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National Cancer Data Base - Data Dictionary PUF 2015

Systemic

Immunotherapy at This Facility

DD_category: 
PUF Data Item Name: 
RX_HOSP_IMMUNOTHERAPY
NAACCR Item #: 
720
length: 
2
Allowable values: 
00, 01, 82, 85-88, 99
Description: 
Records the type of immunotherapy administered as first course treatment at the facility that submitted the record. If immunotherapy was not administered, then this item records the reason it was not administered to the patient.
Registry Coding Instructions: 
  • Code 00 if immunotherapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include immunotherapy.
  • If it is known that immunotherapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended immunotherapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether immunotherapy is usually administered for this type and stage of cancer, and there is no mention in the patient record whether it was recommended or administered.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for instructions for coding immunotherapy, chemotherapeutic and hormonal agents.
  • Update for 2013 PUF: Six drugs previously classified as Chemotherapy are now classified as BRM/Immunotherapy. This change in classification is effective only for cases diagnosed in January 1st, 2013 and forward. While the NCDB does not provide drug-specific data, changes in case counts may be observed for the Chemotherapy and Immunotherapy variables for cases diagnosed in 2013 due to the change in classification. The drugs are: Alemtuzumab/Campath, Bvacizumab/Avastin, Rituximab, Trastuzumab/Herceptin, Pertuzumab/Perjeta, and Cetuxumab/Erbitux.

Analytic Note: 

Immunotherapy is sometimes called biologic response modifier (BRM).

CoC cancer programs are required to identify treatment their patients received from all sources. Immunotherapy may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file.

Hormone Therapy at This Facility

DD_category: 
PUF Data Item Name: 
RX_HOSP_HORMONE
NAACCR Item #: 
710
length: 
2
Allowable values: 
00, 01, 82, 85-88, 99
Description: 
This item records the type of hormone therapy administered as first course treatment by the facility that submitted this record. If hormone therapy was not administered, then this item records the reason it was not administered to the patient. Hormone therapy consists of a group of drugs that may affect the long-term control of a cancer's growth.
Registry Coding Instructions: 
  • Record prednisone as hormonal therapy when administered in combination with chemotherapy, such as MOPP (mechlorethamine, vincristine, procarbazine, prednisone) or COPP (cyclophosphamide, vincristine, procarbazine, prednisone).
  • Do not code prednisone as hormone therapy when it is administered for reasons other than chemotherapeutic treatment.
  • Tumor involvement or treatment may destroy hormone-producing tissue. Hormone replacement therapy will be given if the hormone is necessary to maintain normal metabolism and body function. Do not code hormone replacement therapy as part of first course therapy.
  • Code 00 if hormone therapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include hormone therapy.
  • Code 01 for thyroid replacement therapy which inhibits TSH (thyroid-stimulating hormone). TSH is a product of the pituitary gland that can stimulate tumor growth.
  • If it is known that hormone therapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended hormone therapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether hormone therapy is usually administered for this type and stage of cancer, and there is no mention in the patient record whether it was recommended or administered.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for instructions for coding hormonal, chemotherapeutic and immunotherapy agents.
NCDB System Code Assignments: 

Code Definition
00 None, hormone therapy was not part of the planned first course of therapy. Diagnosed at autopsy.
01 Hormone therapy administered as first course therapy.
82 Hormone therapy was not recommended/administered because it was contraindicated due to patient risk factors (ie, comorbid conditions, advanced age).
85 Hormone therapy was not administered because the patient died prior to planned or recommended therapy.
86 Hormone therapy was not administered. It was recommended by the patient's physician, but was not administered as part of the first course of therapy. No reason was stated in patient record.
87 Hormone therapy was not administered. It was recommended by the patient's physician, but this treatment was refused by the patient, a patient's family member, or the patient's guardian. The refusal was noted in patient record.
88 Hormone therapy was recommended, but it is unknown if it was administered.
99 It is unknown whether a hormonal agent(s) was recommended or administered because it is not stated in patient record. Death certificate only.


Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. This item identifies hormone therapy given at this facility. The item Hormone Therapy records first course hormone therapy from any facility.

