Wisconsin Cancer Reporting System: Collaborative Staging ... · 000000 No mass/tumor foundNo mass/tumor found 001001--988988 001001--988 millimeters (code exact size in mm)988 millimeters

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


•• 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))


•• 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


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

http://www.cancerstaging.org/cstage/

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

http://www.cancerstaging.org/cstage/

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


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


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%)


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


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)


CS ExtensionCS ExtensionBREASTBREAST

CS ExtensionCS Extension


CodeCode DescriptionDescription TNM7TNM7MAPMAP

TNMTNM6MAP6MAP

SS77SS77

MAPMAP

SS2000SS2000MAPMAP

100100 Confined to Confined to breast tissue; breast tissue; Localized Localized NOSNOS

LL LL


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


CS Lymph NodesCS Lymph NodesBREASTBREAST

CS Lymph NodesCS Lymph Nodes


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


CS Mets at DXCS Mets at DXBREASTBREAST

CSCS Mets at DXMets at DX

•• Note 1:Note 1:•• Note 2:Note 2:


TNM 6 TNM 6 MAPMAP

SS77 SS77 MAPMAP

SS2000SS2000MAPMAP

0000 No; NoneNo; None M0M0 M0M0 NONENONE NONENONE


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:


020020 Negative/normal; within normal limitsNegative/normal; within normal limits


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:




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:


000000 Score 0Score 0


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:




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



988988 Not applicable; Not applicable; Information not collected for this caseInformation not collected for this case


CS SiteCS Site--Specific Factor 11Specific Factor 11BREASTBREASTCS SiteCS Site--Specific Factor 11Specific Factor 11HER2: FISH Test InterpretationHER2: FISH Test Interpretation•• NoteNote


988988 Not applicable;Not applicable;Information not collected for this caseInformation not collected for this case


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:




CS SiteCS Site--Specific Factor 13Specific Factor 13BREASTBREAST


HER2: CISH Test InterpretationHER2: CISH Test Interpretation

•• NoteNote




CS SiteCS Site--Specific Factor 14 Specific Factor 14

BREASTBREAST


HER2: Result of other or unknown testHER2: Result of other or unknown test

•• NoteNote



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


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.


ReportingReporting----Prostate Case ScenarioProstate Case ScenarioCS Tumor SizeCS Tumor Size

PROSTATEPROSTATE



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


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



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


CS Mets at DXCS Mets at DXPROSTATEPROSTATE

CS Mets at DXCS Mets at DX


TNM 6 TNM 6 MAPMAP

SS77 SS77 MAPMAP


0000 No; noneNo; none M0M0 M0M0 NONENONE NONENONE


CS SiteCS Site--Specific Factor 3Specific Factor 3PROSTATEPROSTATE


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


MELANOMA SKINMELANOMA SKIN



001001 001001--988 millimeters (code exact size in 988 millimeters (code exact size in millimeters)millimeters)


CS ExtensionCS ExtensionMELANOMA SKINMELANOMA SKIN

CS ExtensionCS Extension


CodCodee

DescriptioDescriptionn

TNM TNM 7 7 MAPMAP

TNM 6 TNM 6 MAPMAP

SS77SS77

MAPMAP


000000 In In situ;nonsitu;noninvasive; invasive; ClarkClark’’s s Level I Level I

TisTis TisTis ISIS ISIS



MELANOMA SKINMELANOMA SKIN



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

[email protected]

QuestionsQuestions

www.DHS.wisconsin.gov/wcrswww.DHS.wisconsin.gov/wcrs

http://www.dhs.wisconsin.gov/wcrs

Collaborative Stage Collaborative Stage Schema WebsiteSchema Website

http://www.cancerstaging.org/cstagehttp://www.cancerstaging.org/cstage

http://www.cancerstaging.org/cstage

Remember,This is a collaborative effort.

TOGETHER We can all help our Cancer Patients

Documents

Wisconsin Cancer Reporting System: Collaborative Staging ... · 000000 No mass/tumor foundNo mass/tumor found 001001--988988 001001--988 millimeters (code exact size in mm)988 millimeters