA (Prostatic Specific Antigen) Lab Value 2018 C 3923 S Category Clinical 2018 H 1

2 C 3924 S Category Pathological 2018 C 3926 Schema Discriminator C 3927 Schema Discriminator C 3928 Schema Discriminator C 3930 Serum Albumin Pretreatment Level 2018 C 3931 Serum Beta-2 Microglobulin Pretreatment Level 2018 C 3932 LDH Pretreatment Lab Value 2018 C 3933 Thrombocytopenia 2018 H 2

3 Below are AJCC ID and Schema ID that go with each required SSDI identified by CoC/NPCR/SEER Program Requirements. Please note that a single SSDI may be used in multiple AJCC ID/Schema ID using the same coding instructions. Please refer to the Site Specific Data Items Manual for more information and specific coding instructions for each item. H 3

4 Below is the complete list of the 163 total 2018 SSDI Data Items the FCDS Required SSDI Items are highlighted in green. Again, FCDS only requires data collection on 43 of the 163 total 2018 SSDI Data Items. Your facility may require collection of additional SSDIs as a participant in NCDB or other case reporting to some other organization or program. Any SSDI on the list not highlighted in green is not required by FCDS but may be required by the CoC and/or SEER. Please refer to the Site Specific Data Items Manual for more information and specific coding instructions for each item. FCDS Item Required Number Item Name Start C 3804 Adenopathy AFP Post-Orchiectomy Lab Value C 3806 AFP Post-Orchiectomy Range AFP Pre-Orchiectomy Lab Value C 3808 AFP Pre-Orchiectomy Range 2018 C 3809 AFP Pretreatment Interpretation AFP Pretreatment Lab Value C 3811 Anemia 2018 C 3812 B symptoms Bilirubin Pretreatment Total Lab Value 3814 Bilirubin Pretreatment Unit of Measure 3815 Bone Invasion C 3816 Brain Molecular Markers 2018 C 3817 Breslow Tumor Thickness CA-125 Pretreatment Lab Value 3819 CEA Pretreatment Interpretation 3820 CEA Pretreatment Lab Value 3821 Chromosome 3 Status 3822 Chromosome 8q Status 3823 Circumferential Resection Margin (CRM) 3824 Creatinine Pretreatment Lab Value 3825 Creatinine Pretreatment Unit of Measure C 3826 Estrogen Receptor Percent Positive or Range 2018 C 3827 Estrogen Receptor Summary 2018 C 3828 Estrogen Receptor Total Allred Score 2018 C 3829 Esophagus and EGJ Tumor Epicenter Extranodal Extension Clin (non-head and Neck) 3831 Extranodal Extension Head and Neck Clinical 3832 Extranodal Extension Head and Neck Pathological 3833 Extranodal Extension Path (non-head and Neck) 3834 Extravascular Matrix Patterns C 3835 Fibrosis Score FIGO Stage C 3837 Gestational Trophoblastic Prognostic Scoring Index 2018 C 3838 Gleason Patterns Clinical 2018 C 3839 Gleason Patterns Pathological 2018 C 3840 Gleason Score Clinical 2018 C 3841 Gleason Score Pathological 2018 C 3842 Gleason Tertiary Pattern 2018 C 3843 Grade Clinical 2018 C 3844 Grade Pathological 2018 C 3845 Grade Post Therapy hcg Post-orchiectomy Lab Value C 3847 hcg Post-orchiectomy Range hcg Pre-orchiectomy Lab Value C 3849 hcg Pre-orchiectomy Range HER2 IHC Summary 3851 HER2 ISH Dual Probe Copy Number 3852 HER2 ISH Dual Probe Ratio H 4

5 3853 HER2 ISH Single Copy Number 3854 HER2 ISH Summary C 3855 HER2 Overall Summary 2018 C 3856 Heritable Trait 2018 C 3857 High Risk Cytogenetics High Risk Histologic Features 3859 HIV Status 3860 International Normalized Ratio Prothrombin Time 3861 Ipsilateral Adrenal Gland Involvement 3862 JAK Ki Invasion Beyond Capsule C 3865 KIT Gene Immunohistochemistry KRAS C 3867 LDH Post-Orchiectomy Range 2018 C 3868 LDH Pre-Orchiectomy Range 2018 C 3869 LDH Pretreatment Level 2018 C 3870 LDH Upper Limits of Normal LN Assessment Method Femoral-Inguinal 3872 LN Assessment Method Para-aortic 3873 LN Assessment Method Pelvic 3874 LN Distant Assessment Method 3875 LN Distant: Mediastinal, Scalene 3876 LN Head and Neck Levels I-III 3877 LN Head and Neck Levels IV-V 3878 LN Head and Neck Levels VI-VII 3879 LN Head and Neck Other 3880 LN Isolated Tumor Cells (ITC) 3881 LN Laterality C 3882 LN Positive Axillary Level I-II 2018 C 3883 LN Size LN Status Femoral-Inguinal, Para-aortic, Pelvic C 3885 Lymphocytosis Major Vein Involvement C 3887 Measured Basal Diameter 2018 C 3888 Measured Thickness Methylation of O6-Methylguanine-Methyltransferase C 3890 Microsatellite Instability (MSI) Microvascular Density 3892 Mitotic Count Uveal Melanoma 3893 Mitotic Rate Melanoma 3894 Multigene Signature Method C 3895 Multigene Signature Results NCCN International Prognostic Index (IPI) 3897 Number of Cores Examined 3898 Number of Cores Positive 3899 Number of Examined Para-Aortic Nodes 3900 Number of Examined Pelvic Nodes 3901 Number of Positive Para-Aortic Nodes 3902 Number of Positive Pelvic Nodes 3903 Oncotype Dx Recurrence Score-DCIS C 3904 Oncotype Dx Recurrence Score-Invasive Oncotype Dx Risk Level-DCIS C 3906 Oncotype Dx Risk Level-Invasive 2018 C 3907 Organomegaly Percent Necrosis Post Neoadjuvant 3909 Perineural Invasion C 3910 Peripheral Blood Involvement 2018 C 3911 Peritoneal Cytology 2018 H 5

6 3913 Pleural Effusion C 3914 Progesterone Receptor Percent Positive or Range 2018 C 3915 Progesterone Receptor Summary 2018 C 3916 Progesterone Receptor Total Allred Score 2018 C 3917 Primary Sclerosing Cholangitis Profound Immune Suppression 3919 Prostate Pathological Extension C 3920 PSA (Prostatic Specific Antigen) Lab Value Residual Tumor Volume Post Cytoreduction 3922 Response to Neoadjuvant Therapy C 3923 S Category Clinical 2018 C 3924 S Category Pathological Sarcomatoid Features C 3926 Schema Discriminator C 3927 Schema Discriminator C 3928 Schema Discriminator Separate Tumor Nodules C 3930 Serum Albumin Pretreatment Level 2018 C 3931 Serum Beta-2 Microglobulin Pretreatment Level 2018 C 3932 LDH Pretreatment Lab Value 2018 C 3933 Thrombocytopenia Tumor Deposits 3935 Tumor Growth Pattern 3936 Ulceration 3937 Visceral and Parietal Pleural Invasion H 6