Presentation by Tim Helliwell at Pathology Horizons 2016 conference in Galway, entitled: " The impact of international pathology guidance on the management of patients with cancer."

1. The impact of international
pathology guidance on the
management of patients with cancer
Tim Helliwell
International Collaboration for Cancer Reporting
Vice-President Royal College of Pathologists
Clinical Director for Cellular Pathology, Liverpool Clinical Laboratories
Pathology Horizons, Galway City. 2016

2. International Collaboration on Cancer Reporting
European
Society of
Pathology
www.iccr-cancer.org

3. Some of the National Programs:
• USA
• United Kingdom
• Australasia
• Canada
• France
• Spain
• Germany
• Netherlands, Switzerland, etc .....
What was the state before ICCR?

4. Aggregated Pathology Cancer Data
• Data duplication
• Interoperability compromised
or precluded
No Data

8. Incompatible datasets
Need:
Standardised, internationally accessible datasets
•Data Elements:
•Naming conventions
•Value lists
•Units and methods of measurement
- and explanatory text

9. www.iccr-cancer.org

10. www.iccr-cancer.org

11. • Publication of evidence based protocols for the
pathology reporting of cancers as structured data
• Improves clinical practice.
• Ensures ‘buy in’ from pathologists
• Quality assurance at this stage underpins
everything else
What does ICCR do?

12. • Electronic implementation of these protocols as discrete data
across large populations enables:
• aggregation and automated analysis of data in real time
• epidemiological and other research
• quality indicators
• public health management
Why does ICCR do this?

13. International Collaboration on Cancer Reporting
Proposed Benefits
Worlds best expertise:
✓Domain knowledge
✓Credibility
One world resource:
✓Dramatically reduced cost
✓Burden on expert resources shared
✓Developing countries have access
Universality means:
✓Simplified IT implementation in the laboratory
✓Simplified IT implementation in eHealth:
✓ Terminology binding
✓ eMessaging
✓Interoperability of health data internationally

14. 2011 Four Pilot Protocols Started
CAP: Lung Cancer
RCPath: Endometrial Cancer
CPAC: Prostate Cancer
RCPA: Melanoma
Arch Path Lab Med
Int J Gynae Path
Histopathology
Am J Surg Path

16. Findings
• All protocols completed successfully within 4 months
• Collaborative Paradox:
• Enthusiastic and productive collaboration
• Easier Internationally > National >
Institutional
• All reduced the number of mandatory items (118 to 66)
• Agreed naming conventions value lists & units
•The importance of a Project Manager was recognised
2011 - Four Pilot Protocols

17. Dataset chair selection
Dataset expert authoring
committee selection
Review existing datasets
for tumour site
Review and grade
existing evidence
Dataset development
Editorial review committee
ICCR Published datasets
Review following
consultation
International open consultation
Process

