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National Cancer Data Base - Data Dictionary PUF 2016

Traditional AJCC Staging System

Mets at Dx Other

PUF Data Item Name: 
METS_AT_DX_OTHER
NAACCR Item #: 
1117
length: 
1
Allowable values: 
0,1,2,8,9
Description: 
This data item identifies whether other metastatic involvement, other than bone, brain, liver, lung or distant lymph nodes exists. Some examples include but are not limited to the adrenal gland, bone marrow, pleura, peritoneum, and skin. The five Mets at Dx Metastatic Sites variables provide information on specific metastatic sites for data analysis.
Registry Coding Instructions: 

Refer to the instructions in the 2018 STORE manual, page 188, at
https://www.facs.org/~/media/files/quality%20programs/cancer/ncdb/store_...

NCDB System Code Assignments: 

Code Description
0 None; no other metastases
1 Yes; distant metastases in known site(s) other than bone, brain, liver, lung or distant lymph nodes.
2 Generalized metastases such as carcinomatosis
8 Not applicable
9 Unknown whether any other metastatic site. Not documented in patient record.

Analytic Note: 

This variable was added as a FORDs item in 2016 and revised in the 2018 STORE manual.

Mets at Dx Distant Lymph Nodes

PUF Data Item Name: 
METS_AT_DX_DISTANT_LN
NAACCR Item #: 
1114
length: 
1
format: 
Allowable values: 
0,1,8,9
text: 
Description: 
This data item identifies whether distant lymph node(s) are an involved metastatic site. The five Mets at Dx Metastatic Site variables provide information on specific metastatic sites for data analysis.
Registry Coding Instructions: 

Refer to the instructions in the 2016 FORDs manual, page 149, at

https://www.facs.org/~/media/files/quality%20programs/cancer/ncdb/fords%... hx

NCDB System Code Assignments: 

Code Description
0 None; no distant lymph node metastases
1 Yes; distant lymph node metastases
8 Not applicable
9 Unknown whether distant lymph node(s) are an involved metastatic site. Not documented in patient record.

Analytic Note: 

This variable was added as a FORDs item in 2016.

Mets at DX-Lung

PUF Data Item Name: 
METS_AT_DX_LUNG
NAACCR Item #: 
1115
length: 
1
format: 
Allowable values: 
0, 1, 8, 9
text: 
Description: 
This data item identifies whether lung is an involved metastatic site.
Registry Coding Instructions: 

Code information about lung metastases only (discontinuous or distant metastases to brain) identified at the time of diagnosis. Lung involvement may be single or multiple. Information about lung involvement may be clinical or pathologic.
Code this field whether or not the patient had any preoperative systemic therapy.
This field should be coded for all solid tumors, Kaposi sarcoma, Unknown Primary Site, and Other and Ill-Defined Sites.
Use code 8 for Hematopoietic, reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms, and Hodgkin’s and non-Hodgkin’s Lymphoma.

Use code 9 when it cannot be determined from the medical record whether the patient specifically had lung metastases; for example, when there is documentation of carcinomatosis but lung is not specifically mentioned as a metastatic site

NCDB System Code Assignments: 

0 = None; no lung metastases 1 = Yes
8 = Not applicable
9 = Unknown whether lung is involved; Not documented in patient record

Analytic Note: 

This is a new item in 2016, replacing the METS_AT_DX_LUNG item.

Mets at DX-Liver

PUF Data Item Name: 
METS_AT_DX_LIVER
NAACCR Item #: 
1115
length: 
1
format: 
Allowable values: 
0, 1, 8, 9
text: 
Description: 
This data item identifies whether liver is an involved metastatic site.
Registry Coding Instructions: 

Code information about liver metastases only (discontinuous or distant metastases to brain) identified at the time of diagnosis. Liver involvement may be single or multiple. Information about liver involvement may be clinical or pathologic.

Code this field whether or not the patient had any preoperative systemic therapy.
This field should be coded for all solid tumors, Kaposi sarcoma, Unknown Primary Site, and Other and Ill-Defined Sites.
Use code 8 for Hematopoietic, reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms, and Hodgkin’s and non-Hodgkin’s Lymphoma.

