Wisconsin Cancer Reporting System: Collaborative Staging ... · 000000 No mass/tumor foundNo...
Transcript of Wisconsin Cancer Reporting System: Collaborative Staging ... · 000000 No mass/tumor foundNo...
Collaborative Staging (CS) for State Reporting
May 20, 2010Wisconsin Cancer Reporting System
Carole Eberle BS, CTRTrainer
Topics Covered
• General Information about Staging (Stage of Disease)
• Collaborative Staging (CS)– General Information
• Site Specific Schema• Required Data Items for State Reporting
Staging in General Staging in General Stage of DiseaseStage of Disease
•• What It IsWhat It Is
•• Why It Is UsedWhy It Is Used
•• Kinds of Staging SystemsKinds of Staging Systems
•• Collaborative EffortsCollaborative Efforts
Staging (Stage of Disease)Staging (Stage of Disease)What It IsWhat It Is
•• Describes how much the cancer has spreadDescribes how much the cancer has spread•• Takes into accountTakes into account
–– Size of TumorSize of Tumor–– How deeply it has penetratedHow deeply it has penetrated–– Whether it has invaded adjacent organsWhether it has invaded adjacent organs–– How many lymph nodes (if any) it has spread toHow many lymph nodes (if any) it has spread to–– Spread to distant organs Spread to distant organs
Staging (Stage of Disease)Staging (Stage of Disease)Why It Is UsedWhy It Is Used
0
10
20
30
40
50
60
70
80
90
100
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4
•• Most powerful predictor of survivalMost powerful predictor of survival——(% (% survival)survival)
Staging (Stage of Disease)Staging (Stage of Disease)Why It Is UsedWhy It Is Used
0
20
40
60
80
100
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4
Surgery
S+C+RT
Surgery
S+ RT
S+C+RT
S+C+RT+O
•• Treatment Based on StageTreatment Based on Stage
Staging (Stage of Disease)Staging (Stage of Disease)Kinds (Systems) of Staging UsedKinds (Systems) of Staging Used
•• Specific to type (for ex: lung or breast)Specific to type (for ex: lung or breast)•• Lymphoma: Ann Arbor StagingLymphoma: Ann Arbor Staging•• HodgkinsHodgkins: I: I--IV scale or Cotswold System or IV scale or Cotswold System or
Modified Ann Arbor Staging SystemModified Ann Arbor Staging System•• Cervical/Ovarian: FIGO systemCervical/Ovarian: FIGO system•• Colon: DukeColon: Duke’’ss•• Melanoma: ClarkMelanoma: Clark’’s Level or s Level or BreslowBreslow DepthDepth•• Prostate: JewettProstate: Jewett--Whitmore Whitmore
Staging (Stage of Disease)Staging (Stage of Disease)Collaborative EffortsCollaborative EffortsMost Used SystemsMost Used Systems
•• NCI/NCI/SEERSEER SummarySummary Staging System (currently using Staging System (currently using Summary Stage 2000 Edition)Summary Stage 2000 Edition)–– InIn--situsitu–– LocalizedLocalized–– RegionalRegional–– DistantDistant
•• AJCC AJCC StagingStaging TNMTNM Staging System (using 7Staging System (using 7thth Edition with Edition with 2010 cases) 2010 cases) –– TumorTumor–– NodesNodes–– MetastasisMetastasis
Staging (Stage of Disease)Staging (Stage of Disease)Collaborative EffortsCollaborative Efforts
The Value of Each SystemThe Value of Each System•• AJCCAJCC TNM TNM
–– Provides forward flexibility and clinical utility for individualProvides forward flexibility and clinical utility for individual cancer casescancer cases–– Dynamic and changes periodically to meet decisionDynamic and changes periodically to meet decision--making needs of making needs of
clinicians regarding appropriate treatment and evaluation of resclinicians regarding appropriate treatment and evaluation of resultsults•• SEER Summary StageSEER Summary Stage
–– Provides a measure for cancer surveillance for populationProvides a measure for cancer surveillance for population--based registriesbased registries–– Provides meaningful data for analysis for populations, particulaProvides meaningful data for analysis for populations, particularly smaller rly smaller
groups of patientsgroups of patients–– Extent of Disease (EOD) coding system provides data that can be Extent of Disease (EOD) coding system provides data that can be used used
for epidemiological and cancer control studies; it assures consifor epidemiological and cancer control studies; it assures consistency over stency over time time
