Site specific - Gynaecological

ICD-10 CODES

Note:

• please refer to Appendix A and B for site specific registerable ICD codes for gynaecological cancer patients

Additional important notes covering borderline tumours of the ovary:

Borderline tumours of the ovary, consist of abnormal cells which develop in the epithelial tissue covering the ovary. They are slow growing and can spread to other organs of the body.

The two main types of borderline tumours are:

• Serous borderline ovarian tumour – M8442/1

• Mucinous borderline ovarian tumour – M8472/1

Originally, gynaecological morphologies of uncertain behaviour were not ‘C’ coded within ICD10 and do not require a COSD record. However, serous and mucinous ovarian borderline tumours must be recorded as an invasive ‘C56’ cancer in your cancer data management system and staged.

Retired data items

The following data item has been retired from v10:

• GY7000 – Surgeon Grade

National Cancer Audit Collaborating Centre (NATCAN)

With the formation of the new National Cancer Audit Collaborating Centre (NATCAN), all previously independent cancer audits have been brought into on organisation. Part of the rationale for this is to reduce the burden of data collection and reporting across the NHS.

As a result, all data moving forward will be from existing data sources. It is important therefore for Trusts to collect all the site specific data items within COSD, as these will form a large part of future analysis for the new ovarian audit.

More information about NATCAN can be found via their official website.

It is important that all stageable cancers are staged for every case. All site specific staging fields are mandatory and a child of ‘CORE – Site Specific Staging’ Section, and together mandates the collection of:

• the date the sample was taken which provided a positive site specific stage outcome or the MDT where the stage was agreed
• the organisation who carried out the stage
  • this is a ‘required’ data item from v10, but important to collect if known
• the stage itself

May be up to one occurrence per CORE - Site Specific Staging (1..1)

Final FIGO Stage

This is a mandatory data item. The FIGO stage is generally confirmed at pathology review in MDT meetings following surgery for uterine and vulval malignancies and for ovarian malignancies undergoing primary surgery.

For ovarian malignancies planned to undergo neoadjuvant chemotherapy and for cases of cervical cancer (which is staged clinically), the final FIGO stage is determined at the time of review of clinical findings, imaging, cytology and biopsy histology at the MDT meeting.

This section is a child of ‘Core – Treatment’ and will mandate:

• the date the treatment started
• the treatment modality
• the organisation that provided the treatment

It is possible that some legacy data may not have all the required mandatory fields. The recommendation is for Trusts to update their data to meet the new requirements and improve/enrich their data submissions, or not upload the legacy data items in the new record (if that data is not available).

May be up to one occurrence per CORE - Treatment - Surgery (0..1)

Residual Disease

The estimated size of the residual disease (tumour) left after the surgery, as documented by the surgeon at the completion of the procedure and would be captured by the MDT. This data item would apply to ovarian, fallopian tube and peritoneal cancers managed surgically.

Note:

• it is important to work with your clinicians to collect this data at MDT following surgery, as this will be used within the new Ovarian Cancer Audit