MCR Text Messages for Registrars (Excerpted from MoSTRA Memos November 23, 2007, vol. 23, issue 1)
Raise your hand if you have ever heard the cry go out from MCR, “Send us text!” Lots of hands going up.
Many of you have no doubt wondered, “Why does MCR require all that text??” After all, you’ve coded all
of the data items. Isn’t it a little redundant to code the item AND enter it in text? If you are one who has
wondered, “What does MCR do with all that text?” - wonder no more! (continued below)
NAACCR Text Minimum text should Additional text The good, the bad and the
Field cover we’d LOVE to see ugly
DX Proc-PE Size and location of any palpable Race, age, sex 38 y/o WF with 3.5 cm mass UOQ rt
masses, DRE results for prostate, (Especially helpful when breast
size and location of skin primaries the patient name is Breast mass
unusual for the gender Pt c/o breast pain and cough
and when unusual or
mixed race codes are
used.)
DX Proc—X- Results of imaging studies that Date test performed 3/3/07 CT: 4 cm RUL mass; pleural
ray/scan describe size and location of fluid, liver mets
primary tumor, other findings that lung mass and mets seen on CT
contribute to Collaborative Staging CT done at outside hospital
DX Proc—Scopes Any findings that describe size and Date test performed 4/7/07 Obstructing cecal mass; bx
location of primary site, findings Biopsy? done
that contribute to Collaborative Colonoscopy showed mass
Staging Scope pos
DX Proc—Lab Any values that are reported in Date test performed 5/8/07 AFP > 10,000
Tests Collaborative Stage fields, any PSA pos
values that contribute to the WBC 9,000; MCV normal; HCT 38
diagnostic process e.g., AFP for (brain primary)
hepatocellular carcinoma, urinary
IgG electophoresis for multiple
myeloma
DX Proc—Op Any findings that describe size and Date of procedure 6/9/07 tumor debulked – gross
location of primary tumor, findings residual dz
that contribute to Collaborate Lung tumor removed
Staging and/or explain extent of Porta-Cath placed for post-op chemo
surgery performed
DX Proc—Path Findings from pathology review of 2.5 cm invasive ductal ca, no DCIS
resection specimens and biopsies seen; 0/8 nodes pos; margins free
that confirm the histologic node dissection positive
diagnosis, contribute to Collaborate adenoca
Staging, status of nodes and
surgical margins
Primary Site Title Specific site and laterality Right breast UOQ
Skin of arm
Lung
Histology Title Histology and tumor Cutaneous T-cell lymphoma
grade Bronchogenic carcinoma (was
coded 8046/3)
Mixed ca (was coded 8346/3)
Staging Findings for the basis of Direct extension to rib; no LN; no
Collaborative Stage (or SEER mets
Summary Stage pre-2004) codes. Liver mets
In chart
Remarks Information that explains unusual It’s all good when it adds clarity to
circumstances, use of estimated the case.
dates, cancer history and the like.
Surgery Primary Enter the name of the procedure Regional lymph node and Lobectomy RML w/mediastinal node
Site for the primary site surgery code other site surgery coded. dissection
used as shown in FORDS. Colon resection
Surgery followed by RT
Radiation (Beam & Modality, volume treated XRT to brain mets
Other) prostate RT
RT by Dr. Zappa
Chemo List the chemo drugs or regimen 5-FU and VP-16
multiple agents (Rx was thio-tepa &
BCG, a BRM)
chemo in Dr’s office
Hormone, BRM, Enter the name of the agent or
Other treatment
MCR Text Messages for Registrars (continued from previous page)
Abstracts must contain corroborating text in order for us to assure that what is entered into the MCR
database is the most accurate information for each case reported. The operative concept here is
“corroborating.” That is, text should provide the rationale for selecting the codes assigned to primary site,
histology, extent of disease and treatment fields. It’s not necessary to strive for great literary expression....
Brief, meaningful comments is all it takes to tell us what we need to know.
At MCR, we get a LOT of abstracts to review. In fact, we get way more abstracts than we do cancer
cases which, of course, means some cases will be reported by two or more facilities. One of the key
functions of MCR is to ensure that each cancer reported to us is represented by only one “best abstract”
in our database. How do we decide which codes to accept when there is a discrepancy between what
General Hospital and Chicago Hope report? Factors such as class of case and treating facility play a part,
but most decisions are made based on the best text documentation. We at MCR have seen abstracts
containing text that rivals War and Peace in length to those containing no text at all. Quality of text has
encompassed the good, the bad and (dare I say) the ugly. So, just what are we looking for in text
documentation on case abstracts? The previous table lists some guidelines for what to enter in the text
fields that are transmitted to MCR, along with some examples of good and of not-so-great text.