Staging (Stage of Disease)Staging (Stage of Disease)Collaborative EffortsCollaborative Efforts
•• Standards SettersStandards Setters–– National Cancer Institute (NCI)/Surveillance, Epidemiology National Cancer Institute (NCI)/Surveillance, Epidemiology
and End Results (SEER) Program and End Results (SEER) Program –– American Joint Committee on Cancer (AJCC)American Joint Committee on Cancer (AJCC)–– Centers for Disease Control and Prevention/National Centers for Disease Control and Prevention/National
Program of Cancer Registries (CDC/NPCR)Program of Cancer Registries (CDC/NPCR)–– National Cancer Registrars Association (NCRA)National Cancer Registrars Association (NCRA)–– North American Association of Central Cancer Registries North American Association of Central Cancer Registries
(NAACCR)(NAACCR)–– American College of Surgeons (American College of Surgeons (ACoSACoS) Commission on ) Commission on
Cancer (Cancer (CoCCoC))
Staging (Stage of Disease)Staging (Stage of Disease)Collaborative EffortsCollaborative Efforts
•• Collaborative Staging Task Force 1998Collaborative Staging Task Force 1998–– Initial focus was to develop conversion methods between Initial focus was to develop conversion methods between
TNM (AJCC) and SEER Summary StageTNM (AJCC) and SEER Summary Stage–– Eliminate duplicate data collection by registrars for hospitals Eliminate duplicate data collection by registrars for hospitals
and other facilities and for central registriesand other facilities and for central registries–– Address concerns of clinicians for more clinically relevant Address concerns of clinicians for more clinically relevant
datadata–– Address public sectorAddress public sector’’s concerns about data reproducibility s concerns about data reproducibility
over timeover time–– Provide higher degree of compatibility between the systemsProvide higher degree of compatibility between the systems–– Expand data sharing opportunities Expand data sharing opportunities
Staging (Stage of Disease)Staging (Stage of Disease)Collaborative EffortsCollaborative Efforts
Collaborative Staging System (CSS)Collaborative Staging System (CSS)•• Carefully selected set of data items that describe how far a canCarefully selected set of data items that describe how far a cancer cer
has spread at time of diagnosishas spread at time of diagnosis•• Most of these data items have been collected by cancer registrarMost of these data items have been collected by cancer registrars s
and these include: tumor size, extension, lymph node status and and these include: tumor size, extension, lymph node status and metastatic statusmetastatic status
•• New items were created to collect information necessary for New items were created to collect information necessary for conversion algorithms and these include evaluation fields that conversion algorithms and these include evaluation fields that describe how the collected data were determined and describe how the collected data were determined and site/histology factors necessary to derive the final stage groupsite/histology factors necessary to derive the final stage groupinging
•• Additionally, this data set also includes several data items derAdditionally, this data set also includes several data items derived ived from the computer algorithms that classify each case into these from the computer algorithms that classify each case into these multiple staging systemsmultiple staging systems——that is AJCC (TNM) and SEER that is AJCC (TNM) and SEER Summary StagingSummary Staging
Collaborative StagingCollaborative Staging(CS) (CS)
•• Version 1 effective with 2004 casesVersion 1 effective with 2004 cases
•• Version 2 effective with 2010 cases Version 2 effective with 2010 cases —— CSv2CSv2
Collaborative Staging (CS) Collaborative Staging (CS) SiteSite--Specific SchemaSpecific Schema
Where to FindWhere to Find
•• http://www.cancerstaging.org/cstage/http://www.cancerstaging.org/cstage/•• It will say It will say ””Collaborative Stage, Data Collection SystemCollaborative Stage, Data Collection System””•• On the left, there will be choice called Site Specific Schema, On the left, there will be choice called Site Specific Schema,