18. ICCR
Board
Dataset
Steering
Committee
Editorial
Review
Committee
Dataset
Authoring
Committees
Dataset
Authoring
Committees
Dataset
Authoring
Committees
Dataset
Authoring
Committees
ICCR
Published
Datasets
Review following
Consultation
Dataset Chair
Selection
Dataset Expert
Authoring
Committee Selection
Review of
existing Datasets
for the given
tumourEvidentiary
Review
(NH&MRC
Level III-2 and
above)
Dataset
Development
International
Open
Consultation
Invasive Melanoma Histopathology Reporting Guide
In ter n a tio n al C o llab o r a tio n o n C a n c e r R e p o rtin g ( I C C R )
V e rs io n 0 .1 2 I nv as i v e M el an o m a - IN T ER N AT IO N A L C O L L A B O R A T IO N O N C A N C E R R E P O R T IN G P a ge 1 o f 2
Family/Last name
Date of birthGiven name(s)
Male Fem ale
Intersex /indeterm inate
Patient identifiers D ate of request Accession/Laborato ry num ber
Gen der
Tu mour sit e
S pecimen laterality
S pecimen typ e
N o t p r o v id ed
E xc is i on
P u n c h
In c is i on
C ur ette
S h a ve
R e -e xc is io n
O th e r SURGIC AL M ARGIN /TIS SU E EDGE S
In -situ comp one nt: Periphe ral margin
D is ta nc e of m e la n om a
in s it u f ro m c lo s e s t m ar g in
S p e c if y lo c ati on ( s ),
if p o s s ib le
S pecimen description
S pecimen orienta tion
(T h is re fe rs to th e in fo rm atio n re c eiv ed f ro m th e s u rg e on
re ga rd in g or ien ta tio n o f th e s pe c im en b y m a rk in g s u tu re s ,
c lip s o r o th er te c h n iq u es w h ic h m u s t b e in c lu d ed in the re po rt
w h en e ve r p ro vid e d )
N o t p r o v id ed S p ec if y ( if k n ow n )
S pecimen dimensions
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n dimen sion s
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n descriptio n
(T h e d e s c rip tio n o f th e l es io n s ho u ld in c lu de s u c h f e atu re s as
s h ap e , c o lo u r, b o rd er, c o n tou r, e vid e nc e of s u rf ac e c ru s tin g o r
u lc era tio n an d its p ro x im ity to th e r es e c t io n m ar gi ns . )
Oth er lesion (s)
N o t id e nt ifie d P re s e nt
Ma cros co pic des criptio n of other le sion (s)
(T h e d e s c rip tio n o f th e les io n in c lu de s s u c h f e at u re s as
s h ap e , c o lo u r, b o rd er, c o n tou r, e vid e n c e of s u rf a c e c ru s tin g
or u lc e ra tio n a n d its p ro xim ity to th e p rim ar y le s ion a nd th e
re s e c tio n m a rg in s )
E lem en ts in black text a re R E Q U I R E D. E le m e n ts in grey text a re R E C O M M E ND E D .
D D – MM – YYYY
L ef t M id lin e R ig h t N ot p r o vid e d
DD – M M – YY YY
N ot p ro v id e d S pe c if y
C a n n o t be as s e s s e d
N o t in vo lve d b y m e lan o m a in s i tu
I n vo lve d b y m e lan o m a in s i tu
m m
S p e c if y lo c ati on ( s ),
if p o s s ib le
In d ete rm in ate ( N ote : D e p th is o p tion a l)
In vasive co mpo nen t: Periph eral ma rg in
D is ta n c e o f in va s iv e m e la n om a
f ro m c lo s es t p er ip h era l m a rg in
S p ec if y lo c a tion ( s ),
i f p o s s ibl e
C a n n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n om a
In v olv ed b y in va s iv e m e la n om a
m m
S p ec if y lo c a tion ( s ),
i f p o s s ibl e
In vasive co mpo nen t: Dee p margin
D is ta n c e o f i nv a s iv e
m el a n o m a fr om m a rg in
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
C a n n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n om a
In v olv ed b y in va s iv e m e la n om a
m m
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
Invasive Melanoma Histopathology Reporting Guide
International Collaboration on Cancer Reportin g (ICC R)
V ersion 0.12 Invasive M elanom a - I NTERNAT IONAL COL LAB ORATI ON ON CAN CER REPOR TING Page 1 of 2
Fam ily/Last nam e
Date of birthGiven name (s)
Ma le Female
Interse x/indete rm inate
