SEER Coding Standards Result in Underestimation of Positive Surgical Margin Incidence at Radical Prostatectomy: Results of a Systematic Audit

Shah, Satyan K.; Fleet, Trisha; Williams, Virginia P.; Smith, Anthony Y.; Skipper, Betty; Wiggins, Charles L.

doi:10.1016/j.juro.2011.04.079

Cited by 24 publications

(12 citation statements)

References 17 publications

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“…However, others have found that coding errors in the SEER database do not significantly change the composition of patients with pT2 vs. pT3 disease [37]. It is also possible that there are inaccuracies in the clinical staging of patients, such as the determination by clinical examination of ECE.…”

Section: Discussionmentioning

confidence: 99%

Differential post-prostatectomy cancer-specific survival of occult T3 vs. clinical T3 prostate cancer: Implications for managing patients upstaged on prostate magnetic resonance imaging

Muralidhar

Dinh

Mahal

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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Section: Discussionmentioning

confidence: 99%

Differential post-prostatectomy cancer-specific survival of occult T3 vs. clinical T3 prostate cancer: Implications for managing patients upstaged on prostate magnetic resonance imaging

Muralidhar

Dinh

Mahal

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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“…First, recent work from one of the SEER sites has suggested that the SEER data may underreport PSM. 26 Information regarding comorbidities was not available and several groups have reported that increased body mass index is associated with an increased risk of PSM. 21,27,28 The location and number of positive cores from transrectal ultrasound (TRUS) guided biopsies of the prostate guide surgeons with surgical planning.…”

mentioning

confidence: 99%

Positive surgical margins at radical prostatectomy: Population-based averages within PSA and Gleason strata

Izard

Salazar

Chatterjee

et al. 2013

CUAJ

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Background: Positive surgical margins (PSM) are an important determinant of biochemical recurrence after radical prostatectomy (RP). We use a population-based cancer registry to evaluate PSM by stage, Gleason and prostate-specific antigen (PSA). Methods: We identified men undergoing RP from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2007. Differences between those with and without PSM were compared with chi-squared tests. The proportion of cases with PSM were stratified by PSA and Gleason sum for both pT2 and pT3a tumours. Factors associated with PSM were analyzed using chi square and multivariate logistic regression analysis. A composite variable was used in a second multivariate analysis to display the odds ratio (OR) for a PSM for each discrete combination of PSA, Gleason score and pT stage Results: In total, 28 461 RP patients were identified and a PSM was present in 19.5%. PSM were 42% in pT3a and 16% in pT2 cases. Higher PSAs (<4.0, 4-9.9, >10) were associated with higher proportions of PSM (12%, 20% and 28%, p < 0.001). Similarly, higher Gleason scores (≤6, 3+4, 4+3, ≥8) were associated with higher PSM (12%, 22%, 27% and 33%, p < 0.001). For pT2 tumours, the proportion of PSM ranged from 8% (Gleason ≤6, PSA <4.0) to 28% (Gleason 8-10, PSA ≥10). For pT3a tumours, the PSM was higher in each Gleason/PSA strata compared to those with pT2 tumours, reaching 63% for those with pT3a, Gleason 8-10, PSA >10 disease. On multivariate analysis, stage was the largest predictor for PSM (OR 3.05, 95% confidence interval 2.81-3.30), although Gleason score and PSA remained statistically significant. Conclusion: In this population-based study of PSM after RP, the proportion of PSM vary significantly within different PSA and Gleason strata for organ-confined and extracapsular disease. These data can be used as a reference for urologist self-assessment.

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“…The introduction of these codes, as well as the corresponding coding guidelines, should resolve the previously observed underestimation of the incidence of positive surgical margins at radical prostatectomy. 23 Given that preoperative PSA has been incorporated into AJCC 7th edition staging, it may seem somewhat surprising that 1.3% of prostate cancer patients diagnosed in 2010 did not receive a PSA test and that an additional 15.2% have unknown values (Table 1). This finding indicates that central cancer registries are not completely capturing information from physician urology practices.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer collaborative stage data items—their definitions, quality, usage, and clinical implications: A review of SEER data for 2004‐2010

Howlader

Chen

Ries

et al. 2014

Cancer

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BACKGROUND: Version 2 of the Collaborative Stage Data Collection System (CSv2) became effective with cases diagnosed in 2010. This report focuses on the CSv2 components required to derive the American Joint Committee on Cancer (AJCC) stage for prostate cancer and on the site-specific factors for prostate cancer captured in CSv2. The report also highlights differences between the AJCC 6th and 7th editions for classifying prostate cancer stage. METHODS: Data from 18 Surveillance, Epidemiology, and End Results (SEER) Program population-based registries (SEER-18) were analyzed for the years 2004-2010, which included 400,591 prostate cancer cases. RESULTS: CSv2 provides specificity with regard to the Gleason grading system by distinguishing between clinical and pathologic patterns and scores. The AJCC 7th edition incorporates prostate-specific antigen values into staging, subdivides stage II into IIA and IIB, and reclassifies extraprostatic invasion with microscopic bladder neck invasion from T4 in the 6th edition to T3a; this latter change affected the AJCC stage of 283 cases in 2010. Of the 44,578 prostate cancer cases diagnosed in 2010 that would have been classified as stage II in the AJCC 6th edition, 32.7%, 27.5%, and 39.8% are classified as stages I, IIA, and IIB, respectively, in the 7th edition. CONCLUSIONS: CSv2 provides more information than was previously available to researchers using SEER prostate data.

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SEER Coding Standards Result in Underestimation of Positive Surgical Margin Incidence at Radical Prostatectomy: Results of a Systematic Audit

Cited by 24 publications

References 17 publications

Differential post-prostatectomy cancer-specific survival of occult T3 vs. clinical T3 prostate cancer: Implications for managing patients upstaged on prostate magnetic resonance imaging

Differential post-prostatectomy cancer-specific survival of occult T3 vs. clinical T3 prostate cancer: Implications for managing patients upstaged on prostate magnetic resonance imaging

Positive surgical margins at radical prostatectomy: Population-based averages within PSA and Gleason strata

Prostate cancer collaborative stage data items—their definitions, quality, usage, and clinical implications: A review of SEER data for 2004‐2010

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