click on thatclick on that•• There will be several choices, the easiest to use is the There will be several choices, the easiest to use is the
Alphabetical Order list, click on thatAlphabetical Order list, click on that•• Click on the site preferenceClick on the site preference•• Click on the specific element needed, for example: CS Tumor Click on the specific element needed, for example: CS Tumor
Size or CS Lymph NodesSize or CS Lymph Nodes•• This will give you all the schematic elements and codes for This will give you all the schematic elements and codes for
that part of the schema that part of the schema
Collaborative Staging (CS)Collaborative Staging (CS)SiteSite--Specific SchemaSpecific Schema
ExamplesExamplesBREASTBREASTC50.0C50.0--C50.6, C50.8C50.6, C50.8--C50.9C50.9C50.0 NippleC50.0 NippleC50.1 Central Portion of BreastC50.1 Central Portion of BreastC50.2 Upper inner quadrant of BreastC50.2 Upper inner quadrant of BreastC50.3 Lower inner quadrant of BreastC50.3 Lower inner quadrant of BreastC50.4 Upper outer quadrant of BreastC50.4 Upper outer quadrant of BreastC50.5 Lower outer quadrant of BreastC50.5 Lower outer quadrant of BreastC50.6 C50.6 AxillaryAxillary Tail of BreastTail of BreastC50.8 Overlapping Lesion of BreastC50.8 Overlapping Lesion of BreastC50.9 Breast, NOS C50.9 Breast, NOS Note: Laterality must be coded for this siteNote: Laterality must be coded for this site
CS Tumor SizeCS Tumor Size RegReg LN ExamLN ExamCS ExtensionCS Extension CS Mets at CS Mets at DxDxCS Tumor Size/Ext CS Tumor Size/Ext EvalEval CS Mets CS Mets EvalEvalCS Lymph NodesCS Lymph Nodes CS Site Specific Factor 1CS Site Specific Factor 1RegReg LN PosLN Pos CS Site Specific Factor 2CS Site Specific Factor 2
Collaborative Stage (CS)Collaborative Stage (CS)SiteSite--Specific SchemaSpecific Schema
ExamplesExamplesBreastBreastCS Tumor SizeCS Tumor Size•• Note 1 through Note 5:Note 1 through Note 5:
000000 No mass/tumor foundNo mass/tumor found001001--988988 001001--988 millimeters (code exact size in mm)988 millimeters (code exact size in mm)989989 989 millimeters or larger989 millimeters or larger990990 MicroinvasionMicroinvasion; microscopic focus or foci ; microscopic focus or foci
only, no size given, described as less than 1 only, no size given, described as less than 1 mm; stated asT1mi, NOS with no other info mm; stated asT1mi, NOS with no other info on sizeon size
Collaborative Stage (CS)Collaborative Stage (CS)SiteSite--Specific SchemaSpecific Schema
SiteSite--Specific Factors (SSF)Specific Factors (SSF)•• Vary for each siteVary for each site•• Some have more than Some have more than othersothers BREASTBREAST has 24 (which has 24 (which
is the most), others may have as few as 2 (for example, is the most), others may have as few as 2 (for example, LUNG)LUNG)
•• Refers to factors that are specific to the site, for Refers to factors that are specific to the site, for example: ERA test, PRA test which is specific to the example: ERA test, PRA test which is specific to the breastbreast
•• Each factorEach factor’’s value is recorded, for example ERA value s value is recorded, for example ERA value for a breast cancerfor a breast cancer
•• These prognostic factors help in determining the stage These prognostic factors help in determining the stage
Collaborative Staging (CS) Collaborative Staging (CS) SiteSite--Specific SchemaSpecific Schema
Where to FindWhere to Find
•• http://www.cancerstaging.org/cstage/http://www.cancerstaging.org/cstage/•• It will say It will say ””Collaborative Stage, Data Collection SystemCollaborative Stage, Data Collection System””•• On the left, there will be choice called Site Specific Schema, On the left, there will be choice called Site Specific Schema,
click on thatclick on that•• There will be several choices, the easiest to use is the There will be several choices, the easiest to use is the
Alphabetical Order list, click on thatAlphabetical Order list, click on that•• Click on the site preferenceClick on the site preference•• Click on the specific element needed, for example: CS Tumor Click on the specific element needed, for example: CS Tumor
