1. 2016 Edits

2. Choice Lists We are still waiting on NPCR to give us the choice list
Until we receive the choice list make sure to look at the appropriate chapters for the site you are abstracting

3. Edit: Primary Site, AJCC Stage Group 2016 - Ed 7 (COC)
E:TNM Clin Stage Group is invalid for site/hist combination Date of Diagnosis (530) = [Y:2016 M:03 D:08] TNM Edition Number (938) = [07] Primary Site (540) = [C443] Histologic Type ICD-O-3 (550) = [8743] CS Site-Specific Factor10 (1030) = [988] CS Site-Specific Factor25 (1075) = [988] Over-ride Site/TNM-StgGrp (1895) = [<BLANK>] Age at Diagnosis (193) = [064] Grade (555) = [9] _ TNM Clin Stage Group (970) = [1] TNM Path Stage Group (952) = [1]
This edit is here because melanoma of the skin requires 1a or 1b. This was only staged as a stage 1
It is very important to open your ajcc staging manual to the chapter of the site you are abstracting to find the details of how each site can be staged
This edit says that the stage group is not applicable for the site. So for this case we have a melanoma that was given a clinical stage group 1. For melanomas we have to choose whether they are A or B based on ulceration.

4. Edit: TNM T, N, M , In Situ (CoC)
E:Conflict between TNM Path T (pIS) and TNM Clin Stage Group (99)
Date of Diagnosis (530) = [Y:2016 M:04 D:21] Primary Site (540) = [C182]
Histologic Type ICD-O-3 (550) = [8210] Behavior Code ICD-O-3 (554) = [3]
TNM Path T (940) = [pIS] TNM Path N (944) = [p0] Should be [c0] TNM Path M (948) = [c0] TNM Path Stage Group (952) = [0] TNM Clin T (958) = [cX] Should be [pTis] TNM Clin N (962) = [c0] TNM Clin M (966) = [c0] TNM Clin Stage Group (970) = [99] TNM Path Descriptor (956) = [0]
In your AJCC Manual on page 12 table 1.8 it states that carcinoma in situ, stage pTis cN0 cM0 as both clinical and pathologic stage(if the case is eligible for pathologic staging)
The only instance where you would not use pTis cN0 cM0 pathologic stage 0 is if the patient went to surgery and they found the disease was progressed further than in situ
For 2016 cases an insitu cancer should be coded Clinical pTis, cN0, cM0. If the patient goes onto to have a resection and the disease in more than insitu you can then make the case pathologically more. If the disease is insitu pathologically as well then you should put pTis, cN0, cM0 for pathologic staging as well.

5. Edit: Primary Site, TNM Clin Stage Valid B-Ed 7 (COC)
The purpose of this edit is to validate the coded TNM categories, and site-specific
staging parameters where used, with the coded Stage Group assignments. The edit is
used for site/histology groups in AJCC 7th Edition chapters 29 through 57. Some TNM
chapters require elements in addition to T, N, and M categories, such as grade or
mitotic rate. for correct stage assignment. In this edit description, these elements are called staging parameters. The edit will not be skipped but will pass if any of TNM Clin N or a required staging parameter is blank. The edit compares the combination of TNM Clin T, TNM Clin N, TNM Clin M categories, and staging parameter where required, with TNM Clin
Stage Group.
E:Inconsistency between TNM categories TcX Nc0 Mc0 and assigned TNM stage TNM Clin T (958) = [cX] _ _ TNM Clin N (962) = [c0] _ _ TNM Clin M (966) = [c0] _ _ TNM Clin Stage Group (970) = [2] _ Primary Site (540) = [C541] _ _ _ _ Histologic Type ICD-O-3 (550) = [8380] _ _ _ _ Behavior Code ICD-O-3 (554) = [3] _ Date of Diagnosis (530) = [Y:2016 M:03 D:16] _ _ _ _ _ _ _ _ _ _ _
You can not give a patient a stage grouping if the required elements aren’t filled out. You can’t give a stage clinical or pathologic without all the elements (t, n, and m)
This case should have been clinical stage group 99. The only instances where this would work would be when the x value made no difference in staging. For example, if we have a cancer of the renal pelvis and you had pT4, pNX, and cM0 you could give that a stage IV, because no matter what the N was the cancer would still be staged as a stage IV based on pT4 and cM0.

6. Edit: TNM Path T, Primary Site, Surgery - Ed 7 (COC)
M:TNM Chapter: Date of Diagnosis (530) = [Y:2016 M:03 D:04] Type of Reporting Source (563) = [1] Primary Site (540) = [C679]
Histologic Type ICD-O-3 (550) =[8120] Behavior Code ICD-O-3 (554) = [3] TNM Path T (940) = [p2] RX Summ--Surg Prim Site (1567) = [27]
A TURBT doesn’t count for pathologic staging criteria for bladder
Pathologic staging can only be given if the patient has a cystectomy per chapter 45

7. Edit: TNM Clin Stage Group, SSF 2 Lymphoma (COC)
E:TNM Clin Stage Group (2) and CS Site-Specific Factor 2 (000) conflict TNM Clin Stage Group (970) =[2]
CS Site-Specific Factor 2 (1006) =[000]
Date of Diagnosis (530) = [Y:2016 M:02 D:24] Histologic Type ICD-O-3 (550) = [9695] Primary Site (540) = [C778] Type of Reporting Source (563) = [1] Behavior Code ICD-O-3 (554) = [3]
If TNM Clin Stage Group = 1A, 2A, 3A, or 4A, then CS SSF 2 must = 000 (No B symptoms) or 020 (Pruritis)
If TNM Clin Stage Group = 1B, 2B, 3B, or 4B, then CS SSF 2 must = 010 (any B symptoms) or 030 (any B symptoms +
pruritis)
If TNM Clin Stage Group = 1, 2, 3, or 4
then CS SSF 2 must = 999 (unknown or no information

8. Edit: TNM T, SSize, Site Spec - Ed 7, ICDO3 (CoC)
M:TNM Chapter: 08B Tumor Size Summary (850) = [077] TNM Clin T (958) = [c1A] TNM Path T (940) = [p1A] Date of Diagnosis (530) = [Y:2016 M:02 D:23] Primary Site (540) =[C739] Histologic Type ICD-O-3 (550) =[8260] Behavior Code ICD-O-3 (554) = [3]
Make sure you are careful with putting in tumor sizes when the size helps derive the staging
This patient had a tumor size of 7.7 mm which should’ve been put in as 008 with rounding