IF1167: Inconsistency between TNM categories T [value] N [value] M [value] and assigned TNM stage [value]
IF1167: Combination of T [value] N [value] M [value] is invalid for TNM staging
IF1167: T [value] N [value] M [value], staging parameter for [value], inconsistent with TNM stage [value]
IF1167: Combination T [value] N [value] M [value], staging parameter for [value], invalid for TNM staging

specification

This edit is skipped if any of the following conditions are true:

Year of Date of Diagnosis is less than 2016, blank (unknown), or invalid
TNM Edition Number is not = 07, U7, 88
Histologic Type ICD-O-3 is blank
Behavior Code ICD-O-3 = 0 (benign) or 1 (borderline)
TNM Path Stage Group is blank
TNM Path T, TNM Path N,or TNM Path M is blank
TNM Path Descriptor = 4 or 6

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 3 through 28. 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 a required staging parameter is blank.

The edit compares the combination of TNM Path T, TNM Path N, TNM Path M categories, and staging parameter where required, with TNM Path Stage Group. The edit is skipped if TNM Path Descriptor is 4 or 6, indicating stage assignment after neoadjuvant treatment. (With neoadjuvaant treatment, combinations of T, N, M and staging parameters are allowed that would not be valid otherwise.)

The designation of "c" or "p" within the individual T, N, and M codes is ignored for this edit. Valid codes for individual fields (TNM Path T, TNM Path N, TNM Path M, TNM Path Stage Group), and for these individual fields by primary site, are checked in other edits.

An edit failure is returned if the Path Stage Group is inconsistent with the expected group assignment for the coded T, N, M, and staging parameter if required, based on the AJCC stage tables. If a T, N, or M value is coded that is not included in the AJCC stage tables -- for example T4 is coded but only T4A and T4B are staged -- the stage assignment will not be checked and the edit will pass.

An edit failure is also returned if either the coded Path Stage Group returns "ERROR" from the lookup table, meaning that the combination of T, N, M, and staging parameter is invalid. Invalid combinations include T0N0M0/M0I+; T in situ with positive N and/or positive M category; and a Testis stage with an invalid S category. An invalid S category results when one or more of the 3 site-specific factors required to determine the category (SSF 13-AFP, SSF 15-hCG, SSF 16-LDH) is coded 988, meaning not applicable.

The site/histology groups are listed below. The number next to each site title indicates the respective chapter in the AJCC Cancer Staging Manual, Edition 7.The site/histology groups and group stage values are identified by site and histology in the edit Primary Site, Stage Group 2016 - Ed 7. Subdivisions of some groups were required for this edit; they are identified below with their criteria. Site-specific staging parameters are also identified. The description does not include the list of TNM categories, staging parameters, and stage groups; this information is contained in a table within EditWriter that contains around 14,700 records.

Lip and Oral Cavity
Pharynx

4A. Oropharynx and Hypopharynx

4B. Nasopharynx

4C. Nasopharynx

4D. Oropharynx - Pharyngeal Tonsil

Larynx

5A. Supraglottis, Subglottis, Other

5B. Glottis

Nasal Cavity and Paranasal Sinuses

Major Salivary Glands
Thyroid Gland

8A. Thyroid: Papillary/follicular, age less than 045

8B. Thyroid: Papillary/follicular, age greater than or equal 045 but not 999

8C. Thyroid: Papillary/follicular, age equal 999 (unknown)

8D. Thyroid: Medullary

8E. Thyroid: Anaplastic

8F. Thyroid: Anaplastic

Mucosal Melanoma of the Head and Neck

Esophagus and Esophagus Gastric Junction

10A. Esophagus

Division for Staging:

10C. Esophagus Adenocarcinoma
Histologies:8050, 8140-8147, 8160-8162, 8170-8175, 8180-8221, 8250-8507, 8514-8551,8571-8574, 8576, 8940-8941

10D. Esophagus Squamous Cell Carcinoma
Histologies: 8000-8046, 8051-8131, 8148-8157, 8230-8249, 8508, 8510-8513, 8560-8570, 8575, 8905, 8980-8981
Sites and TNM not included in 10E, 10H