Size or CS Lymph NodesSize or CS Lymph Nodes•• This will give you all the schematic elements and codes for This will give you all the schematic elements and codes for
that part of the schema that part of the schema
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReporting
•• Required for ALL sitesRequired for ALL sites–– CS Tumor SizeCS Tumor Size–– CS ExtensionCS Extension–– CS Tumor Size/Ext CS Tumor Size/Ext EvalEval–– CS Lymph NodesCS Lymph Nodes–– CS Mets at DXCS Mets at DX
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
Reporting (works in tandem with CS Reporting (works in tandem with CS Mets at DX)Mets at DX)
•• 4 NEW fields4 NEW fields–– BONE (excluding marrow)BONE (excluding marrow)–– LUNG (excluding pleura and pleural fluid)LUNG (excluding pleura and pleural fluid)–– BRAIN (excluding spinal cord and other CNS)BRAIN (excluding spinal cord and other CNS)–– LIVERLIVER
•• Code 0 when CS Mets at DX is 00Code 0 when CS Mets at DX is 00•• Code StructureCode Structure
–– 00——NoNo–– 11——YesYes–– 88——Not ApplicableNot Applicable–– 99----UnknownUnknown
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReportingSiteSite--Specific Factors Specific Factors
•• Site Specific Factors (for selected primary sites)Site Specific Factors (for selected primary sites)•• PleuraPleura SSF1SSF1•• RetinoblastomaRetinoblastoma SSF1SSF1•• Corpus AdenosarcomaCorpus Adenosarcoma SSF2SSF2•• Corpus CarcinomaCorpus Carcinoma SSF2SSF2•• Corpus SarcomaCorpus Sarcoma SSF2SSF2•• ProstateProstate SSF3SSF3•• BreastBreast SSF1, SSF2, SSF8, SSF9, SSF10, SSF11, SSF12, SSF13,SSF14SSF1, SSF2, SSF8, SSF9, SSF10, SSF11, SSF12, SSF13,SSF14•• NOTE: SSF25 is required for NOTE: SSF25 is required for all all sites, some sites will be auto filled, other sites, some sites will be auto filled, other
sites the abstractor will need to fill in (see attachment) sites the abstractor will need to fill in (see attachment)
CSCS--Data Items Required for State Data Items Required for State ReportingReporting
SiteSite--Specific Factor 25Specific Factor 25C11.1 C11.1
All All histologieshistologiesexcept 8720except 8720--87908790
C24.0C24.0
All All histologieshistologies
C69.4C69.4
87208720--87908790
C69.5C69.5
All All histologieshistologies
C16.1, C16.2, C16.1, C16.2, 80008000--8152, 81548152, 8154--8231, 82438231, 8243--8245, 8245, 8247, 8248, 82508247, 8248, 8250--8934, 89408934, 8940--9136, 9136, 91419141--9582, 97009582, 9700--97019701
C48.0C48.0--C48.2, C48.2, C48.8, 8000C48.8, 8000--8576, 8576, 85908590--8671, 89308671, 8930--8934, 89408934, 8940--91109110
CS Data Items for State ReportingCS Data Items for State ReportingSite Specific Factor 25Site Specific Factor 25
Low Probability of ReportingLow Probability of ReportingOne Half of One Percent of the TimeOne Half of One Percent of the Time
((½½ of 1%)of 1%)
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReportingWhat This MeansWhat This Means
•• When you are abstracting a cancer case, these When you are abstracting a cancer case, these required data items must be completedrequired data items must be completed
•• There are drop down menus which will helpThere are drop down menus which will help•• Primary site code and histology code must be Primary site code and histology code must be
filled in correctly, otherwise the correct menus filled in correctly, otherwise the correct menus will not appearwill not appear
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReportingBreast Case ScenarioBreast Case Scenario
Pathology Report on Lumpectomy for Breast Cancer: Pathology Report on Lumpectomy for Breast Cancer: Two millimeter infiltrating duct carcinoma of upper Two millimeter infiltrating duct carcinoma of upper outer quadrant of right breast. The cancer was outer quadrant of right breast. The cancer was completely confined to the breast. There were two completely confined to the breast. There were two lymph nodes taken. lymph nodes taken. ImmunohistochemistryImmunohistochemistry tests tests showed the nodes were negative with a HER2 score showed the nodes were negative with a HER2 score of 0 (negative). Neither the FISH or CISH tests were of 0 (negative). Neither the FISH or CISH tests were done. ERA and PRA were both negative. done. ERA and PRA were both negative.
