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National Cancer Data Base - Data Dictionary PUF 2014

Scope of Regional LN Surgery

DD_category: 
PUF Data Item Name: 
RX_SUMM_SCOPE_REG_LN_SUR
NAACCR Item #: 
1292
length: 
1
Allowable values: 
0-1, 9
Description: 
Identifies the removal, biopsy, or aspiration of regional lymph node(s) at the time of surgery of the primary site or during a separate surgical event.
Registry Coding Instructions: 

The scope of regional lymph node surgery is collected for each surgical event even if surgery of the primary site was not performed.

Record surgical procedures which aspirate, biopsy, or remove regional lymph nodes in an effort to diagnose or stage disease in this data item. Record the date of this surgical procedure in data item Date of First Course of Treatment (NAACCR Item #1270) and/or Date of First Surgical Procedure (NAACCR Item #1200) as appropriate.

For primaries of the meninges, brain, spinal cord, cranial nerves, and other parts of the central nervous system (C70.0-C70.9, C71.0-C71.9, C72.0-C72.9), code 9.

For lymphomas with a lymph node primary site (C77.0-C77.9), code 9.

For an unknown or ill-defined primary (C76.0-C76.8, C80.9) or for hematopoietic, reticuloendothelial, immunoproliferative, or myeloproliferative disease regardless of site, code 9.

Do not code distant lymph nodes removed during surgery to the primary site for this data item. Distant nodes are coded in the data field Surgical Procedure/Other Site (NAACCR Item #1294).

Refer to the applicable AJCC Cancer Staging Manual for site-specific identification of regional lymph nodes.

If the procedure coded in this item was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record this surgery in the item Palliative Care (NAACCR Item #3270).

 

NCDB System Code Assignments: 

0 = No regional lymph node surgery
1 = Regional lymph node surgery
9 = Unknown if there was any regional lymph node surgery

Analytic Note: 

This item was reported as a site-specific item under the ROADS manual for diagnosis years 1998 - 2002. Those cases were converted to FORDS form by NCDB.  For cases diagnosed on or after January 1, 2003, the scope of regional lymph node surgery is no longer specific to the organ of origin.
 
Sentinel Lymph Nodes:  Data on Scope of Regional Lymph Node Surgery have been found to under-report Sentinel Lymph Node Biopsy (SLNBx) procedures either alone or with Axillary Dissection (ALND). Reviews by the Commission on Cancer (CoC), the Centers for Disease Control and Prevention's National Program of Cancer Registries (CDC/NPCR), and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program (NCI SEER) all confirmed mis-coding of this data element. Revised coding rules and associated instructions were developed that put emphasis on securing information from the operative report in contrast to the pathology report. These revised coding instructions were implemented for cases diagnosed January 1, 2012 and later. All population based and facility based cancer registry programs are coordinating implementation through shared materials, communications, training, and quality assessments. Therefore, CoC use of the item “Scope of Regional Lymph Node Surgery” is curtailed in all data years prior to 2012 contained in the PUF. The item is used only to identify whether or not a patient underwent regional lymph node surgery, effectively removing any distinction between the type or extent of surgical intervention. For all sites, codes for this item are limited to 0, 1 and 9.

Starting with the 2013 PUF, an expanded version of this variable is available for cases diagnosed in 2012 to the most recent diagnosis year in the PUF. This item, Scope of Regional LN Surgery 2012, can be found here: http://ncdbpuf.facs.org/node/417.