Chemotherapy at This Facility

DD_category: 
PUF Data Item Name: 
RX_HOSP_CHEMO
NAACCR Item #: 
700
length: 
2
Allowable values: 
00-03, 82, 58-88, 99
Description: 
Records the type of chemotherapy administered as first course treatment by the facility that submitted this record. If chemotherapy was not administered, then this item records the reason it was not administered to the patient.
Registry Coding Instructions: 
  • Code 00 if chemotherapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include chemotherapy.
  • If it is known that chemotherapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended chemotherapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether chemotherapy is usually administered for this type and stage of cancer and there is no mention in the patient record whether it was recommended or administered.
  • If the managing physician changes one of the agents in a combination regimen, and the replacement agent belongs to a different group (chemotherapeutic agents are grouped as alkylating agents, antimetabolites, natural products, or other miscellaneous) than the original agent, the new regimen represents the start of subsequent therapy, and only the original agent or regimen is recorded as first course therapy.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for coding of chemotherapeutic, hormonal and immunotherapies.

Update effective starting with 2013 PUF: Six drugs previously classified as Chemotherapy are now classified as BRM/Immunotherapy. This change in classification is effective only for cases diagnosed in January 1st, 2013 and forward. While the NCDB does not provide drug-specific data, changes in case counts may be observed for the Chemotherapy and Immunotherapy variables for cases diagnosed in 2013 due to the change in classification. The drugs are: Alemtuzumab/Campath, Bvacizumab/Avastin, Rituximab, Trastuzumab/Herceptin, Pertuzumab/Perjeta, and Cetuxumab/Erbitux.

NCDB System Code Assignments: 

Code Definition
00 None, chemotherapy was not part of the planned first course of therapy. Diagnosed at autopsy.
01 Chemotherapy administered as first course therapy, but the type and number of agents is not documented in patient record.
02 Single-agent chemotherapy administered as first course therapy.
03 Multiagent chemotherapy administered as first course therapy.
82 Chemotherapy was not recommended/administered because it was contraindicated due to patient risk factors (ie, comorbid conditions, advanced age).
85 Chemotherapy was not administered because the patient died prior to planned or recommended therapy.
86 Chemotherapy was not administered. It was recommended by the patient's physician, but was not administered as part of the first course of therapy. No reason was stated in patient record.
87 Chemotherapy was not administered. It was recommended by the patient's physician, but this treatment was refused by the patient, a patient's family member, or the patient's guardian. The refusal was noted in patient record.
88 Chemotherapy was recommended, but it is unknown if it was administered.
99 It is unknown whether a chemotherapeutic agent(s) was recommended or administered because it is not stated in patient record. Death certificate only.


Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. This item identifies chemotherapy given at the reporting facility. The item Chemotherapy identifies chemotherapy given by any facility.

Systemic Surgery Sequence

DD_category: 
PUF Data Item Name: 
RX_SUMM_SYSTEMIC_SUR_SEQ
NAACCR Item #: 
1639
length: 
1
Allowable values: 
0, 2-6, 9
Description: 
Records the sequencing of systemic treatment and surgical procedures given as part of the first course of treatment.
Registry Coding Instructions: 

Surgical procedures include Surgical Procedures of the Primary Site (NAACCR Item #1290, Scope of Regional Lymph Node Surgery (NAACCR Item #1292), and Surgical Procedure/Other Site (NAACCR Item #1294). Systemic therapy includes Chemotherapy (NAACCR Item #1390), Hormone Therapy (NAACCR Item #1300), Immunotherapy (NAACCR Item #1410) and Hematologic Transplant and Endocrine Procedure (NAACCR Item #3250). If no surgical procedure was performed, or no systemic treatment was given, this item is coded 0.

If both surgery and systemic treatment were provided for this cancer, then code 2-9, as appropriate.

Analytic Note: 

This item was added to FORDS for use with cases diagnosed in 2006 or later.

CoC cancer programs are required to identify treatment their patients received from all sources. Treatment may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file.