Use code 9 when it cannot be determined from the medical record whether the patient specifically had liver metastases; for example, when there is documentation of carcinomatosis but liver is not specifically mentioned as a metastatic site.

NCDB System Code Assignments: 

0 = None; no liver metastases 1 = Yes
8 = Not applicable
9 = Unknown whether liver is involved; Not documented in patient record

Analytic Note: 

This is a new item in 2016, replacing the METS_AT_DX_LIVER item.

Mets at DX-Brain

PUF Data Item Name: 
METS_AT_DX_BRAIN
NAACCR Item #: 
1113
length: 
1
format: 
Allowable values: 
0, 1, 8, 9
text: 
Description: 
This data item identifies whether brain is an involved metastatic site.
Registry Coding Instructions: 

Code information about brain metastases only (discontinuous or distant metastases to brain) identified at the time of diagnosis. This field should not be coded for involvement of spinal cord or other parts of the central nervous system. Brain involvement may be single or multiple. Information about brain involvement may be clinical or pathologic.

Code this field whether or not the patient had any preoperative systemic therapy.
This field should be coded for all solid tumors, Kaposi sarcoma, Unknown Primary Site, and Other and Ill-Defined Sites.
Use code 8 for Hematopoietic, reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms, and Hodgkin and non-Hodgkin’s Lymphoma.

Use code 9 when it cannot be determined from the medical record whether the patient specifically had brain metastases; for example, when there is documentation of carcinomatosis but brain is not specifically mentioned as a metastatic site.

NCDB System Code Assignments: 

0 = None; no brain metastases 1 = Yes
8 = Not applicable
9 = Unknown whether brain is involved; Not documented in patient record

Analytic Note: 

This is a new item in 2016, replacing the CS_METS_AT_DX_BRAIN item.

Mets at DX-Bone

PUF Data Item Name: 
Mets at DX-Bone
NAACCR Item #: 
1112
length: 
1
format: 
Allowable values: 
0, 1, 8, 9
text: 
Description: 
This data item identifies whether bone is an involved metastatic site.
Registry Coding Instructions: 

Code information about bone metastases only (discontinuous or distant metastases to bone) identified at the time of diagnosis. This field should not be coded for bone marrow involvement. Bone involvement may be single or multiple. Information about bone involvement may be clinical or pathologic.

Code this field whether or not the patient had any preoperative systemic therapy.
This field should be coded for all solid tumors, Kaposi sarcoma, Unknown Primary Site, and Other and Ill-Defined Sites.
Use code 8 for Hematopoietic, reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms, and Hodgkin’s and non-Hodgkin’s Lymphoma.

Use code 9 when it cannot be determined from the medical record whether the patient specifically had bone metastases; for example, when there is documentation of carcinomatosis but bone is not specifically mentioned as a metastatic site.

NCDB System Code Assignments: 

0 = None; no bone metastases 1 = Yes
8 = Not applicable
9 = Unknown whether bone is involved; Not documented in patient record

Analytic Note: 

This is a new item in 2016, replacing the CS_METS_AT_DX_BONE item.

Diagnostic and Staging Procedure at This Facility

PUF Data Item Name: 
RX_HOSP_DXSTG_PROC
NAACCR Item #: 
740
length: 
2
Allowable values: 
00-07, 09
Description: 
Records the type of surgical diagnostic and/or staging procedure performed at the reporting facility. This data item was added to the 2015 PUF (data released in Fall 2017), and does not appear in prior versions of the PUF data.
Registry Coding Instructions: 
  • Code the type of procedure performed as part of the initial diagnosis and workup at the reporting institution.
  • Code 02 is used if both an incisional biopsy of the primary site and an incisional biopsy of a metastatic site are done.
  • Surgical procedures which aspirate, biopsy, or remove regional lymph nodes in an effort to diagnose and/or stage disease are not coded in this item. The item Scope of Regional Lymph Node Surgery (NAACCR Item #1292) is used to code these procedures.
  • Brushings, washings, cell aspiration, and hematologic findings (peripheral blood smears) as positive cytologic diagnostic confirmation are coded in the data item Diagnostic Confirmation (NAACCR Item #490). These are not considered surgical procedures and are not be coded in this item.
  • Excisional biopsies with clear or microscopic margins are not coded in this data item. Item Surgical Procedure of Primary Site (NAACCR Item #1290) is used to code these procedures.
  • Palliative surgical procedures are not coded in this data item. The item Palliative Procedure (NAACCR Item #3270) is used to code these procedures.

