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Lung Cancer Stage IA3

Vocabulary Users
#1

So I have Stage IA3 for Lung Cancer.

I don’t seem to be able to find it in any vocabularies. Suggestions?

JD

#2

You will very soon, @jliddil1. We are finalizing the release of the cancer attribute vocabularies. We’ll roll it out properly.

#3

cool thanks

#4

It looks like IA3 is an ‘Overall Stage’ derived from a particular combination of T and N and M for Lung Cancer. A particular combination that depends on a new T possible value introduced in AJCC/UICC 8 edition: T1c. See here for reference:

https://www.jtcvs.org/article/S0022-5223(17)32136-0/pdf.

The OMOP Oncology CDM extension is targeting to make NAACCR/SEER the standard OMOP oncology diagnosis modifier vocabulary. However, currently, we can only obtain UICC 7th edition TNM values for the following NAACCR variables:

TNM CLIN T NAACCR 940
TNM CLIN N NAACCR 950
TNM CLIN M NAACCR 960

AJCC TNM CLIN T NAACCR 1001
AJCC TNM CLIN N NAACCR 1002
AJCC TNM CLIN M NAACCR 1003

TNM PATH T NAACCR 880
TNM PATH N NAACCR 890
TNM PATH M NAACCR 900

AJCC TNM PATH T NAACCR 1011
AJCC TNM PATH N NAACCR 1012
AJCC TNM PATH M NAACCR 1013

See here for the values we will be pulling for Clinical T/Pathological T/TNM Stage Group for Lung Cancer:

https://staging.seer.cancer.gov/tnm/input/1.9/lung/clin_t/?breadcrumbs=(~schema_list~),(~view_schema~,~lung~)

https://staging.seer.cancer.gov/tnm/input/1.9/lung/path_t/?breadcrumbs=(~schema_list~),(~view_schema~,~lung~)

https://staging.seer.cancer.gov/tnm/input/1.9/lung/clin_stage_group_direct/?breadcrumbs=(~schema_list~),(~view_schema~,~lung~)

So that would mean even with the ingestion of NAACCR/SEER into the OMOP vocabulary, ‘IA3’ would not be supported. Thanks for catching this. We will have to push for a way to obtain AJCC/UICC 8th edition for NAACCR/SEER variables.

Also, in general, if you have a lot of oncology diagnosis modifier use cases, could you please begin assessing how well NAACCR/SEER will be able to handle them?

#5

We use only NAACCR, AJCC, SEER terms so if OMOP pulled int he latest versions we would be good to go for the most part. Then we have Biomarkers … :slight_smile:

#6

For biomarker coverage, please take a look at the CAP Cancer Protocols:

Let us know if the CAP Cancer Protocols cover your biomarkers of interest.
We hope (eventually) to get the CAP biomarker coverage via the Nebraska Lexicon: an effort to normalize the CAP Cancer Protocols to standardized vocabularies like SNOMED and LOINC. See here:
https://www.unmc.edu/pathology/informatics/tdc

#7

CAP does and I feel along with the genomics work being done we can keep pace with the ever changing immunotherapy landscape.

#8

@jliddil1
FYI:

Go get the latest Registry Manual from STandards for Oncology Registry Entry (STORE)

https://www.facs.org/quality-programs/cancer/ncdb/registrymanuals/cocmanuals

Go to ‘AJCC TNM Clin Stage Group’. Look at the ‘Coding Instructions’. You will see a table that includes ‘IA3’. Looks like this is what we need to source.

#9

Curious to know if this issue of stage 1A3 missing was resolved. I am working with the latest version of NAACCR from Athena and it seems the staging attribute is still missing.

#10

@jmcawood A new version of the Cancer Modifier vocabulary will be released in the next couple of weeks that will include AJCC version 8, which 1A3 should be a part of. I hope that AJCC stage groups will a part of the new release. I will let the vocab team answer that. Eventually, NAACCR will become a non-standard source vocabulary for AJCC staging and it will be fixed to include all values with some mapping solution to map to the new Cancer Modifier standard.

#11

Thank you for the quick response. Who from the vocab team can speak to the availability of the Cancer Modifier vocab? Do we need to have the Oncology Extension installed to take advantage? As well, is there a roadmap to put NAACCR AJCC staging to non-standard?

#12

Hello, @jmcawood thanks for your interest in Cancer-related vocabularies. This May we released new version of Cancer Modifier Staging and Grading concept class. The concept_class currently inherits many standard concepts able to capture the majority of staging related events. They were designed as precoordinated entities with no need to use any type of concept values to cover the source semantics.
To get all the potency of the vocabulary I will advocate to convert your data into 5.4 version of CDM or OncoModel module. Both approaches permit the direct modification of Cancer diagnosis from Condition table by the Staging/Grading Measurements.
As for the NAACCR Staging de-standardization it is an ongoing task for OncoWG, welcome to the scheduled for the Vocab subgroup to know more.

t