California Cancer Reporting System Standards, Volume III

TNM Path Fields Update Logic

FIELDS

TNM Path T [NAACCR #880]

TNM Path N [NAACCR #890]

TNM Path M [NAACCR #900]

TNM Path Stage Group [NAACCR #910]

TNM Path Descriptor [NAACCR #920]

TNM Path Staged By [NAACCR #930]

SPECIFICATION

Tumor Level

Multi-Document Consolidation Process

Relevant Source Documents

• All active (not deleted or merged) admissions with a Year of Diagnosis 2015 and later linked to the current tumor that also has a Year of Diagnosis 2015 and later.

Definitions

• Known TNM Path fields: does not meet the definitions defined below for criteria not met/unknown TNM Path fields.

• Criteria not met/unknown TNM Path fields:

• TNM Path T: Blank

• TNM Path N: Blank

• TNM Path M: Blank

• TNM Path Stage Group: 99 or blank

Triggers

• The set of relevant source documents linked to the tumor changed  

• Year of Diagnosis, one or more TNM Path fields, Class of Case, or RX--Hosp Surg Prim Site are changed in a relevant source document

• Special global re-consolidation processes   

Process

The system follows the hierarchies below to determine which single admission should be utilized to consolidate all TNM Path fields. Prior to each step, the system will also check to see if all TNM Path fields match in the admissions. If all TNM Path fields match, stop here.

1. Compare the admission’s Year of Diagnosis, with 2016 and forward being highest:

• Year of Diagnosis 2016-9998

• Year of Diagnosis 2015
  

2. If the system is unable to determine which single admission has the highest hierarchy using the Year of Diagnosis ranges, then attempt to break the tie by using the admissions’ TNM fields known and unknown definitions. Use the hierarchy below:

• Known TNM Path fields

• Criteria not met/unknown TNM Path fields
  

3. If the system is unable to determine which single admission has the highest hierarchy using the known and unknown definitions, then attempt to break the tie using the admissions’ TNM Path Descriptor. Use the TNM Path Descriptor hierarchy below:

• 4

• All other TNM Path Descriptor codes
  

4. If the system is unable to determine which single admission has the highest hierarchy using the TNM Path Descriptor hierarchy, then attempt to break the tie using the admissions’ Class of Case values. Use the Class of Case hierarchy below:

• 22

• 21

• 20

• 12

• 13

• 11

• 10

• 14

• 00

• 34

• 36

• 42

• 40

• 41

• 30

• 31

• 32

• 43

• 38

• 33

• 99

• 35

• 37

• 49
  

5. If the system is unable to determine which single admission has the highest hierarchy using Class of Case, then attempt to break the tie using the admissions’ RX Hosp--Surg Prim Site. Use the RX Hosp--Surg Prim Site hierarchy below:

• 20-80

• 10-19

• 98

• 90

• 00

• 99
  

6. If the system is unable to determine which single admission has the highest hierarchy using RX Hosp--Surg Prim Site, then attempt to break the tie using the admissions’ TNM Path Staged By. Use the TNM Path Staged By hierarchy below:

• 88

• 13

• 12

• 14

• 11

• 15

• 10

• 30

• 20

• 40

• 50

• 60

• 99

• 00
  

7. If the system is unable to determine which single admission has the highest hierarchy using TNM Path Staged By, then attempt to break the tie using the admissions’ TNM Path Stage group, giving hierarchy to known values over unknown. Use the hierarchy below:

• 88

• All values excluding 88, 99, blank

• 99

• Blank
  

8. If the system is unable to determine which single admission has the highest hierarchy using known over unknown TNM Path Stage Group values, then attempt to break the tie using TNM Path Stage Group, giving hierarchy to the highest known values. Use the hierarchy below:

• 88

• 4S, 4E

• 4C

• 4B

• 4A

• 4

• 3S, 3E

• 3C2

• 3C1

• 3C

• 3B

• 3A

• 3

• 2S, 2E

• 2C

• 2B

• 2A2

• 2A1

• 2A

• 2

• 1S, 1E

• 1C

• B2

• B1

• 1B2

• 1B1

• 1B

• A2

• A1

• 1A2

• 1A1

• 1A

• 1

• 0IS

• 0S

• 0A

• 0

• OC

• 99

• Blank
  

9. If the system is unable to determine which single admission has the highest hierarchy using TNM Path Stage Group, then attempt to break the tie using the admissions’ TNM Path T, giving hierarchy to known values over unknown. Use the hierarchy below:

• 88

• All values excluding 88, pX, blank

• pX, Blank
  

10. If the system is unable to determine which single admission has the highest hierarchy using known over unknown TNM Path T values, then attempt to break the tie using TNM Path T, giving hierarchy to the highest known values. Use the hierarchy below:

• 88

• p4E

• p4D

• p4C

• p4B

• p4A

• p4

• p3D

• p3C

• p3B

• p3A

• p3

• p2D

• p2C

• p2B

• p2A2

• p2A1

• p2A

• p2

• p1D

• p1C

• p1B2

• p1B1

• p1B

• p1A2

• p1A1

• p1A

• p1

• p1mI

• pISD

• pISU

• pIS

• pA

• p0

• pX, blank
  

11. If the system is unable to determine which single admission has the highest hierarchy using TNM Path T, then attempt to break the tie using the admissions’ TNM Path N, giving hierarchy to known values over unknown. Use the hierarchy below:

• 88

• All values excluding 88, pX, blank

• pX, blank
  

12. If the system is unable to determine which single admission has the highest hierarchy using known over unknown TNM Path N values, then attempt to break the tie using TNM Path N, giving hierarchy to the highest known values. Use the hierarchy below:

• 88

• p4

• p3C

• p3B

• p3A

• p3

• p2C

• p2B

• p2A

• p2

• p1C

• p1B

• p1A

• p1

• p0B

• p0A

• p1MI

• p0M+

• p0M-

• p0I+

• p0I-

• p0

• c0

• pX, blank
  

13. If the system is unable to determine which single admission has the highest hierarchy using TNM Path N, then attempt to break the tie using the admissions’ TNM Path M, giving hierarchy to known values over unknown. Use the hierarchy below:

• 88

• All values excluding 88
  
14. If the system is unable to determine which single admission has the highest hierarchy using known over unknown TNM Path M values, then attempt to break the tie using TNM Path M, giving hierarchy to the highest known values. Use the hierarchy below:
• 88

• c1E

• c1D

• c1C

• c1B

• c1A

• c1

• p1E

• p1D

• p1C

• p1B

• p1A

• p1

• c0I+

• c0

• Blank
  

15. If the system is unable to determine which single admission has the highest hierarchy using TNM Path M, then break the final tie using Admission ID (lowest number is highest in the sub-hierarchy).
    
16. Then set all TNM Path fields with all codes that are different from current consolidated codes from the single admission determined to be highest in the relevant source document hierarchy and stop here.

Manual Change

Not allowed

historical changes