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Newsletter Winter 2022

MISSISSIPPI CANCER REGISTRY

DECEMBER 2022

VOLUME 17 ISSUE 4

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AJCC Cancer Staging Manual

Cases with a diagnosis date of 01/01/2018 and forward should be staged using AJCC 8th Edition Cancer Staging Manual. The 3rd printing 2018 Edition is now available.

Please visit https://www.facs.org/quality-programs/cancer-programs/american-joint-committee-on-cancer/updates-and-corrections/ for all 8th Edition updates and corrections. For all other information, visit https://cancerstaging.org/.

Summary Stage 2018

The 2018 version of Summary Stage applies to every site and/or histology combination, including lympho-mas and leukemias. Summary Stage uses all information available in the medical record; in other words, it is a combination of the most precise clinical and pathological documentation of the extent of disease. The Summary Stage 2018 manual is available at https://seer.cancer.gov/tools/ssm/.

Site Specific Data Items (SSDI)

Site Specific Data Items (SSDI) are similar to the Site Specific Factors (SSF) collected with Collaborative Stage. These data items are specific to certain site/histology combinations. For example, the SSDI’s for breast will be used to collect information such as estrogen receptor status, progesterone receptor status, Her2 status, Nottingham grade, and additional information related to primary tumors of the breast. The in-formation collected in these data items are specific to breast. The SSDI manual is available at https://apps.naaccr.org/ssdi/list/.

Grade

Beginning with cases diagnosed in 2018 grade information will be collected in three fields; Clinical Grade, Pathological Grade, and Post-Therapy Grade. Within the Grade Manual you will find definitions for the three new grade data items, coding instructions, and the site/histology specific grade tables. The Grade manual is available at https://www.naaccr.org/SSDI/Grade-Manual.pdf?v=1527859766.

SEER Hematopoietic and Lymphoid Neoplasm Database

This provides data collection rules for hematopoietic and lymphoid neoplasms for 2010+. The SEER Hematopoietic and Lymphoid Neoplasm manual is available at

https://seer.cancer.gov/tools/heme/Hematopoietic_Instructions_and_Rules.pdf.

Solid Tumor Coding Manual

Use the 2018 Solid Tumor coding rules to determine the number of primaries to abstract and the histology to code for cases diagnosed 2018 and forward. The Solid Tumor coding rules replace the 2007 Multiple Prima-ry and Histology( MP/H) Rules. The manual is available at https://seer.cancer.gov/tools/solidtumor/. The change log contains updates made to the FINAL module sections. This does not include changes made to the drafts.

STORE Manual

The STORE Manual has replaced the FORDS Manual. The STORE is now available at https://www.facs.org/quality-programs/cancer-programs/national-cancer-database/ncdb-call-for-data/cocmanuals/.

Coding Sentinel Lymph Node Biopsy when Non-Sentinel Nodes are also Sampled:

Scenario: 2022

 

Surgery Text: 09-30-2022 Left radioactive seed localized lumpectomy with lymphatic mapping and sentinel lymph node biopsy

 

Operative Text [pertaining to lymph nodes] The patient was injected with 5 cc of Lymphazurin blue in the left side and a five-minute massage ensued.The patient was found to have a hot spot in the Left axilla.The blue lymphatic channels were followed to the hot and blue lymph nodes. These were excised and counted ex vivo.They were deep to the clavipectoral fascia.There were several very small sentinel nodes which were blue.There were no further blue lymphatic channels or hot spots. There were no further palpable nodes. It was felt that the area of concern had been adequately evaluated.

 

Path Text: [lymph node portion] Status of Regional Lymph Nodes:

Number of Sentinel Lymph Nodes Examined: 4

Total Number of Lymph Nodes Examined: 06

Number of Lymph Nodes with Isolated Tumor Cells: 0

Number of Lymph Nodes with micrometastases (>0.2 mm to 0.2 cm): 0

Number of Lymph Nodes with macrometastases (>0.2 cm): 0

 