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS Tumor SizeCS Tumor SizeBREASTBREAST
CS Tumor SizeCS Tumor Size
•• Note 1 through Note 5:Note 1 through Note 5:
CodeCode DescriptionDescription
010010 001001--988 millimeters (code exact size in 988 millimeters (code exact size in millimeters)millimeters)
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS ExtensionCS ExtensionBREASTBREAST
CS ExtensionCS Extension
•• Note 1 through Note 7:Note 1 through Note 7:
CodeCode DescriptionDescription TNM7TNM7MAPMAP
TNMTNM6MAP6MAP
SS77SS77
MAPMAP
SS2000SS2000MAPMAP
100100 Confined to Confined to breast tissue; breast tissue; Localized Localized NOSNOS
LL LL
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS Tumor Size/Ext CS Tumor Size/Ext EvalEvalBREASTBREAST
CodeCode DescriptionDescription Staging BasisStaging Basis
33 Surgical resection Surgical resection performed performed WITHOUT preWITHOUT pre--surgical systemic surgical systemic treatment or treatment or radiationradiation
pp
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS Lymph NodesCS Lymph NodesBREASTBREAST
CS Lymph NodesCS Lymph Nodes
•• Note 1 through Note 7:Note 1 through Note 7:
CodeCode DescriptionDescription TNMTNM7 7 MAPMAP
TNM 6 TNM 6 MAPMAP
SS77 SS77 MAPMAP
SS2000 SS2000 MAPMAP
000000 None; No None; No LN detected LN detected by IHCby IHC
NoneNone NoneNone
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS Mets at DXCS Mets at DXBREASTBREAST
CSCS Mets at DXMets at DX
•• Note 1:Note 1:•• Note 2:Note 2:
CodeCode DescriptionDescription TNMTNM7 7 MAPMAP
TNM 6 TNM 6 MAPMAP
SS77 SS77 MAPMAP
SS2000SS2000MAPMAP
0000 No; NoneNo; None M0M0 M0M0 NONENONE NONENONE
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 1Specific Factor 1BREASTBREASTCS SiteCS Site--Specific Factor 1Specific Factor 1Estrogen Receptor Assay (ERA)Estrogen Receptor Assay (ERA)•• Note 1 through Note 4:Note 1 through Note 4:
CodeCode DescriptionDescription
020020 Negative/normal; within normal limitsNegative/normal; within normal limits
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 2Specific Factor 2BREASTBREASTCS SiteCS Site--Specific Factor 2Specific Factor 2Progesterone Receptor Assay (PRA)Progesterone Receptor Assay (PRA)•• Note 1 through Note 4:Note 1 through Note 4:
CodeCode DescriptionDescription
020020 Negative/normal; within normal limitsNegative/normal; within normal limits
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 8Specific Factor 8BREASTBREASTCS SiteCS Site--Specific Factor 8Specific Factor 8HER2: IHC Test Lab ValueHER2: IHC Test Lab Value•• Note 1:Note 1:•• Note 2:Note 2:
CodeCode DescriptionDescription
000000 Score 0Score 0
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 9Specific Factor 9BREASTBREASTCS SiteCS Site--Specific Factor 9Specific Factor 9HER2: IHC Test InterpretationHER2: IHC Test Interpretation•• Note 1:Note 1:
CodeCode DescriptionDescription
020020 Negative/normal; within normal limitsNegative/normal; within normal limits
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 10Specific Factor 10BREASTBREAST
CS SiteCS Site--Specific Factor 10Specific Factor 10
HER2: Fish Test Lab ValueHER2: Fish Test Lab Value