Pa tient identifiers Date of requ est A ccession/Laborato ry num be r
Gender
T um our site
S pe cime n late rality
S pe cime n ty pe
N ot provide d
Excisio n
Punch
Incisio n
C urette
S hav e
R e-exci sio n
Ot her SU RGICAL MA RGIN / TIS SU E ED GE S
In -situ co mpo nent : Perip h eral m argin
Distance of mela noma
in s itu from close st m argin
Specify l ocation( s),
if poss ible
S pe cime n de scriptio n
S pe cime n orien ta tion
( This refers to the inform ati on re ceived from t he surge on
r egarding o rientation o f the spec imen by m arking sut ures,
cl ips or othe r techniques which m ust be incl uded in the report
w henever provided)
N ot provide d Spe cify (if kno wn)
S pe cime n dime nsion s
x w id th m mlen gt h m m x d ept h m m
M ac rosco pic p rim ary le sion dime nsion s
x w id th m mlen gt h m m x d ept h m m
M ac rosco pic p rim ary le sion de sc rip tio n
( The descri pt ion of the lesion sho uld include suc h features as
shape, colour, border, contour, ev idenc e of surface crust ing or
ulc eration and i ts proxim ity to the resection margi ns.)
Other les ion (s)
Not i dentified Present
Macroscop ic descrip tion of o th er le sion (s)
(The description of the l esi on incl udes such features as
shape , colour, bo rder, contour, evidence of surface crusting
or ul cerat ion and its proxi mity to the pri mary lesion and the
resec tion m argins)
Elements in bla ck text are R EQUIRED. Elements in g re y tex t are R ECO MM EN DED.
DD – MM – YYYY
Left Mi dline Right Not prov ided
DD – MM – YYYY
N ot provided S pec ify
C annot be as sess ed
Not involved by melanoma in situ
Involved by melanoma in situ
m m
Specify l ocation( s),
if poss ible
I ndeterm inate (No te: Depth is opt ional)
In vasive com po ne nt: Pe rip he ra l ma rgin
Distance of invasive melanoma
from closest peripheral margin
S pecify locat ion( s),
if possible
C annot be as sess ed
Not involved by invasi ve melanoma
Involved by invasi ve melanoma
m m
S pecify locat ion( s),
if possible
In vasive com po ne nt: Dee p margin
Dis tance of invasive
m elanom a from margi n
Specify location(s ),
if possible
C annot be as sess ed
Not involved by invasi ve melanoma
Involved by invasi ve melanoma
m m
Specify location(s ),
if possible
Invasive Melanoma Histopathology Reporting Guide
In ter n a tio n al C o llab o r a tio n o n C a n c e r R e p o rtin g ( I C C R )
V e rs io n 0 . 1 2 I nv as i ve M el an o m a - IN T ER N AT IO N A L C O L LA B O R A T IO N O N C A N C E R R E P O R T IN G Pa ge 1 o f 2
Family/Las t name
Date of birthGiven na me(s)
Male Fem ale
Intersex /indeterm ina te
Patient iden tifiers Date of requ est Accession/Laboratory num ber
Gender
Tu mou r site
S pecimen laterality
S pecimen typ e
N o t p r ov id ed
E xc is i on
Pu n c h
In c is i on
C ur e tte
S h a ve
R e -e xc is io n
O th e r S URGIC AL M ARGIN /TIS SU E EDGE S
In -situ c omp one nt: Periphe ral margin
D is ta nc e of m e la n om a
in s itu f ro m c lo s e s t m ar g in
S p e c if y lo c ati on ( s ),
if p os s ib le
S pecimen description
S pecimen orien ta tion
(T h is re fe rs to th e in fo rm atio n re c eiv ed f ro m th e s u rg e on
re ga rd in g or ien ta tio n o f th e s pe c im en b y m a rk in g s u t u re s ,
c lip s o r o th er te c h n iq u es w h ic h m u s t b e in c lu d ed in t he re po rt
w h en e ve r p ro vid e d )
N o t p r ov id ed S p ec if y ( if k n ow n )
S pecimen dimensions
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n dimensions
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n des criptio n
(T h e d e s c rip tio n o f t h e l es io n s ho u ld in c lu de s u c h f e a tu re s as
s h ap e , c o lo u r, b o rd e r, c o n tou r, e vid e nc e of s u rf ac e c r u s tin g o r
u lc era tio n an d its p ro x im ity to t h e r es e c tio n m ar gi ns . )
O th er lesion (s)