Data Field	Value	Rationale
Scope of Regional Lymph Node Surgery	2	STORE 2022 When a SLNBx is performed, additional non-sentinel nodes can be taken during the same operativeprocedure. These additional non-sentinel nodes are palpably abnormal and selectively removed (or harvested) as part of the SLNBx procedure by the surgeon or may be discovered by the pathologist. Code this as a SLNBx (code 2). If review of the operative report confirms that a regional lymph node dissection followed the SLNBx, code these cases as 6.
Date of Sentinel Lymph Node Biopsy	09-30-2022	STORE 2022Records the date of the sentinel lymph node(s) biopsy procedure. This data item is required for CoC accredited facilities for cases diagnosed 01/01/2018 and later. This data item is required for breast and cutaneous melanoma cases only.
Sentinel Lymph Nodes Examined	06	STORE 2022 If, during a sentinel node biopsy procedure, a few non-sentinel nodes happen to be sampled, document the total number of nodes sampled during the sentinel node procedure in this data item. I.e., record the total number of nodes from the sentinel node biopsy procedure regardless of sentinel node status
Sentinel Lymph Nodes Positive	00	STORE 2022 If, during a sentinel node biopsy procedure, a few non-sentinel nodes happen to be sampled and are positive, document the total number of positive nodes identified during the sentinel node procedure in this data item. I.e., record the total number of positive nodes from the sentinel nodebiopsy procedure regardless of whether the nodes contain dye or colloidal material (tracer or radiotracer).
Date of Regional Lymph Node Dissection	BLANK	STORE 2022Records the date non-sentinel regional node dissection was performed.[If you read the op report, the surgeon only performed a SLN procedure, a separate lymph node sampling was not performed, leave this date BLANK.]
Regional Lymph Nodes Examined	06	STORE 2022The number of regional lymph nodes examined is cumulative from all procedures that removed lymph nodes through the completion of surgeries in the first course oftreatment with the exception of aspiration or core biopsies coded to 95
Regional Lymph Nodes Positive	00	STORE 2022 The number of regional lymph nodes positive is cumulative from all procedures that remove lymph nodes through the completion of surgeries in the first course oftreatment

Source: Omega Healthcare – Tumor Tip of the Week

SURGERY CODES:  Use Appendix C when coding surgeries. It gives more information regarding the type of surgery than just using your software’s drop-down menu.

SEER Appendix C 2021

For Example: Colon - Code 30 (see SEER Note for more detail)

30 Partial colectomy [but less than hemicolectomy] segmental resection 32 Plus resection of contiguous organ; example: small bowel, bladder

[SEER Note: Code 30 includes but is not limited to the following procedures: Appendectomy (for an appendix primary only), enterocolectomy, ileocolectomy, partial colectomy, NOS, partial resection of transverse colon and flexures, and segmental resection (such as cecectomy or sigmoidectomy). Note that the removal of a short portion of the distal ileum is not “removal of a contiguous organ.”]

For any questions, please contact Angel Davis, adavis6@umc.edu

 

2023 - New Year, New Changes….

AJCC VERSION 9:

The updated Version 9 disease site changes for Anus, Appendix, and Brain and Spinal Cord will go into effect on January 1, 2023 and the cost of each protocol is $9.99 USD (plus applicable tax). Please be on the lookout for more educational material regarding the 3 updated protocols on social media, the Journal of Registry Management, and the AJCC website.

Version 9 | ACS (facs.org)

The AJCC Anus, Appendix, and Brain and Spinal Cord Version 9 Cancer Staging Protocols are now available via Amazon. The Amazon version is available through Kindle and will soon be available via Amazon print on demand. When the printed version is made available an additional announcement will be released.

Version 9 of the AJCC Cancer Staging System (4 book series) Kindle Edition (amazon.com)

 

MCR STAFF

Director UMMC & MCR: Deirdre Rogers, dbrogers@umc.edu

MCR Manager: La’Tawnya Roby, ldroby@umc.edu

Clinical Systems Analyst-Intermediate: Tresheena Boyd, tboyd@umc.edu

Data Quality Analyst–Trainer: Angel Davis, adavis6@umc.edu

Data Quality Analyst-Auditor: April Wright, ahuggins@umc.edu

Electronic Data Source Coordinator: Lisa Hamel, lhamel@umc.edu

 

Cancer Registrars:                                                                                          

Stacy Major, semajor@umc.edu

Laken A. Frederick, lfrederick@umc.edu

Madeline N. Hall, mnhall@umc.edu

Mallory R. Israel, misrael@umc.edu

 

Administrative Assistant:

Michelle R. Smith, mrsmith2@umc.edu

 

University of MS Medical Center

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Jackson, MS 39216

Phone: (601) 815-5482

Fax: (601) 815-5483