NHS Data Model and DictionaryNHS Digital
Type:Patch
Reference:1692
Version No:1.0
Subject:Cancer Outcomes and Services Data Set Attributes
Effective Date:Immediate
Reason for Change:Patch
Publication Date:26 November 2018

Background:

It has been identified that some of the attributes in the Cancer Outcomes and Services Data Set have three columns and these are causing a problem for conversion to the new version of the dictionary.

This patch removes the extra column and ensures that the items match the Cancer Outcomes and Services Data Set specification at: http://www.ncin.org.uk/collecting_and_using_data/data_collection/cosd_downloads_v8.

To view a demonstration on "How to Read an NHS Data Model and Dictionary Change Request", visit the NHS Data Model and Dictionary help pages at: http://www.datadictionary.nhs.uk/Flash_Files/changerequest.htm.

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Summary of changes:

Attribute Definitions
ANN ARBOR STAGE   Changed Description
ANN ARBOR SYMPTOMS INDICATION CODE   Changed Description
BINET STAGE   Changed Description
INTERGROUP RHABDOMYOSARCOMA STUDY POST SURGICAL GROUP   Changed Description
INTERNATIONAL NEUROBLASTOMA RISK GROUP STAGING SYSTEM STAGE   Changed Description
INTERNATIONAL STAGING SYSTEM STAGE FOR RETINOBLASTOMA   Changed Description
MURPHY ST JUDE STAGE   Changed Description
MYELOMA INTERNATIONAL STAGING SYSTEM STAGE   Changed Description
PATHOLOGICAL RISK CLASSIFICATION CODE AFTER NEPHRECTOMY   Changed Description
PATHOLOGICAL RISK CLASSIFICATION CODE AFTER PREOPERATIVE CHEMOTHERAPY   Changed Description
PRETEXT STAGING SYSTEM STAGE   Changed Description
RHABDOMYOSARCOMA SITE PROGNOSIS CODE   Changed Description
S CATEGORY CODE   Changed Description
WILMS TUMOUR STAGE   Changed Description
 

Date:26 November 2018
Sponsor:Alex Elias, Information Representation Services Director, NHS Digital

Note: New text is shown with a blue background. Deleted text is crossed out. Retired text is shown in grey. Within the Diagrams deleted classes and relationships are red, changed items are blue and new items are green.

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ANN ARBOR STAGE

Change to Attribute: Changed Description

The Ann Arbor Staging System stage based on the location and extent of the detected disease for a PATIENT during a Haematological Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
1lOne region of lymph nodes, or spleen or thymus or Waldeyer's ring enlarged
2ll2 regions of lymph nodes enlarged, on same side of diaphragm
3llllymph nodes enlarged on both sides of diaphragm
4lVdisease outside lymph nodes e.g. liver, bone marrow excluding 'E'
1Stage l: One region of lymph nodes, or spleen or thymus or Waldeyer's ring enlarged
2Stage ll: 2 regions of lymph nodes enlarged, on same side of diaphragm
3Stage lll: lymph nodes enlarged on both sides of diaphragm
4Stage lV: disease outside lymph nodes e.g. liver, bone marrow excluding 'E'
 

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ANN ARBOR SYMPTOMS INDICATION CODE

Change to Attribute: Changed Description

An indication of the additional Ann Arbor Staging System stage designation based on presence or absence of specific symptoms.

National Codes:

CODEINDICATORDESCRIPTION
AANo Symptoms
BBPresence of any of the following: unexplained persistent or recurrent fever (greater than 38°C / 101.5°F), drenching night sweats, unexplained weight loss of 10% or more within the last 6 months
ANo Symptoms
BPresence of any of the following: unexplained persistent or recurrent fever (greater than 38°C / 101.5°F), drenching night sweats, unexplained weight loss of 10% or more within the last 6 months
 

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BINET STAGE

Change to Attribute: Changed Description

The Binet Classification stage.