NCDB Analytic Stage Group

PUF Data Item Name: 
ANALYTIC_STAGE_GROUP
length: 
1
Allowable values: 
0-5, 8, 9
Description: 
Analytic Stage Group is assigned the value of reported Pathologic Stage Group. Clinical Stage Group is used if pathologic stage is not reported. Sub-stage groups are collapsed into the corresponding general stage designation. The alphanumeric representation of stage group is provided for ease of display.
Registry Coding Instructions: 

None.

NCDB System Code Assignments: 

Code Definition
0 Stage 0
1 Stage I
2 Stage II
3 Stage III
4 Stage IV
5 Occult (lung only)
8 AJCC Staging Not Applicable
9 AJCC Staging Unknown


TNM Edition Number

PUF Data Item Name: 
TNM_EDITION_NUMBER
NAACCR Item #: 
1060
length: 
2
Allowable values: 
00-07, 88, 99
Description: 
Identifies the edition number of the AJCC Cancer Staging Manual used to stage the case.
Registry Coding Instructions: 

None; this item may be auto-coded by cancer registry software.

Analytic Note: 

AJCC staging is coded according to the version of the AJCC Staging Manual in use at the time the case was diagnosed. Prior to implementation of the 5th edition of the manual, some "slippage" in version occurred, and edition numbers are not included in the PUF for those older cases.

AJCC Pathologic Stage Group

PUF Data Item Name: 
TNM_PATH_STAGE_GROUP
NAACCR Item #: 
910
length: 
4
Allowable values: 
Alphanumeric, Uppercase
Description: 
Identifies the pathologically-determiend anatomic extent of disease based on the T, N, and M elements as defined by the American Joint Committee on Cancer (AJCC).
Registry Coding Instructions: 

Refer to the applicable AJCC Cancer Staging Manual for coding rules.

Analytic Note: 

For cases diagnosed prior to December 31, 2003, this item was expected to be completed by an attending physician, though registry staff were frequently involved in the determination of the information coded in this item through the review of clinical and patient notes available to registry staff. For cases diagnosed January 1, 2004, through December 31, 2007, the CoC required registries to copy the staging elements from a standardized document, as recorded by the managing physician.

Beginning with 2008 diagnoses, the rules changed again. Physicians were no longer required to stage, but cancer committees in CoC cancer programs were required to devise plans to ascertain that staging was used appropriately to make treatment decisions. Registries were encouraged to record physician staging when it was available, but were not required to do so. The CoC determined that the stage groups derived from the Collaborative Stage Data Collection System met the criteria expected of pathologic staging, in providing an AJCC "final stage". PUF users are likely to see a decrease in the completeness of pathologic staging in the "AJCC' staging items in the years following 2008.

Cases are coded using the AJCC Cancer Staging Manual edition in use during the year in which the case was diagnosed. Consult the appropriate edition of this manual for organ or site specific codes and their definitions. See AJCC TNM Edition Number (NAACCR Item #1060). Prior to implementation of the 5th edition of the manual, some "slippage" in version was allowed, such that some codes for cases diagnosed the year prior to implementation of a given edition and the year following its replacement may also have codes from the edition.

Codes on this list comprise all codes valid for any AJCC manual through the 7th edition and for any chapter. Please consult the applicable manual and chapter for codes that are valid for specific site, histology and AJCC edition combinations.

There is no standard mechanism to recode AJCC items from one edition to another. Careful review of the individual definitions in the respective AJCC manuals is necessary before combining or comparing data across two or more AJCC editions.

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