Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Collecting Cancer Data: Ovary 2013 ‐ 2014 NAACCR Webinar Series December 5, 2013 Q&A � Please submit all questions concerning webinar content through the Q&A panel. Reminder: � If you have participants watching this webinar at your site, please collect their names and emails. � We will be distributing a Q&A document in about one week. This document will fully answer questions asked during the webinar and will contain any corrections that we may discover after the webinar. Fabulous Prizes NAACCR 2013-2014 We b ina r Se rie s 1
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Agenda � Grade Coding Instructions 2014 � Overview � Staging Systems for Ovary � Treatment Instructions for Coding Grade 1/1/2014 and Forward Grade � Coding grade has been complicated by � Site ‐ specific grading systems � Differing instructions in FORDS and SEER PCSM � Revised instructions � http://seer.cancer.gov/tools/grade/ � Are applicable for cases diagnosed 1/1/2014 and forward � Will be incorporated in 2014 FORDS and 2014 SEER PCSM NAACCR 2013-2014 We b ina r Se rie s 2
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Grade Alte r nate Name Ite m # L e ngth Sour c e of Sta nda rd Gra de , Diffe re ntia tio n, o r Ce ll 440 1 SE E R/ Co C L ine a g e Indic a to r (SE E R/ CCCR) Gra de / Diffe re ntia tio n (Co C) Coding Grade for Hematopoietic & Lymphoid Neoplasms � Cell indicator describes lineage or phenotype of cell � Codes 5 ‐ 8 used only for hematopoietic & lymphoid neoplasms T e rminology Grade Code T -c e ll; T -pre c urso r 5 B-c e ll; Pre -B; B-pre c urso r 6 Null c e ll; No n T -no n B 7 NK c e ll (na tura l kille r c e ll) 8 Gra de unkno wn, no t sta te d, o r no t a pplic a b le 9 Coding Grade for Hematopoietic & Lymphoid Neoplasms 1. Determine histology using Hematopoietic & Lymphoid Neoplasm Manual 2. Apply the grade of tumor rules to determine the cell indicator for the histology NAACCR 2013-2014 We b ina r Se rie s 3
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Coding Grade for Solid Tumors � Grade measures resemblance of the tumor cells to organ of origin � Codes 1 ‐ 4 and 9 � 3 systems � 2 ‐ grade � 3 ‐ grade � 4 ‐ grade Coding Grade for Solid Tumors 1. Code grade prior to neoadjuvant treatment even if unknown 2. Code grade from primary tumor only 3. Code grade for histologic terms that imply grade � Carcinoma, undifferentiated (8020/34) � Follicular adenocarcinoma, well differentiated (8331/31) � See Instructions document for entire list Coding Grade for Solid Tumors 4. In situ a. Code grade for in situ tumor if given b. Code grade for invasive portion of tumor, even if unknown, for tumors with both in situ and invasive components 5. Code highest grade from applicable system if there is more than 1 grade even if only a focus; priority order for applicable systems a. Special grade systems listed in #6 b. Differentiation per #7 c. Nuclear grade per #7 d. Code it if not clear if differentiation or nuclear grade e. Terminology per #8 NAACCR 2013-2014 We b ina r Se rie s 4
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Coding Grade for Solid Tumors 6. Use special grade systems first CS Sc he ma Spe c ial Gr ade Syste m Bre a st No tting ha m o r BR Sc o re / Gra de (SSF 7) Pro sta te Gle a so n’ s Sc o re o n Bio psy/ T URP (SSF 8) Pro sta te Gle a so n’ s Sc o re o n Pro sta te c to my/ Auto psy (SSF 10) He a rt, Me dia stinum Gra de fo r Sa rc o ma s (SSF 1) Pe rito ne um Gra de fo r Sa rc o ma s (SSF 1) Re tro pe rito ne um Gra de fo r Sa rc o ma s (SSF 1) So ft T issue Gra de fo r Sa rc o ma s (SSF 1) K idne y Pa re nc hyma F uhrma n Nuc le a r Gra de (SSF 6) Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system a. Two ‐ grade system Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system b. Three ‐ grade system NAACCR 2013-2014 We b ina r Se rie s 5
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system c. Four ‐ grade system Coding Grade for Solid Tumors 8. Terminology De sc ription Grade Code E xc e ption for Bre ast & Prostate Diffe re ntia te d NOS I 1 We ll diffe re ntia te d I 1 Only sta te d a s ‘ Gra de I ’ I 1 De sc ription Grade Code E xc e ption for Bre ast & Prostate F a irly we ll diffe re ntia te d I I 2 I nte rme dia te diffe re ntia tio n I I 2 L o w g ra de I -I I 2 1 Mid diffe re ntia te d I I 2 Mo de ra te ly diffe re ntia te d I I 2 Mo de ra te ly we ll diffe re ntia te d I I 2 Pa rtia lly diffe re ntia te d I I 2 Pa rtia lly we ll diffe re ntia te d I -I I 2 1 Re la tive ly o r g e ne ra lly we ll I I 2 diffe re ntia te d Only sta te d a s ‘ Gra de I I ’ I I 2 NAACCR 2013-2014 We b ina r Se rie s 6