•• Note 1 through Note 3:Note 1 through Note 3:
CodeCode DescriptionDescription
988988 Not applicable; Not applicable; Information not collected for this caseInformation not collected for this case
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 11Specific Factor 11BREASTBREASTCS SiteCS Site--Specific Factor 11Specific Factor 11HER2: FISH Test InterpretationHER2: FISH Test Interpretation•• NoteNote
CodeCode DescriptionDescription
988988 Not applicable;Not applicable;Information not collected for this caseInformation not collected for this case
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 12 Specific Factor 12 BREASTBREASTCS SiteCS Site--Specific Factor 12Specific Factor 12HER2: CISH Test Lab ValueHER2: CISH Test Lab Value•• Note 1 through Note 3:Note 1 through Note 3:
CodeCode DescriptionDescription
988988 Not applicable;Not applicable;Information not collected for this caseInformation not collected for this case
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 13Specific Factor 13BREASTBREAST
CS SiteCS Site--Specific Factor 13Specific Factor 13
HER2: CISH Test InterpretationHER2: CISH Test Interpretation
•• NoteNote
CodeCode DescriptionDescription
988988 Not applicable;Not applicable;Information not collected for this caseInformation not collected for this case
Collaborative Stage (CS)Collaborative Stage (CS)Breast Case ScenarioBreast Case Scenario
CS SiteCS Site--Specific Factor 14 Specific Factor 14
BREASTBREAST
CS SiteCS Site--Specific Factor 14Specific Factor 14
HER2: Result of other or unknown testHER2: Result of other or unknown test
•• NoteNote
CodeCode DescriptionDescription
988988 Not applicable;Not applicable;Information not collected for this caseInformation not collected for this case
CS Breast Case Scenario AnswersCS Breast Case Scenario Answers
Data ItemData Item CodeCode Data ItemData Item CodeCode
CS T SizeCS T Size 010010 SSF 8SSF 8 000000
CS ExtCS Ext 100100 SSF 9SSF 9 020020
CS TS/Ext CS TS/Ext EvalEval
33 SSF 10SSF 10 988988
CS LNCS LN 000000 SSF 11SSF 11 988988
CS Mets/DXCS Mets/DX 0000 SSF 12 SSF 12 988988
SSF 1SSF 1 020020 SSF 13SSF 13 988988
SSF 2SSF 2 020020 SSF 14SSF 14 988988
CS Breast Case Scenario AnswersCS Breast Case Scenario AnswersCS Mets at DXCS Mets at DX
CS Mets at DXCS Mets at DX BoneBone 00
CS Mets at DXCS Mets at DX LungLung 00
CS Mets at DXCS Mets at DX LiverLiver 00
CS Mets at DXCS Mets at DX BrainBrain 00
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReportingProstate Case ScenarioProstate Case Scenario
This 70 year old male was seen in the doctorThis 70 year old male was seen in the doctor’’s s office because of an elevated PSA. DRE office because of an elevated PSA. DRE revealed an abnormal in size prostate. Prostatic revealed an abnormal in size prostate. Prostatic needle core biopsy showed an needle core biopsy showed an adenocarcinomaadenocarcinomaof the prostate. Doctor stated it was a T2 of the prostate. Doctor stated it was a T2 lesion. Two regional nodes were taken for lesion. Two regional nodes were taken for assessment and found to be negative. No other assessment and found to be negative. No other disease progression noted. disease progression noted.