National Codes:

CODESTAGEDESCRIPTION
AAPLATELETS COUNT greater than 99 and HAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) greater than 99 and 0, 1 or 2 areas of organ enlargement (number of lymph node groups plus score 1 for hepatomegaly, 1 for splenomegaly)
BBPLATELETS COUNT greater than 99 and HAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) greater than 99 and 3, 4 or 5 areas of organ enlargement
CCHAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) less than 100 or PLATELETS COUNT less than 100
AStage A: if PLATELETS COUNT greater than 99 and HAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) greater than 99 and 0, 1 or 2 areas of organ enlargement (number of lymph node groups plus score 1 for hepatomegaly, 1 for splenomegaly)
BStage B: if PLATELETS COUNT greater than 99 and HAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) greater than 99 and 3, 4 or 5 areas of organ enlargement
CStage C: if HAEMOGLOBIN CONCENTRATION (GRAMS PER LITRE) less than 100 or PLATELETS COUNT less than 100
 

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INTERGROUP RHABDOMYOSARCOMA STUDY POST SURGICAL GROUP

Change to Attribute: Changed Description

The Intergroup Rhabdomyosarcoma Study Post Surgical Grouping System post-surgical disease group at PATIENT DIAGNOSIS for a PATIENT during a Sarcoma Cancer Care Spell.

National Codes:

CODEGROUPDESCRIPTION
11Primary complete resection
22Microscopic residual disease or primary complete resection with (completely resected) lymph node involvement
33Macroscopic residual disease
44Distant metastases
1Group 1: Primary complete resection
2Group 2: Microscopic residual disease or primary complete resection with (completely resected) lymph node involvement
3Group 3: Macroscopic residual disease
4Group 4: Distant metastases
 

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INTERNATIONAL NEUROBLASTOMA RISK GROUP STAGING SYSTEM STAGE

Change to Attribute: Changed Description

The International Neuroblastoma Risk Group Staging System stage for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
L1L1The Tumour is located only in the area where it started; no Image-Defined Risk Factors (IDFSs) are found on imaging scans, such as CT or MRI
L2L2The Tumour has not spread beyond the area where it started and the nearby TISSUE; Image-Defined Risk Factors (IDFSs) are found on imaging scans, such as CT or MRI
MMThe Tumour has spread to other parts of the body (except stage MS)
MSMSThe Tumour has spread to only the skin, liver, and/or bone marrow (less than 10% marrow involvement) in PATIENTS less than 18 months
L1Stage L1: The Tumour is located only in the area where it started; no Image-Defined Risk Factors (IDFSs) are found on imaging scans, such as CT or MRI
L2Stage L2: The Tumour has not spread beyond the area where it started and the nearby TISSUE; Image-Defined Risk Factors (IDFSs) are found on imaging scans, such as CT or MRI
MStage M: The Tumour has spread to other parts of the body (except stage MS)
MSStage MS: The Tumour has spread to only the skin, liver, and/or bone marrow (less than 10% marrow involvement) in PATIENTS less than 18 months
 

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INTERNATIONAL STAGING SYSTEM STAGE FOR RETINOBLASTOMA

Change to Attribute: Changed Description

The International Retinoblastoma Staging System stage for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
00PATIENTS treated conservatively, grouped according to intraocular classification
1IEye enucleated, completely resected histologically
2IIEye enucleated, microscopic residual Tumour
3IIIRegional extension
a) Overt orbital disease
b) Pre-auricular or cervical Lymph Node extension
4IVMetastatic disease
a) Haematogenous metastasis 1. Single lesion 2. Multiple lesions
b) CNS (Central Nervous System) extension 1. Prechiasmatic lesion 2. CNS mass 3. Leptomeningeal disease
0Stage 0: PATIENTS treated conservatively, grouped according to intraocular classification
1Stage I: Eye enucleated, completely resected histologically
2Stage II: Eye enucleated, microscopic residual Tumour
3Stage III: Regional extension
a) Overt orbital disease
b) Pre-auricular or cervical Lymph Node extension
4Stage IV: Metastatic disease
a) Haematogenous metastasis 1. Single lesion 2. Multiple lesions
b) CNS (Central Nervous System) extension 1. Prechiasmatic lesion 2. CNS mass 3. Leptomeningeal disease
 