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 De sc ription Grade Code E xc e ption for Bre ast & Prostate Me dium g ra de , inte rme dia te I I -I I I 3 2 g ra de Mo de ra te ly po o rly diffe re ntia te d I I I 3 Mo de ra te ly undiffe re ntia te d I I I 3 Po o rly diffe re ntia te d I I I 3 Re la tive ly po o rly diffe re ntia te d I I I 3 Re la tive ly undiffe re ntia te d I I I 3 Slig htly diffe re ntia te d I I I 3 De diffe re ntia te d I I I 3 Only sta te d a s ‘ Gra de I I I ’ I I I 3 Coding Grade for Solid Tumors De sc ription Grade Code E xc e ption for Bre ast & Prostate Hig h g ra de I I I -I V 4 3 Undiffe re ntia te d, a na pla stic , no t I V 4 diffe re ntia te d Only sta te d a s ‘ Gra de I V’ I V 4 No n-hig h g ra de 9 Coding Grade for Solid Tumors 9. If no description fits or grade is unknown prior to neoadjuvant therapy, code as 9 (unknown) NAACCR 2013-2014 We b ina r Se rie s 7
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Special Grade System Rules � Breast � Use Bloom Richardson (BR) or Nottingham score/grade to code grade based on SSF7 � Code grade using the following priority � BR scores 3 ‐ 9 � BR grade (low, intermediate, high) � Do not use the table if only grade 1 ‐ 4 with no information on score and unclear if it is Nottingham or BR grade � Code highest score if multiple scores are reported De sc ription CS Grade Code Code Sc o re o f 3 030 1 Sc o re o f 4 040 1 Sc o re o f 5 050 1 Sc o re o f 6 060 2 Sc o re o f 7 070 2 Sc o re o f 8 080 3 Sc o re o f 9 090 3 L o w g ra de , BR g ra de 1, sc o re no t g ive n 110 1 Me dium (inte rme dia te ) g ra de , BR g ra de 2, sc o re no t 120 2 g ive n Hig h g ra de , BR g ra de 3, sc o re no t g ive n 130 3 23 Special Grade System Rules � Kidney parenchyma � Use Fuhrman Nuclear Grade to code grade based on SSF6 � Do NOT use for renal pelvis De sc ription CS Code Grade Code Gra de 1 010 1 Gra de 2 020 2 Gra de 3 030 3 Gra de 4 040 4 NAACCR 2013-2014 We b ina r Se rie s 8
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Special Grade System Rules � Soft Tissue includes soft tissue, heart, mediastinum, peritoneum, and retroperitoneum � Use Grade for Sarcomas to code grade based on SSF1 � Record grade from any three ‐ grade sarcoma grading system � Code terminology using table from #8 Special Grade System Rules � Soft tissue De sc ription CS Code Grade Code Spe c ifie d a s g ra de 1 [o f 3] 010 2 Spe c ifie d a s g ra de 2 [o f 3] 020 3 Spe c ifie d a s g ra de 3 [o f 3] 030 4 Gra de sta te d a s lo w g ra de NOS 100 2 Gra de sta te d a s hig h g ra de NOS 200 4 Special Grade System Rules � Prostate � Use highest Gleason score from biopsy/TURP (SSF8) or prostatectomy/autopsy (SSF10) NAACCR 2013-2014 We b ina r Se rie s 9
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Special Grade System Rules: Prostate AJCC 7 th Gle ason CS Code Gr ade Code SE E R 2003- Sc ore 2013 2 002 1 G1 G1 3 003 1 G1 G1 4 004 1 G1 G1 5 005 1 G1 G2 6 006 1 G1 G2 7 007 2 G2 G3 8 008 3 G3 G3 9 009 3 G3 G3 10 010 3 G3 G3 Overview Ovary Statistics � Estimated new cases and deaths from ovarian primaries in the United States in 2013 � New cases: 22,240 � Deaths: 14,030 NAACCR 2013-2014 We b ina r Se rie s 10
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Risk Factors � ~5 ‐ 10% of ovarian cancers are familial � Highest risk is for women with two or more first degree relatives with the disease � Three distinct hereditary patterns have been identified: � Ovarian alone � Ovarian and breast � Ovarian and colon BRCA � BRCA1 and BRCA2 are human genes that produce tumor suppressor proteins � Inherited mutations increase the risk of female breast and ovarian cancers BRCA � General population � BRCA 1 or BRCA2 gene mutation positive population � ~12% of women will develop breast cancer � ~55 ‐ 60% women with BRCA1 and � ~1.4% will develop ovarian cancer about 45% with BRCA2 mutation will develop breast cancer by age 70. � ~30% of women with BRCA1 and about 11 ‐ 17% of with BRCA2 will develop ovarian cancer by age 70. NAACCR 2013-2014 We b ina r Se rie s 11
Co lle c ting Ca nc e r Da ta : Ova ry 12/ 5/ 13 Anatomy Overview 34 I llustra tio n c o urte sy o f the Ame ric a n So c ie ty o f Clinic a l Onc o lo g y. 35 NAACCR 2013-2014 We b ina r Se rie s 12
Recommend
More recommend