N ot id e nt ifie d P re s e nt
Ma crosco pic descriptio n of other le sion(s)
(T h e d e s c rip tio n o f th e les io n in c lu de s s u c h f e atu re s as
s h ap e , c o lo u r, b o rd er, c o n to u r, e vid e nc e of s u rf ac e c ru s tin g
or u lc e ra tio n a n d its p ro xim ity to th e p rim ar y le s ion a nd th e
re s ec tio n m a rg in s )
E lem en ts in black text a re R E Q U I R E D. E le m e n ts in grey text a re R E C O M M E N D E D .
D D – MM – YYYY
L ef t M id lin e R ig h t N ot p ro vid e d
DD – M M – YY YY
N ot p ro vid e d S p e c if y
C an n o t be as s e s s e d
N o t in v o lve d b y m e lan o m a in s i tu
I n v o lve d b y m e lan o m a in s i tu
m m
S p e c if y lo c ati on ( s ),
if p os s ib le
In d ete rm in ate ( N ote : D e p t h is o p tion a l)
In vasive co mpo nent: Periph eral ma rg in
D is ta n c e o f in va s iv e m e la n o m a
f ro m c lo s es t p er ip h era l m a rg in
S p ec if y lo c a tion ( s ),
i f p os s ibl e
C an n o t be as s e s s e d
N ot in v o lv ed b y in v a s iv e m e la n om a
In v o lv ed b y in v a s iv e m e la n om a
m m
S p ec if y lo c a tion ( s ),
i f p os s ibl e
In vasive co mpo nent: Dee p margin
D is ta n c e o f i nv as iv e
m el an o m a fr om m a rg in
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
C an n o t be as s e s s e d
N ot in v o lv ed b y in v a s iv e m e la n om a
In v o lv ed b y in v a s iv e m e la n om a
m m
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
Invasive Melanoma Histopathology Reporting Guide
In ter n a tio n al C o llab o r a tio n o n C a n c e r R e p o r tin g ( I C C R )
V e rs io n 0 .1 2 I nv as i ve M el an o m a - IN T ER N AT IO N A L C O L L A B O R A T I O N O N C A N C E R R E P O R T IN G Pa g e 1 o f 2
Family/Last name
Date of birthGiven name(s)
M ale Fem ale
Intersex /indeterm inate
Patient iden tifiers Date of requ est Accession/Laboratory num ber
Gender
Tu mou r site
Specimen laterality
Specimen typ e
N o t p r ov id ed
E xc is i on
Pu n c h
In c is i on
C ur et te
S h a ve
R e -e xc is io n
O th e r SURGICAL M ARGIN /TISSU E EDGE S
In-situ c ompone nt : Periphe ral margin
D is ta nc e of m e la n om a
in s itu f ro m c lo s e s t m ar g in
S p e c if y lo c ati on ( s ),
if p os s ib le
Specimen description
Specimen orien ta tion
(T h is re fe rs to th e in fo rm atio n r e c eiv ed f ro m th e s u rg e on
re ga rd in g or ien ta tio n o f th e s pe c im en b y m a rk in g s u t u re s ,
c lip s o r o t h er te c h n iq u es w h ic h m u s t b e in c lu d ed in the re po rt
w h en e ve r p ro vid e d )
N o t p r ov id ed S p ec if y ( if k n ow n )
Specimen dimensions
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n dimen sion s
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n des criptio n
(T h e d e s c rip tio n o f th e l es io n s ho u ld in c lu d e s u c h f e at u re s as
s h ap e , c o lo u r, b o rd er , c o n tou r, e vid e nc e of s u rf ac e c ru s tin g o r
u lc era tio n an d its p ro x im ity to t h e r es e c tio n m ar gi ns .)
Oth er les ion (s)
N ot id e nt ifie d P re s e nt
Ma crosco pic descriptio n of other le sion (s)
(T h e d e s c rip tio n o f th e les io n in c lu de s s u c h f e atu r e s as
s h ap e , c o lo u r, b o rd er, c o n to u r, e vid e nc e of s u rf ac e c ru s tin g
or u lc e ra tio n a n d its p ro xim ity to th e p rim ar y le s io n a nd th e
re s ec t io n m a rg in s )
E lem en ts in black text a re R E Q U I R E D . E le m e n ts in grey text a re R E C O M M E N D E D .
D D – MM – YYYY
L ef t M id lin e R ig h t N ot p ro v id e d
DD – M M – YY YY
N ot p ro vid e d S pe c if y
C an n o t be as s e s s e d
N o t in v o lve d b y m e lan o m a in s i tu
I n v o lve d b y m e lan o m a in s i tu
m m
S p e c if y lo c ati on ( s ),
if p os s ib le