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MURPHY ST JUDE STAGE

Change to Attribute: Changed Description

The St Jude System (Murphy Staging System) stage for a PATIENT during a Haematological Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
11Stage 1 disease is limited to a single Tumour or to one lymph node group (e.g., neck, axilla, groin, etc.) outside of the abdomen or mediastinum.
22Stage 2 disease is limited to one Tumour with local lymph node involvement; or to two or more Tumours or lymph node groups on the same side of the diaphragm; or to a completely resected primary Tumour of the gastrointestinal tract with/without involvement of local lymph nodes.
33Stage 3 disease includes Tumours or lymph node groups involved on both sides of the diaphragm; or any primary intrathoracic Tumour (mediastinal, pleural or thymic disease); or extensive Non-Hodgkin lymphoma (NHL) within the abdomen; or any paraspinal or epidural Tumours.
44Stage 4 disease involves the bone marrow and / or central nervous system (CNS), with/without other sites of involvement. Bone marrow involvement in NHL is defined as >5% - <25% malignant CELLS in an otherwise normal bone marrow. (> 25% malignant CELLS in the bone marrow is defined as leukaemia).
1Stage 1: disease is limited to a single Tumour or to one lymph node group (e.g., neck, axilla, groin, etc.) outside of the abdomen or mediastinum
2Stage 2: disease is limited to one Tumour with local lymph node involvement; or to two or more Tumours or lymph node groups on the same side of the diaphragm; or to a completely resected primary Tumour of the gastrointestinal tract with/without involvement of local lymph nodes
3Stage 3: disease includes Tumours or lymph node groups involved on both sides of the diaphragm; or any primary intrathoracic Tumour (mediastinal, pleural or thymic disease); or extensive Non-Hodgkin lymphoma (NHL) within the abdomen; or any paraspinal or epidural Tumours
4Stage 4: disease involves the bone marrow and / or central nervous system (CNS), with/without other sites of involvement. Bone marrow involvement in NHL is defined as >5% - <25% malignant CELLS in an otherwise normal bone marrow. (> 25% malignant CELLS in the bone marrow is defined as leukaemia)
 

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MYELOMA INTERNATIONAL STAGING SYSTEM STAGE

Change to Attribute: Changed Description

The International Staging System (ISS) stage.

For PATIENTS with myeloma this is derived from:

National Codes:

CODESTAGEDESCRIPTION
11
BETA2 MICROGLOBULIN LEVEL less than 3.5 and ALBUMIN LEVEL greater than 34
22
BETA2 MICROGLOBULIN LEVEL less than 3.5 and ALBUMIN LEVEL less than 35
OR
33
BETA2 MICROGLOBULIN LEVEL greater than 5.5
1Stage 1: BETA2 MICROGLOBULIN LEVEL less than 3.5 and ALBUMIN LEVEL greater than 34
2Stage 2: BETA2 MICROGLOBULIN LEVEL less than 3.5 and ALBUMIN LEVEL less than 35 OR BETA2 MICROGLOBULIN LEVEL 3.5 - 5.5
3Stage 3: BETA2 MICROGLOBULIN LEVEL greater than 5.5
 

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PATHOLOGICAL RISK CLASSIFICATION CODE AFTER NEPHRECTOMY

Change to Attribute: Changed Description

A classification to determine the histological risk, after an immediate nephrectomy (the surgical procedure of removing a kidney or section of a kidney) for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODERISKDESCRIPTION
FFavourableNon-anaplastic Wilms Tumour (all subtypes); cystic partially differentiated nephroblastoma; mesoblastic nephroma; diffuse nephroblastomatosis
U UnfavourableAnaplastic Wilms Tumour (focal and diffuse); malignant rhabdoid Tumour of kidney; clear cell sarcoma of the kidney; renal cell carcinoma
FFavourable: Non-anaplastic Wilms Tumour (all subtypes); cystic partially differentiated nephroblastoma; mesoblastic nephroma; diffuse nephroblastomatosis
UUnfavourable: Anaplastic Wilms Tumour (focal and diffuse); malignant rhabdoid Tumour of kidney; clear cell sarcoma of the kidney; renal cell carcinoma
 

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PATHOLOGICAL RISK CLASSIFICATION CODE AFTER PREOPERATIVE CHEMOTHERAPY

Change to Attribute: Changed Description

A classification to determine the histological risk, after preoperative Chemotherapy, for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODERISKDESCRIPTION
LLowCystic partially differentiated nephroblastoma; completely necrotic nephroblastoma; mesoblastic nephroma; diffuse nephroblastomatosis
IIntermediateNephroblastoma type - epithelial; stromal; mixed; regressive; focal anaplasia
HHighNephroblastoma blastemal type; nephroblastoma with anaplasia; malignant rhabdoid Tumour of the kidney; clear cell sarcoma of the kidney; renal cell carcinoma
LLow: Cystic partially differentiated nephroblastoma; completely necrotic nephroblastoma; mesoblastic nephroma; diffuse nephroblastomatosis
IIntermediate: Nephroblastoma type - epithelial; stromal; mixed; regressive; focal anaplasia
HHigh: Nephroblastoma blastemal type; nephroblastoma with anaplasia; malignant rhabdoid Tumour of the kidney; clear cell sarcoma of the kidney; renal cell carcinoma
 