Hematologic Transplant and Endocrine Procedures

DD_category: 
PUF Data Item Name: 
RX_SUMM_TRNSPLNT_ENDO
NAACCR Item #: 
3250
length: 
2
Allowable values: 
00, 10 -12, 20, 30, 40, 82, 85 – 88, 99
Description: 
Identifies systemic therapeutic procedures performed as part of the first course of treatment at this and all other facilities. If none of these procedures was performed, then this item records the reason why not. These procedures include bone marrow transplants, stem cell harvests, and surgical and/or radiation endocrine therapy.
Registry Coding Instructions: 
  • Bone marrow transplants should be coded as either autologous (bone marrow originally taken from the patient) or allogeneic (bone marrow donated by a person other than the patient). For cases in which the bone marrow transplant was syngeneic (transplanted marrow from an identical twin), the item is coded as allogeneic.
  • Stem cell harvests involve the collection of immature blood cells from the patient and the reintroduction by transfusion of the harvested cells following chemotherapy or radiation therapy.
  • Endocrine irradiation and/or endocrine surgery are procedures which suppress the naturally occurring hormonal activity of the patient and thus alter or effect the long-term control of the cancer's growth. These procedures must be bilateral to qualify as endocrine surgery or endocrine radiation. If only one gland is intact at the start of treatment, surgery and/or radiation to that remaining gland is coded as endocrine surgery or endocrine radiation.
  • Code 00 if a transplant or endocrine procedure was not administered to the patient, and it is known that these procedures are not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include a transplant or endocrine procedure.
  • If it is known that a transplant or endocrine procedure is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused a recommended transplant or endocrine procedure, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether a transplant or endocrine procedure is usually administered for this type and stage of cancer, and there is no mention in the patient record whether it was recommended or administered.
  • If hematologic transplant or endocrine 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 the hematologic transplant or endocrine procedure provided in the item Palliative Care (NAACCR Item #3270) and/or Palliatiave Care at This Facility (NAACCR Item #3280), as appropriate.
Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. Procedures may have occurred at any facility, not limited to the one whose report is included in this file.

Immunotherapy

DD_category: 
PUF Data Item Name: 
RX_SUMM_IMMUNOTHERAPY
NAACCR Item #: 
1410
length: 
2
Allowable values: 
00, 01, 82, 85 – 88, 99
Description: 
Records the type of immunotherapy administered as first course treatment at this and all other facilities. If immunotherapy was not administered, then this item records the reason it was not administered to the patient. Immunotherapy consists of biological or chemical agents that alter the immune system or change the host's response to tumor cells.
Registry Coding Instructions: 
  • Code 00 if immunotherapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include immunotherapy.
  • If it is known that immunotherapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended immunotherapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether immunotherapy is usually administered for this type and stage of cancer, and there is no mention in the patient record whether it was recommended or administered.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for instructions for coding immunotherapy, chemotherapeutic and hormonal agents.
  • If immunotherapy was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record the immunotherapy administered in the item Palliative Care (NAACCR Item #3270).

Update for 2013 PUF: Six drugs previously classified as Chemotherapy are now classified as BRM/Immunotherapy. This change in classification is effective only for cases diagnosed in January 1st, 2013 and forward. While the NCDB does not provide drug-specific data, changes in case counts may be observed for the Chemotherapy and Immunotherapy variables for cases diagnosed in 2013 due to the change in classification. The drugs are: Alemtuzumab/Campath, Bvacizumab/Avastin, Rituximab, Trastuzumab/Herceptin, Pertuzumab/Perjeta, and Cetuxumab/Erbitux.

Analytic Note: 

Agents included for immunotherapy are also known at biologic response modifiers.

CoC cancer programs are required to identify treatment their patients received from all sources. Immunotherapy may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file.

Immunotherapy, Days from Dx

DD_category: 
PUF Data Item Name: 
DX_IMMUNO_STARTED_DAYS
length: 
4
Allowable values: 
0 – 9999
Description: 
The number of days between the date of diagnosis (NAACCR Item #390) and the date on which immunotherapy at any facility was started (NAACCR Item #1240).
Registry Coding Instructions: 

None.

Analytic Note: 

Agents included for immunotherapy are also known at biologic response modifiers.

CoC cancer programs are required to identify treatment their patients received from all sources. Immunotherapy may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file. This refers to the first administration of immunotherapy for the cancer by any facility.

Code Definition
0 - 9999 Number of Elapsed Days
Blank Immunotherapy not administered, immunotherapy unknown, or cannot compute days elapsed due to missing or incomplete dates