In d ete rm in ate ( N ote : D e p th is o p tion a l)
Invasive co mpo nen t: Periph eral ma rg in
D is ta n c e o f in va s iv e m e la n om a
f ro m c lo s es t p er ip h era l m a rg in
S p ec if y lo c a tion ( s ),
i f p os s ibl e
C an n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n om a
In v olv ed b y in va s iv e m e la n om a
m m
S p ec if y lo c a tion ( s ),
i f p os s ibl e
Invasive co mpo nen t: Dee p margin
D is ta n c e o f i nv as iv e
m el an o m a fr om m a rg in
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
C an n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n om a
In v olv ed b y in va s iv e m e la n om a
m m
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
Invasive Melanoma Histopathology Reporting Guide
In ter n a tio n al C o llab o r a tio n o n C a n c e r R e p o rt in g ( I C C R )
V e rs io n 0 .1 2 I nv as i ve M el an o m a - IN T ER N AT IO N A L C O L L A B O R A T IO N O N C A N C E R R E P O R T IN G Pa ge 1 o f 2
Family/Last name
Date of birthGiven na me(s)
M ale Fem ale
Intersex /indeterm ina te
Patient iden tifiers Date of request Accession/Laboratory num ber
Gender
Tu mou r site
S pecimen lat erality
S pecimen typ e
N o t p r ov id ed
E xc is i on
Pu n c h
In c is i on
C ur ett e
S h a v e
R e -e xc is io n
O th e r S URGICAL M ARGIN /TIS SU E EDGE S
In -situ comp one nt : Periphe ral margin
D is ta nc e of m e la n om a
in s itu f ro m c lo s e s t m ar g in
S p e c if y lo c ati on ( s ),
if p os s ib le
S pecimen description
S pecimen orien ta tion
(T h is re fe r s to th e in fo rm atio n re c eiv ed f ro m th e s u rg e on
re ga rd in g or ien ta tio n o f th e s pe c im en b y m a rk in g s u tu re s ,
c lip s o r o th er te c h n iq u es w h ic h m u s t b e in c lu d ed in the re po rt
w h en e ve r p ro vid e d )
N o t p r ov id ed S p ec if y ( if k n o w n )
S pecimen dimensions
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n dimen sion s
x w id t h m ml e n g th m m x d e p th m m
Ma crosco pic primary lesio n descriptio n
(T h e d e s c r ip tio n o f th e l es io n s ho u ld in c lu de s u c h f e atu re s as
s h ap e , c o lo u r, b o rd er, c o n tou r, e vid e nc e of s u rf ac e c ru s tin g o r
u lc era tio n an d its p ro x im ity to th e r es e c tio n m ar gi ns . )
Other les ion(s)
N ot id e nt ifie d P re s e nt
Ma crosco pic descriptio n of ot her le sion (s)
(T h e d e s c rip tio n o f th e les io n in c lu de s s u c h f e atu re s as
s h ap e , c o lo u r, b o r d er, c o n tou r, e vid e nc e of s u rf ac e c ru s tin g
or u lc e ra tio n a n d its p ro xim it y to th e p r im ar y le s io n a nd th e
re s ec tio n m a rg in s )
E le m en ts in black text a re R E Q U I R E D. E le m e n ts in grey text a re R E C O M M E ND E D .
D D – MM – YYYY
L ef t M id lin e R ig h t N ot p ro v id e d
DD – M M – YY YY
N ot p ro vid e d S pe c if y
C an n o t be as s e s s e d
N o t in vo lve d b y m e lan o m a in s i tu
I n vo lve d b y m e lan o m a in s i tu
m m
S p e c if y lo c ati on ( s ),
if p os s ib le
In d ete rm in ate ( N ote : D e p th is o p tion a l)
In vasive co mpo nen t: Periph eral ma rg in
D is ta n c e o f in va s iv e m e la n om a
f ro m c lo s es t p er ip h era l m a rg in
S p ec if y lo c a tion ( s ),
i f p os s ibl e
C an n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n o m a
In v olv ed b y in va s iv e m e la n o m a
m m
S p ec if y lo c a tion ( s ),
i f p os s ibl e
In vasive co mpo nen t: Dee p margin
D is ta n c e o f i nv as iv e
m el an o m a fr om m a rg in
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
C an n o t be as s e s s e d
N ot in v olv ed b y in va s iv e m e la n o m a
In v olv ed b y in va s iv e m e la n o m a
m m
S p ec i fy loc a tio n (s ) ,
if p o s s ib le
GovernanceProcess

