Primary Site, TNM Clin Stage Valid B-Ed 7 (COC) and related edits

[Loretta Huston]

We’re a central registry that reports to both SEER and NPCR. SEER has worked with UICC to allow some values for TNM Staging which are not defined in AJCC materials. We currently include the edit “Primary Site, TNM Clin Stage Valid B-Ed 7 (COC)” because it’s in the ‘Central: Vs16 NPCR Required – Consol-All Edits’ set.

The documentation for this edit states “If a T, N, or M value is coded that is not included in the AJCC stage tables — for example T4 is coded but only T4A and T4B are staged — the stage assignment will not be checked and the edit will pass.” However, we have found at least one case where this does not appear to be true (the edit fails):

Prostate 8140/3 diagnosed 2016
Grade = 2
SSF 1 = 069
SSF 8 = 007
SSF10 = 998
SSF 13 = 991
SSF 15 = 010
Clin T= c2
Clin N = c0
Clin M = c0
Clin Stage Group = 2A (as defined in SEER/UICC tables)
TNM Edition Number = U7

I believe the edit fails because “cT2″(NOS) is not defined in the AJCC stage group table — the T2a, T2b or T2c subcategory is required to assign a stage group for AJCC. When we change only Clin Stage Group to 99, the edit clears. But doesn’t the edit documentation cited above mean that our original codes should pass/stage group should not be checked?

If so, related edits with similar documentation may also need to be checked to ensure they pass with these types of values — such as “Primary Site, TNM Clin Stage Valid A- Ed 7 (COC)”; “Primary Site, TNM Path Stage Valid A-Ed 7 (COC)”; “Primary Site, TNM Path Stage Valid B- Ed 7 (COC)”; and “Primary Site, TNM Cl Stge Valid Esoph- Ed 7 (COC)”.

[Jim Hofferkamp]

Hi Loretta,
You are correct, this edit only checks stage group if the T, N, and M values are valid for that particular site/histology. If T4 is not a valid value, then the edit would pass. The purpose of the edit is to check valid T, N, M combinations against the assigned stage group.

The edit referred to above is a CoC edit and is included in the Hosp edit set. I believe the case you described could be a Stage IIA or IIB based on the subcategory of the T2. Per AJCC, this case should have a stage group of 99 since the missing subcategory could change the stage group. NPCR, SEER, and CoC are aware of how this edit works and the scenario above has been discussed (ad nauseam) during edits WG calls will all of the standard setters present.

Standard setters may use the directly assigned T, N, and M to calculate a stage group and may choose to “downstage” to a IIA. This edit would not be run against calculated or derived stage groups.

Does that help?

[Loretta Huston]

Yes! Thanks very much for the clarification.

[Author]

Posts