Information Specification

The data items required for National Cancer Data Standards for Wales – Site Specific – Thyroid and their equivalent labels in COSD V9.0, where there is an equivalent, are listed below.

 

Where the specification cites NHS Wales Data Dictionary, please refer to the Dictionary for the relevant guidance i.e. definition, format, or code list.

 

For consistency, all dates listed in the Specification are standardised as ccyymmdd.

 

Where D is denoted in Status, this indicates that the information should be derived from another data item. This typically occurs with data items that are simply text representations of their code counterparts. Other Status codes are M (Mandatory), R (Required) – the data item should be recorded where applicable and O (Optional).

 

 

Core data items should be collected for all cancers.  To reduce replication of information, Core data items have not been listed in this site-specific Standard and users should refer to National Cancer Data Standards for Wales 1. National Cancer Data Set - Full list DSCNs.xlsx (live.com) for a list of Core requirements. However, in some cases, the site-specific application of Core data items may differ e.g. a particular tumour site may require additional or fewer codes to those already published in Core, or perhaps have additional business rules as to how the Core data item should be coded. Where this occurs, the Core data item will be replicated in the site-specific Standard with the respective additional site-specific detail. These are flagged in the following table with an * next to the data item name.

 

 

For data items used in the National Cancer Data Standards for Wales that already exist within the NHS Wales Data Dictionary. These data items have been flagged with an † next to the data item name, as whilst this introduces a change to an existing information standard, the immediate use of this mandate will be used as a framework for the development of the CIS, therefore service/data providers should continue with ‘business as usual’ in terms of the data being collected and reported.

 

 

 

National Cancer Data Standards for Wales – Thyroid

 

Data Item

Definition

Format

Code List
(Code)

Code List (Text)

Status

COSD

For Differentiated & Medullary Thyroid Cancers (DTC & MTC). Key Investigations - Imaging. To carry additional imaging details for Thyroid patients

Pre-Operative Ultrasound - U Score

Record the pre-operative U Score of the primary thyroid tumour before treatment

Code List

1

Normal - no nodules

R

N/A

2

Benign - hyperechoic or isoechoic with a halo/cystic change with ring down artefact (colloid)/microcystic or spongiform appearance/peripheral egg-shell calcification/peripheral vascularity

3

Indeterminate - solid homogenous markedly hyperechoic nodule with halo (follicular lesions)/hypoechoic with equivocal echogenic foci or cystic change/mixed or central vascularity

4

Suspicious - solid hypoechoic (compared with thyroid)/solid very hypoechoic (compared with strap muscles)/hypoechoic with disrupted peripheral calcification/lobulated outline

5

Malignant - solid hypoechoic with a lobulated or irregular outline and microcalcification (papillary carcinoma)/solid hypoechoic with lobulated or irregular outline and globular calcification (medullary carcinoma)/intranodular vascularity/taller than wide axilly (AP>ML)/characteristic associated lymphadenopathy

Pre-Operative Ultrasound Key Staging Reported

Record if the pre-operative staging ultrasound scan reports on key staging items:
(a) the size of the tumour
(b) the lymph node status

Code List

Y

Yes

R

N/A

N

No

For Differentiated Thyroid Cancers (DTC). Pre- Operative Staging

Diagnosed at Pre Op

Patients staged at pre-operative diagnosis

Code List

Y

Yes

R

N/A

N

No

Pre-operative Diagnostic Category - Cytology (FNA)

Select the appropriate pre-operative diagnostic category from FNA cytology

Code List

1

Thy1

R

N/A

2

Thy2

3

Thy3a

4

Thy3f

5

Thy4

6

Thy5

For Differentiated & Medullary Thyroid Cancers (DTC & MTC). Surgery. (One occurrence of this group per Core - Surgery)

Calcium Supplements

For patients who have undergone total thyroidectomy, was calcium supplements prescribed

Code List

Y

Yes

R

N/A

N

No

For Differentiated & Medullary Thyroid Cancers (DTC & MTC). Post Surgical Complications

Post Surgical Complications

Record if there were any associated post surgical complications. Possible multiple entries

Code List

0

No Post Surgical Complication

R

N/A

2

Hypoparathyroidism

3

Recurrent Vocal Cord Palsy

7

Other Post Surgical Complication

Other Post Surgical Complication

Record any other associated post surgical complication/s

Note: Only provide this information if Code 7 - Other Post Surgical Complication was recorded for Data Item Post Surgical Complications

an100

N/A

N/A

R

N/A

For Differentiated & Medullary Thyroid Cancer (DTC & MTC). Post Surgical Assessment

Post Operative Vocal Cord Functional Assessment Performed

Record if the patient had a post operative vocal cord functional assessment after receiving thyroid surgery

Code List

Y

Yes

R

N/A

N

No

Date Vocal Cord Functional Assessment Performed

Specify the date the functional vocal cord assessment was performed

ccyymmdd

N/A

N/A

R

N/A

Calcium/Vitamin D Supplementation Requirement 
(3 months Post Surgery)

Did the patient require Calcium/Vitamin D Supplements 3 months post surgery in order to maintain a normal serum calcium level

Code List

Y

Yes

R

N/A

N

No

For Differentiated Thyroid Cancers (DTC). Prognostic Score

MACIS Prognostic Score

 3.1 (if aged less than or equal to 39 years) or 0.08 x age (if aged greater than or equal to 40 years), + 0.3 x tumour size (in centimetres), +1 (if incompletely resected), +1 (if locally invasive), +3 (if distant metastases present).
 Twenty-year cause-specific survival rates for patients with:

MACIS < 6: 99%
MACIS 6-6.99: 89%
MACIS 7-7.99: 56%
MACIS 8+: 24%

Code List

1

Low Risk (<6)

R

N/A

 2

Median Risk (6–7.99)

3

High Risk (8+)

For Differentiated Thyroid Cancer (DTC). Subsequent Treatment

Radioactive Iodine Therapy Given Following Surgery

For DTC, record if radioactive iodine therapy was given following surgery

Code List

Y

Yes

R

N/A

N

No

For Medullary Thyroid Cancer (MTC). Post Treatment assessment

Tumour Marker Post operative Calcitonin Value

Record the post operative Calcitonin Absolute Value (ng/l)
 

max n2.max n1

N/A

N/A

R

N/A