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TNM
A system based on information models will use attributes in the information model to describe attributes of a clinical concept. For TNM classification in an openEHR based system we will use a combination of anatomical location and a generic term for the TNM codes.
The following set of SNOMED-CT codes will be used within the openEHR Templates.
Code |
Value |
Comment |
Tumor stage finding (finding) |
||
58790005 |
T0 category (finding) |
|
23351008 |
T1 category (finding) |
|
261646003 |
Tumor stage T1a (finding) |
|
261649005 |
Tumor stage T1b (finding) |
|
261650005 |
Tumor stage T1c (finding) |
|
67673008 |
T2 category (finding) |
|
261651009 |
Tumor stage T2a (finding) |
|
261652002 |
Tumor stage T2b (finding) |
|
261653007 |
Tumor stage T2c (finding) |
|
14410001 |
T3 category (finding) |
|
261654001 |
Tumor stage T3a (finding) |
|
261655000 |
Tumor stage T3b (finding) |
|
261658003 |
Tumor stage T3c (finding) |
|
65565005 |
T4 category (finding) |
|
261659006 |
Tumor stage T4a (finding) |
|
261660001 |
Tumor stage T4b (finding) |
|
261661002 |
Tumor stage T4c (finding) |
|
67101007 |
TX category (finding) |
|
Node category finding (finding) |
||
62455006 |
N0 category (finding) |
|
53623008 |
N1 category (finding) |
|
46059003 |
N2 category (finding) |
|
5856006 |
N3 category (finding) |
|
79420006 |
NX category (finding) |
|
Metastasis category finding (finding) |
||
30893008 |
M0 category (finding) |
|
55440008 |
M1 category (finding) |
|
258297005 |
Metastasis stage M2 (finding) |
|
258298000 |
Metastasis stage M3 (finding) |
|
258299008 |
Metastasis stage M4 (finding) |
|
27167007 |
MX category (finding) |
|
Code |
Text |
Desc |
718465002 |
Clinical stage 0 (finding) |
|
13104003 |
Clinical stage I (finding) |
|
60333009 |
Clinical stage II (finding) |
|
50283003 |
Clinical stage III (finding) |
|
2640006 |
Clinical stage IV (finding) |
We will use the following terminology to define the different edition of TNM classifications: This is the current version used by most clinicians today: TNM Classification of Malignant Tumours, 8th Edition
UICC-TNM-VERSION::Edition6::UICC TNM Versjon 6
UICC-TNM-VERSION::Edition7::UICC TNM Versjon 7
UICC-TNM-VERSION::Edition8::UICC TNM Versjon 8
UICC-TNM-VERSION::Edition9::UICC TNM Versjon 9Palpation of prostate is part of the examination of a patient under examination for cancer or other diseases in the organ. The TNM classification is not well-suited for this. To classify as T1 you need histopatologic evidence which is not (yet) present at the outpatient clinic.
Thus for prostate cancer DIPS will use registry-specific coding system for this. KREMT is an acronym for the messaging portal for the Norwegian Cancer Registry.
KREMT-TNM-VERSION::PROSTATA_1_0::Kreftregisteret TNM prostata palpatorisk (v4.0)KREMT-PROSTATA-TNM-PALPATORISK::1::Ikke palpabel tumor (tilsvarende T0/T1)
KREMT-PROSTATA-TNM-PALPATORISK::2::Tumor uten ekstraprostatisk vekst (tilsvarende T2)
KREMT-PROSTATA-TNM-PALPATORISK::3::Ekstraprostatisk vekst (tilsvarende T3a)
KREMT-PROSTATA-TNM-PALPATORISK::4::Innvekst i vesikler (tilsvarende T3b)
KREMT-PROSTATA-TNM-PALPATORISK::5::Innvekst i omliggende vev (tilsvarende T4)
KREMT-PROSTATA-TNM-PALPATORISK::6::Ikke vurdert / kan ikke vurderes (tilsvarende TX)The following list T-codes specific for prostate.
- WARNING
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We do not recommend such specific codes for openEHR based systems. The semantic meaning of the codes will be defined by a combination of anatomical location and generic T-codes.
369833007 T1a - Histologisk påvist kreft ≤ 5% av transuretralt reseceret prostatavev
369834001 T1b - Histologisk påvist kreft > 5% av transuretralt reseceret prostatavev
369835000 T1c - Histologisk kreft påvist ved nålebiopsi
384984004 T2a - Tumor involverer halvdelen eller mindre av den ene prostatahalvdelen
384985003 T2b - Tumor involverer mer enn en prostatahalvdel
384986002 T2c - Tumor involverer begge halvdeler av prostata
369838003 T3a - Ekstraprostatisk vekst
369839006 T3b - Innvekst i vesikler
384990000 T4 - Innvekst i omkringliggende vev