Hormone Therapy

DD_category: 
PUF Data Item Name: 
RX_SUMM_HORMONE
NAACCR Item #: 
1400
length: 
2
Allowable values: 
00, 01, 82, 85 – 88, 99
Description: 
Records the type of hormone therapy administered as first course treatment at any facility. If hormone therapy was not administered, then this item records the reason it was not administered to the patient. Hormone therapy consists of a group of drugs that may affect the long-term control of a cancer's growth.
Registry Coding Instructions: 
  • Record prednisone as hormonal therapy when administered in combination with chemotherapy, such as MOPP (mechlorethamine, vincristine, procarbazine, prednisone) or COPP (cyclophosphamide, vincristine, procarbazine, prednisone).
  • Do not code prednisone as hormone therapy when it is administered for reasons other than chemotherapeutic treatment.
  • Tumor involvement or treatment may destroy hormone-producing tissue. Hormone replacement therapy will be given if the hormone is necessary to maintain normal metabolism and body function. Do not code hormone replacement therapy as part of first course therapy.
  • Code 00 if hormone therapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include hormone therapy.
  • Code 01 for thyroid replacement therapy which inhibits TSH (thyroid-stimulating hormone). TSH is a product of the pituitary gland that can stimulate tumor growth.
  • If it is known that hormone therapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended hormone therapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether hormone therapy is usually administered for this type and stage of cancer, and there is no mention in the patient record whether it was recommended or administered.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for instructions for coding hormonal, chemotherapeutic and immunotherapy agents.
  • If hormone therapy was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record the hormone therapy administered in the item Palliative Care (NAACCR Item #3270).
Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. Hormone treatment may have been given by any facility, or at multiple facilities, not limited to the one whose report is included in this file.

Hormone Therapy, Days from Dx

DD_category: 
PUF Data Item Name: 
DX_HORMONE_STARTED_DAYS
length: 
4
Allowable values: 
0 – 9999
Description: 
The number of days between the date of diagnosis (NAACCR Item #390) and the date on which hormone therapy at any facility was started (NAACCR Item #1230).
Registry Coding Instructions: 

None.

Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. Hormone treatment may have been provided by any facility, or multiple facilities, not limited to the one whose report is included in this file. This refers to the first administration of hormone treatment for the cancer by any facility.

Code Definition
0 - 9999 Number of Elapsed Days
Blank Hormone therapy not administered, hormone therapy unknown, or cannot compute elapsed days due to missing or incomplete dates


Chemotherapy

DD_category: 
PUF Data Item Name: 
RX_SUMM_CHEMO
NAACCR Item #: 
1390
length: 
2
Allowable values: 
00 – 03, 82, 85 – 88, 99
Description: 
Records the type of chemotherapy administered as first course treatment at any facility. If chemotherapy was not administered, then this item records the reason it was not administered to the patient. Chemotherapy consists of a group of anticancer drugs that inhibit the reproduction of cancer cells by interfering with DNA synthesis and mitosis.
Registry Coding Instructions: 
  • Code 00 if chemotherapy was not administered to the patient, and it is known that it is not usually administered for this type and stage of cancer.
  • Code 00 if the treatment plan offered multiple options, and the patient selected treatment that did not include chemotherapy.
  • If it is known that chemotherapy is usually administered for this type and stage of cancer, but was not administered to the patient, use code 82, 85, 86, or 87 to record the reason why it was not administered.
  • Code 87 if the patient refused recommended chemotherapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended.
  • Code 99 if it is not known whether chemotherapy is usually administered for this type and stage of cancer and there is no mention in the patient record whether it was recommended or administered.
  • If the managing physician changes one of the agents in a combination regimen, and the replacement agent belongs to a different group (chemotherapeutic agents are grouped as alkylating agents, antimetabolites, natural products, or other miscellaneous) than the original agent, the new regimen represents the start of subsequent therapy, and only the original agent or regimen is recorded as first course therapy.
  • Refer to SEER*Rx (http://seer.cancer.gov/tools/seerrx/) for coding of chemotherapeutic, hormonal and immunotherapies.
  • If chemotherapy was provided to prolong a patient’s life by controlling symptoms, to alleviate pain, or to make the patient more comfortable, then also record the chemotherapy administered in the item Palliative Care (NAACCR Item #3270).

Update for 2013 PUF: Six drugs previously classified as Chemotherapy are now classified as BRM/Immunotherapy. This change in classification is effective only for cases diagnosed in January 1st, 2013 and forward. While the NCDB does not provide drug-specific data, changes in case counts may be observed for the Chemotherapy and Immunotherapy variables for cases diagnosed in 2013 due to the change in classification. The drugs are: Alemtuzumab/Campath, Bvacizumab/Avastin, Rituximab, Trastuzumab/Herceptin, Pertuzumab/Perjeta, and Cetuxumab/Erbitux.

Analytic Note: 

CoC cancer programs are required to identify treatment their patients received from all sources. Chemotherapy treatment may have occurred at any facility, or at multiple facilities, not limited to the one whose report is included in this file. This refers to chemotherapy to treat the cancer by any facility.

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