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MCR MINI-UPDATE APRIL 2013 Fellow Registrars, No foolin'? The calendar and my heart say spring, but I saw snowflakes this morning! I guess we've been spoiled by early spring warmth the past few years. In any case, I hope this finds you well. Here's your April Update. MCR NEWS Due Date: All hospitals should report abstracted cases to us by April 15, 2013. To be on schedule this should include cases diagnosed through Sept 2012. EDUCATION - SAVE THE DATE! Fundamentals of Abstracting Workshop will be April 29-30, 2013 at the Missouri Cancer Registry and Research Center. This is a hands-on class for those new to abstracting. Each MCR-ARC required data item is discussed using the MCR-ARC Abstract Code Manual and laptops are available to abstract practice cases using Abstract Plus software. The class is generally small and there is ample time for questions and one on one help. Class size is limited so if you want to register please do so as soon as possible! NAACCR Webinars Recorded Webinars are now available to view. Request Access Now! Check out our Education and Training page to find out how you can receive access to the recorded NAACCR Webinars. April 4, 2013 - Collecting Cancer Data: Breast Live Meetings April 10, 2013 - Web Plus File Upload, Presenter Alena Headd May 8, 2013 - Understanding Edits, Presenter Nancy Rold. If you have a particular edit that you would like explained, please let me know in advance so that I can include it. As always, to register for any of our educational opportunities, contact Shari Ackerman (note name/email change) at [email protected] or 1-866-240-8809. Please be sure to clarify which you will be attending when you register. ABSTRACTING TIPS from the QA Staff Coding and text for surgical procedures - Just a reminder that in some instances various components of the tumor data and the appropriate surgery and date may be defined in other than the most definitive surgery. It is necessary for text with procedure names/dates and the brief but concise findings to be documented for all biopsies and procedures performed on the patient to support coded data items. Specify the anatomical source of tissue specimens removed as a part of the procedure. Example: Breast case - 1/10/13 core biopsy of UOQ mass shows invasive ductal ca, MBR grade 3; then 1/20/13 excisional biopsy grossly removing the entire tumor with SLN bx reveals a 3cm invasive ductal carcinoma, pleomorphic type, MBR grade 2, no dermal lymphatic invasion, 3/3+ SLN's; but 2/15/13 modified radical mastectomy reveals residual 5mm invasive ductal ca, MBR 2, 4/8+ axillary lymph nodes. In this case The grade would be coded from the core bx because it is the highest of the multiple path diagnoses; The CSE, histology and date of first surgery would be coded from the excisional biopsy because it is the most representative tumor specimen and the first date that cancer directed treatment was received (Note: If documented gross tumor is left behind on a stated excisional biopsy that is followed by a mastectomy, the mastectomy would be the first date of cancer directed treatment.) CS LN's and scope of regional LN surgery would be coded from both the excisional bx and mastectomy specimen; The surgery summary would be coded from the mastectomy specimen. If only the most definitive surgery is recorded in the text, without brief but concise information from previous bxs/excisional bxs, the appropriate codes for some key data elements cannot be verified. Another scenario is an incisional bx may be performed and there is no residual tumor on an excisional bx or mastectomy. That renders the bx as an actual excisional bx because the entire tumor was removed. Therefore, it becomes the most representative tumor specimen and the date of first cancer directed treatment. In addition to the excisional bx and/or mastectomy information, it is very important to include the date and tumor data for the incisional biopsy in the text and to code the date of first surgical procedure based on that. Just stating in the text that the patient had a bx and excisional bx or mastectomy without specifics is not adequate. Colon Histology - Adenocarcinoma NOS - For colon cases, a final diagnosis stated as mucinous/colloid carcinoma or signet ring cell carcinoma are assigned histology codes 8480 or 8490, respectively - per MP/H rule H5. If the final dx is Adenocarcinoma along with a stated term such as "with features of mucinous ca" or "with features of signet ring cell ca", histology codes 8480 and 8490 do not apply unless the microscopic description verifies that the mucinous or signet ring cell component is 50 % or more. In the absence of that confirmation, the correct histology code is 8140, per MP/H rule H6. If the final dx is 'Adenocarcinoma' and no other descriptor, before assigning the histology code to 8140 always review the microscopic description to confirm if mucinous/colloid or signet ring cell components are included and, if so, the percentage. Paired Sites and MP/H Rules for Other Sites - For Multiple Primary/Histology, when determining multiple primaries for paired sites in the Other schema, use Table 1 - Paired Sites and Organs with Laterality, per rule M8. The table is located in the Terms and Definitions section for Other Sites. Keep in mind that the paired sites table shown for a specific module in the MP/H manual pertains only to determining multiple primaries for sites within the module. i.e.: To determine if two tumors of the tonsil are multiple primaries refer to the paired sites table within Terms and Definitions for 'Head and Neck', not to the paired sites table within Terms and Definitions for 'Other', in the MPH schema. STANDARD SETTER NEWS From NPCR: The NPCR-CSS SSDI Web site has recently been updated with data generated by the Social Security Administration for the 4th quarter of 2012. From NAACCR: The Fast Stats page http://faststats.naaccr.org has been updated with the latest 2005-2009 Incidence data and is now available to anyone visiting the NAACCR website. NAACCR Fast Stats is an interactive tool for quick access to key NAACCR and US cancer statistics for major cancer sites by age, sex, race/ethnicity, registry and data type. Statistics are presented as graphs and tables and can be stratified by: Cancer Site Race/Sex Race/Ethnicity Age at Diagnosis Sex Registry Data Type RESOURCES Lymphoseek Approved by FDA for Lymph Node Detection http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm343525.htm Nanoparticle Chemotherapy is Gentler on Fertility http://www.medicalnewstoday.com/articles/258172.php Math Models to Predict Spread of Cancer http://www.futurity.org/health-medicine/google-math-predicts-lung-cancer%E2%80%99s-path/ Nasopharynx Cancer Detection Using Brushings and Blood Analysis for Epstein - Barr Virus Load http://clincancerres.aacrjournals.org/content/early/2013/03/14/1078-0432.CCR-12-2897 Chemotherapy in Metastatic Prostate Cancer http://www.urologic.theclinics.com/article/S0094-0143(12)00073-0/fulltext#sec8 LVI Prognostic in Renal Cell Carcinoma http://www.urologiconcology.org/article/S1078-1439(12)00395-X/abstract Increased Incidence of Breast Cancer in Young Women http://jama.jamanetwork.com/article.aspx?articleid=1656255 Nancy H. Rold, CTR QA Unit Supervisor Missouri Cancer Registry and Research Center