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PRETEXT STAGING SYSTEM STAGE

Change to Attribute: Changed Description

The Pretext Staging System stage relating to the sectors of the liver involved for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
11Tumour involves only 1 quadrant
22Tumour involves 2 adjoining quadrants; 2 adjoining sections free
33Tumour involves 3 adjoining quadrants; only 1 quadrant free or 2 non-adjoining quadrants free
44Tumour involves all 4 quadrants
1Stage 1: Tumour involves only 1 quadrant
2Stage 2: Tumour involves 2 adjoining quadrants; 2 adjoining sections free
3Stage 3: Tumour involves 3 adjoining quadrants; only 1 quadrant free or 2 non-adjoining quadrants free
4Stage 3: Tumour involves all 4 quadrants
 

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RHABDOMYOSARCOMA SITE PROGNOSIS CODE

Change to Attribute: Changed Description

The PATIENT's prognosis code for the site for Rhabdomyosarcoma during a Sarcoma Cancer Care Spell.

National Codes:

CODEPROGNOSISDESCRIPTION
FFavourableFavourable sites: Orbit; genitourinary Non Bladder Prostate; Non Parameningeal Head and Neck
UUnfavourableUnfavourable sites: All other sites of disease
FFavourable: Orbit; genitourinary Non Bladder Prostate; Non Parameningeal Head and Neck
UUnfavourable: All other sites of disease
 

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S CATEGORY CODE

Change to Attribute: Changed Description

The code to identify the serum Tumour markers (measurable biochemicals associated with a malignancy of Tumour CELLS) for testicular cancer only.

This is derived following recording of the biochemistry test items:National Codes:

SXLDH - Marker studies not available or not performed; HCG - Marker studies not available or not performed; AFP - Marker studies not available or not performed
S0LDH - Normal; HCG - Normal; AFP - Normal
S1LDH - Less than 1.5 x normal; HCG - Less than 5,000; AFP - Less than 1,000
S2LDH - 1.5-10 x normal; HCG - 5,000-50,000 AFP - 1,000-10,000
S3LDH - Greater than 10 x normal; HCG - Greater than 50,000; AFP - Greater than 10,000

S CATEGORY CODE is derived following recording of the biochemistry test items:

National Codes:

CODELDH (UNITS/LITRE)HCG (MILLIUNITS/MILLILITRE)AFP (NANOGRAMS/MILLILITRE)
SXMarker studies not available or not performedMarker studies not available or not performedMarker studies not available or not performed
S0NormalNormalNormal
S1Less than 1.5 x normalLess than 5,000Less than 1,000
S21.5-10 x normal5,000-50,0001,000-10,000
S3Greater than 10 x normalGreater than 50,000Greater than 10,000
 

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WILMS TUMOUR STAGE

Change to Attribute: Changed Description

The Wilms Tumour Stage determined by the results of the imaging studies and both the surgical and pathologic findings at nephrectomy (kidney removal) for a PATIENT during a Children Teenagers and Young Adults Cancer Care Spell.

National Codes:

CODESTAGEDESCRIPTION
11Tumour is limited to the kidney and completely resected
22Tumour is completely resected, and there is no evidence of Tumour at or beyond the margins of resection but the Tumour extends beyond the kidney (penetration of capsule, invasion of blood vessels outside renal parenchyma)
33There is residual Tumour following surgery that is confined to the abdomen
44There are distant metastases (lung, liver, bone, brain), or lymph node metastases outside the abdominopelvic region
55Involvement of both kidneys is present at diagnosis
1Stage 1: Tumour is limited to the kidney and completely resected
2Stage 2: Tumour is completely resected, and there is no evidence of Tumour at or beyond the margins of resection but the Tumour extends beyond the kidney (penetration of capsule, invasion of blood vessels outside renal parenchyma)
3Stage 3: There is residual Tumour following surgery that is confined to the abdomen
4Stage 4: There are distant metastases (lung, liver, bone, brain), or lymph node metastases outside the abdominopelvic region
5Stage 5: Involvement of both kidneys is present at diagnosis
 

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For enquiries about this Change Request, please email information.standards@nhs.net

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