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State
ReportingReporting----Prostate Case ScenarioProstate Case ScenarioCS Tumor SizeCS Tumor Size
PROSTATEPROSTATE
CS Tumor SizeCS Tumor Size
CodeCode DescriptionDescription
999999 Unknown; size not statedUnknown; size not statedNot documented in patient Not documented in patient recordrecord
CSCS--Required Data Items for State Required Data Items for State ReportingReporting----Prostate Case ScenarioProstate Case ScenarioCS ExtensionCS Extension--Clinical ExtensionClinical Extension
PROSTATEPROSTATE
CS ExtensionCS Extension——Clinical ExtensionClinical Extension
•• Note 1 through Note 7:Note 1 through Note 7:CodCodee
DescriptioDescriptionn
TNM7 TNM7 MAPMAP
TNM TNM 6 6 MAPMAP
SS77 SS77 MAPMAP
SS2000 SS2000 MAPMAP
240240 Clinically Clinically apparent;coapparent;conn--fined to fined to prostate prostate NOSNOS
T2NOST2NOS T2T2NOSNOS
LL LL
CSCS--Required Data Items for State Required Data Items for State ReportingReporting——Prostate Case ScenarioProstate Case Scenario
CS Tumor Size/Ext CS Tumor Size/Ext EvalEvalPROSTATEPROSTATE
CS Tumor Size/Ext CS Tumor Size/Ext EvalEval
•• Note 1 through Note 9:Note 1 through Note 9:
CodeCode DescriptionDescription Staging BasisStaging Basis
11 Does not meet criteria for Does not meet criteria for path staging; No path staging; No prostatectomy done; prostatectomy done; evaluation based on needle evaluation based on needle core core bxbx, etc, etc
cc
CSCS--Required Data Items for State Required Data Items for State ReportingReporting--Prostate Case ScenarioProstate Case Scenario
CS Lymph NodesCS Lymph NodesPROSTATEPROSTATE
CS Lymph NodesCS Lymph Nodes
•• Note:Note:
CodeCode DescriptionDescription TNMTNM7MAP7MAP
TNMTNM6MAP6MAP
SS77 SS77 MAPMAP
SS2000SS2000MAPMAP
000000 None; no None; no regional LN regional LN involvementinvolvement
N0N0 N0N0 NoneNone NoneNone
CSCS--Required Data Items for State Required Data Items for State ReportingReporting——Prostate Case ScenarioProstate Case Scenario
CS Mets at DXCS Mets at DXPROSTATEPROSTATE
CS Mets at DXCS Mets at DX
CodeCode DescriptionDescription TNMTNM7 7 MAPMAP
TNM 6 TNM 6 MAPMAP
SS77 SS77 MAPMAP
SS2000 SS2000 MAPMAP
0000 No; noneNo; none M0M0 M0M0 NONENONE NONENONE
CSCS--Required Data Items for State Required Data Items for State ReportingReporting——Prostate Case ScenarioProstate Case Scenario
CS SiteCS Site--Specific Factor 3Specific Factor 3PROSTATEPROSTATE
CS SiteCS Site--Specific Factor 3Specific Factor 3
CS Extension CS Extension –– Pathologic ExtensionPathologic Extension
•• Note 1 through Note 10:Note 1 through Note 10:CodeCode DescriptionDescription TNMTNM
7 7 MAPMAP
TNM 6 TNM 6 MAPMAP
SS77 SS77 SS2000SS2000
970970 No No prostatprostat--ectomyectomy done done within 1within 1stst
course course txtx
TXTX TXTX UU UU
CS Prostate Case Scenario AnswersCS Prostate Case Scenario Answers
Data ItemData Item CodeCode Data ItemData Item CodeCode
CS Tumor CS Tumor SizeSize
999999 CS Lymph CS Lymph NodesNodes
000000
CS ExtCS Ext 240240 CS Mets at CS Mets at DXDX
0000
CS TS/Ext CS TS/Ext EvalEval
11 SSF 3SSF 3 970970
CSCS--Required Data Items for State Required Data Items for State ReportingReporting--Prostate Case ScenarioProstate Case Scenario
CS Mets at DXCS Mets at DX——NEW FieldsNEW FieldsCS Mets at DXCS Mets at DX BoneBone 00
CS Mets at DXCS Mets at DX LungLung 00
CS Mets at DXCS Mets at DX LiverLiver 00
CS Mets at DXCS Mets at DX BrainBrain 00
Collaborative Stage (CS)Collaborative Stage (CS)Required Data Items for State Required Data Items for State ReportingReporting——Melanoma Case Melanoma Case
ScenarioScenario
The patient was seen in the dermatologist office for a darkened The patient was seen in the dermatologist office for a darkened area on the right upper arm which has been present for about 2 area on the right upper arm which has been present for about 2 months. Pathology Report (after excision of the area in the months. Pathology Report (after excision of the area in the doctordoctor’’s office) showed: a 1 mm malignant melanoma at a s office) showed: a 1 mm malignant melanoma at a ClarkClark’’s Level I. One area lymph node was taken and it was s Level I. One area lymph node was taken and it was noted to be negative. No wide excision was necessary, as the noted to be negative. No wide excision was necessary, as the whole affected area was removed. No skin graft was necessary. whole affected area was removed. No skin graft was necessary. The patient will be followed up in one month and then in 6 The patient will be followed up in one month and then in 6 month increments. month increments.
