Cancer Synoptic Reporting Project Group

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As part of the SNOMED Quality Initiative we are about to embark on a review of the hierarchies relating to Malignant neoplasms. We are aware that these have been based upon the content of ICD and we wish to establish an understanding of the descriptions used and their definitions.

The attached paper highlights the issues and asks a number of questions about the clinical terminology used by domain specialists.

I would be grateful if as many of you as possible could review the document and respond to the questions raised, either by use of the discussion forum below or directly by email.

The timescales for resolving these issues to enable implementation for the July 2019 release is short but any comments you have will contribute to the the wider consultation which is being held within a small number of national cancer registries. In particular we would value your thoughts from a clinical rather than classification perspective.

kind regards
Paul
Paul Amos
Principal Terminologist
SNOMED International
pam@snomed.org

  File Modified
PDF File Briefing note - Malignant Neoplasm Issues v1.0.pdf 2019-Feb-21 by Paul Amos

2 Comments

  1. Paul Amos

    Hi All,

    Just a short reminder regarding feedback on the Malignant Neoplasm issues that the final date for receipt will be Friday 8th March after which we will review the feedback received and make a decision as how to represent Primary/Secondary/Malignant neoplasms within SNOMED CT.

    As actions taken in response to this feedback exercise will impact the structure of content within this area and hence extraction and analysis of the data collected using this content I would urge you to review this paper and provide appropriate input.

    Kind regards

    Paul

    Paul Amos

    1. Jeffrey Chen

      Hi Paul,

      I just joint the group and found it is too late to make any feedback for July release. But from my understanding in melanoma:

      • malignant neoplasm of xxx site is not equal to primary malignant neoplasm. It includes both primary and metastatic diseases;
      • Secondary neoplasm refers to any tumour that is either a metastatic offshoot of a primary tumour or an apparently unrelated tumour that increases in frequency following certain cancer treatments such as chemotherapy. So, it could be confused when using secondary for metastatic disease; 
      • Also, the metastatic disease normally means a distant metastatic disease which leads to AJCC N stage. It is different from in-transit, local recurrence, distant lymph node, and regional field disease which will not trigger an AJCC N stage. This is quite important for clinical trial screening and survival prediction. 
      • The histopathology reports normally state it is a primary or metastatic disease but not for histogenesis and cell type. So the primary/secondary flag should be removed from morphology concepts.

      May I please ask if there is any update of the malignant neoplasm concept modelling? Any links to the most current guideline?

      Regards,

      Jeffrey