10E. Esophagus Squamous Cell Carcinoma
Site, TNM: C150, C151, C153, C154
pT2pN0cM0, pT3pN0cM0

10H. Esophagus Squamous Cell Carcinoma
Site, TNM: C152, C155, C158, C159
pT2pN0cM0, pT3pN0cM0

Staging Parameter: Grade

10B. Esophagus Gastric Junction

Division for Staging:

10F. Esophagus Gastric Junction Adenocarcinoma
Histologies: 8050, 8140-8147, 8160-8162, 8170-8175, 8180-8221, 8250-8507, 8514-8551,8571-8574, 8576, 8940-8941

10G. Esophagus Gastric Junction Squamous Cell Carcinoma
Histologies: 8000-8046, 8051-8131, 8148-8157, 8230-8249, 8508, 8510-8513, 8560-8570, 8575, 8905, 8980-8981

Staging Parameter: Grade

Stomach
Small Intestine
Appendix

13A. Appendix: Carcinoma

Staging Parameter: Grade for mucinous and non-mucinous tumors, as collected in CS SSF 11

13B. Appendix: Carcinoid

Colon and Rectum
Anus
Gastrointestinal Stromal Tumor (GIST)

16A. GIST: Gastric

Staging Parameter: Mitotic Count, as collected in CS SSF 6 for GIST Stomach, CS SSF 5 for GIST Omentum

16B. GIST: Small Intestine

Staging Parameter: Mitotic Count, as collected in CS SSF 6 for GIST Esophagus, CS SSF 11 for GIST
Small Intestine, GIST Colon and Rectum, CS SSF 5 for GIST Mesentery

Neuroendocrine Tumors (NET)

17A. NET: Stomach

17B. NET: Small Intestine and Ampulla of Vater

17C. NET: Colon and Rectum

Liver

Intrahepatic Bile Ducts
Gallbladder
Perihilar Bile Ducts
Distal Bile Duct
Ampulla of Vater
Exocrine and Endocrine Pancreas
Lung
Pleural Mesothelioma
Bone

Division for Staging:

27A. Bone Non-Ewing

Histologies: 8800-9136, 9142-9252, 9261-9363, 9365-9582

Staging Parameter: Grade, for Non-Ewing

27B. Bone Ewing

Histologies: 9260, 9364

Soft Tissue Sarcoma (not edited)

Staging Parameter: Grade

historical changes

08/2016	Per NAACCR v16, new edit added.
09/2016	Per NAACCR v16A: Updated stage mapping in table referenced by logic for Thyroid, Esophagus, EsophagusGEJunction. Updated description, edit logic to indicate that grade for site/histology group 028, Soft Tissue, is collected in the Grade field and not in CS Site-Specific Factor 1. Removed "else" after special logic for TXN0M0 for Lung, causing edit to pass inappropriately for other sites. Updated to not edit for site/histology group 028, Soft Tissue Sarcoma, issues with grade assignment, Description notes this group not edited . Corrected Edit Logic to include 9727 as lymphoma rather than lymphoma/leukemia code, to delete 9728-9729 as obsolete codes. Added Group 57C, C420, C421, C424, 9811-9818, 9837 to Edit Logic.
11/2016	Per NAACCR v16B: Removed logic checking for Over-ride Site/TNM-StgGrp. This Over-ride allows pediatric cases to be coded with stage group 88. The stage tables do not look for combinations of 88 88 88 88, so any record with such a combination would not be edited with the edit. An edit failure based on incorrect setting of the Over-ride would duplicate the same edit failure in an edit that checks primary site, stage group values for 2016. Corrected edit logic for assigning site/histology group 011 to group 10B or 999 based on histology and CS Site-Specific Factor 25.
03/2017	Per NAACCR v16D: Added U7 to required TNM Edition Numbers. Table referenced by edit updated, TXN2M0, Stage 3 for lung updated to TXN2M0, Stage 99. Table referenced by edit updated, T4NXM0, Stage 3 for lung updated to T4NXM0, Stage 99. Logic updated to pass T1,T2,T3, or T4 with N0M0 and unknown mitotic rate for site/histo groups 16A, 16B, GIST.