CSCS--Required Data Items for State Required Data Items for State ReportingReporting--Melanoma Case ScenarioMelanoma Case Scenario
CS Tumor SizeCS Tumor Size
MELANOMA SKINMELANOMA SKIN
CS Tumor SizeCS Tumor Size
CodeCode DescriptionDescription
001001 001001--988 millimeters (code exact size in 988 millimeters (code exact size in millimeters)millimeters)
CSCS--Required Data Items for State Required Data Items for State ReportingReporting--Melanoma Case ScenarioMelanoma Case Scenario
CS ExtensionCS ExtensionMELANOMA SKINMELANOMA SKIN
CS ExtensionCS Extension
•• Note 1 through Note 3:Note 1 through Note 3:
CodCodee
DescriptioDescriptionn
TNM TNM 7 7 MAPMAP
TNM 6 TNM 6 MAPMAP
SS77SS77
MAPMAP
SS2000 SS2000 MAPMAP
000000 In In situ;nonsitu;noninvasive; invasive; ClarkClark’’s s Level I Level I
TisTis TisTis ISIS ISIS
CSCS--Required Data Items for State Required Data Items for State ReportingReporting--Melanoma Case ScenarioMelanoma Case Scenario
CS Tumor Size/Ext CS Tumor Size/Ext EvalEval
MELANOMA SKINMELANOMA SKIN
CS Tumor Size/Ext CS Tumor Size/Ext EvalEval
CodeCode DescriptionDescription Staging BasisStaging Basis
33 Surgical Resection performed Surgical Resection performed WITHOUT preWITHOUT pre--surgical surgical systemic or radiation systemic or radiation txtx
pp
CS-Required Data Items for State Reporting-Melanoma Case Scenario
CS Lymph NodesMELANOMA SKINCS Lymph Nodes• Note 1: Note 3:• Note 2: Note 4:
Code Description TNM 7 MAP
TNM 6 MAP
SS77 MAP
SS2000 MAP
000 None; no regional LN involvement
N0 N0 NONE NONE
CS-Required Data Items for State Reporting-Melanoma Case Scenario
CS Mets at DX
MELANOMA SKINCS Mets at DX
Code Description TNM 7 MAP
TNM 6 MAP
SS77 MAP
SS2000 MAP
00 No; none M0 M0 NONE NONE
Melanoma Case Scenario Answers
Data Item Code Data Item Code
CS Tumor Size
001 CS Lymph Nodes
000
CS Ext 000 CS Mets at DX
00
CS Tumor Size/Ext
Eval
3
CS Melanoma Case ScenarioCS Mets at DX
CS Mets at DX Bone 0
CS Mets at DX Lung 0
CS Mets at DX Liver 0
CS Mets at DX Brain 0
Questions
QuestionsQuestions
www.DHS.wisconsin.gov/wcrswww.DHS.wisconsin.gov/wcrs
Collaborative Stage Collaborative Stage Schema WebsiteSchema Website
http://www.cancerstaging.org/cstagehttp://www.cancerstaging.org/cstage
Remember,This is a collaborative effort.
TOGETHER We can all help our Cancer Patients