Anaplastic Thyroid Path Stage

[barbara.hempel@dhhs.nc.gov]

We are getting the following edit when only a biopsy is performed (no surgery) for an Anaplastic Thyroid Carcinoma histology 8021, without any mets. The edit error that we are receiving is: TNM Path Stage Group is invalid for site/hist combination. I found a directly related question that was recently posted to the forum with a response from Donna as follows:
What is pathologic stage for a bx only anaplastic thyroid ca?
01-17-17, 06:06 PM
What would be the correct pathological stage for a thyroid case that was diagnosed by biopsy only, anaplastic CA; no surgery, treated with radiation and chemo. Clin TNM = cT4A, cN0, cM0, c Stage Group 4A. Since patient did not have surgery, my understanding is that this case does not qualify for path staging. pT blank pN blank pM blank, p Stage blank/99. Is this correct?
My software is producing an error – I would like to validate the pathological stage before sending this to the software for an edit fix. The only way to pass the edit currently is for the pathological stage group to be 4A also, leaving path TNM blank.
Please confirm – if a patient does not have surgery for Thyroid CA, the pathological staging fields should be blank.
Thank you,
#2
01-18-17, 11:50 AM
A pathologic stage should not be assigned when the patient does not meet the criteria, which is surgical resection. Especially with a cM0 there is no special rule or exception that would allow a pathologic stage to be assigned.
Donna M Gress, RHIT, CTR
AJCC

So it appears that the pathological stage should be 99 and not a 4a or 4b according Donna Gress. The edits that seem to be creating the problems are Primary Site, Stage Group 2016-Ed7 (NPCR) and Primary Site, AJCC Stage Group 20126 – Ed 7 (COC).
Thanks

[Jim Hofferkamp]

Hi Barbara,
Your staging is correct! We should have allowed a stage group 99 for anaplastic thyroid carcinoma. The edit tables have been updated and the corrected edit will be included in the v16d metafile. Hopefully, the v16d metafile will be released in early February. Until that time, please have your registrar hold the case until the v16d metafile is available to them and they can submit the correct data.

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