19. ICCR Steering Committee
Dataset series champion

20. Governance
DSCBoard
Edit. Review
Comm.Constitution
Conflict
of
Interest

21. Lexicon
Project
Dataset
Framework

22. Levels of evidence

23. Key ICCR dataset development points
Definitions – CORE (REQUIRED) elements
• Core elements - essential for staging, clinical management, or prognosis of
the cancer.
• These elements will either have evidentiary support at Level III-2 or above
(based on prognostic factors in the NHMRC levels of evidence1 document
– “Analysis of prognostic factors amongst persons in a single arm of a
randomised controlled trial”).
• In rare circumstances, where level III-2 evidence is not available an
element may be Core where there is unanimous agreement in the expert
committee. An appropriate staging system eg Pathological TNM staging
would normally be included as a required element.
• The summation of all CORE elements is considered to be the minimum
reporting standard for a specific cancer.

24. Definitions – NON-CORE (RECOMMENDED) elements
• Non-core elements - unanimously agreed should be included in the dataset
but are not supported by level III-2 evidence.
• These elements may be clinically important and recommended as good
practice but are not yet validated or regularly used in patient management.
• Key information other than that which is essential for staging, clinical
management or prognosis which are fundamental to the histological diagnosis
and conclusion
• e.g. macroscopic observations and interpretation, block identification key,
• May be included as either core or non-core elements by consensus of the
expert panel.
Key ICCR dataset development points

25. Key ICCR dataset development points
Commentary on data items
• Commentary is explanatory text, diagrams or tables that clarify the
elements used to:
– defines the way an item should be reported, to ensure clarity and
conformity
– explains why an item is included (e.g. how does the item assist with
clinical management or prognosis of the specific cancer)
– cites published evidence in support of the element
– states any exceptions or issues
• Commentary provides contextual guidance to the reporting pathologist.

26. Key ICCR dataset development points
Breadth of the ICCR datasets
• The goal of the ICCR is to develop a set of data elements which will form
the core of any pathology report on the specific cancer around the
world.
• Debate: how to provide datasets that work well in resource-rich and
resource poor countries? Working on layered datasets to allow
combination of morphological and molecular items
• Pathologists may add other elements etc when implementing or
reporting. The intent is not to restrict them from adding in additional
items they feel are important/fit local practice.

27. Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4Q1 Q2 Q3 Q4Q1 Q2 Q3 Q4Q2 Q3 Q4
2011 2012 2013 2014 2015
Timelines
Lung
Prostate
Melanoma
Endometrium
Kidney
Lung
Mediastinum
Genitourinary
Ovary
Heart
Head & Neck
Liver
Cervix
✓
✓
✓
✓
Pleura
✓
✓
✓
✓

28. Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4Q1 Q2 Q3 Q4Q1 Q2 Q3 Q4Q2 Q3 Q4
2011 2012 2013 2014 2015
Genitourinary
Kidney
Kidney core
Bladder Bx TUR
Bladder Resect
Urethrectomy
Nephro-urethra
Prostate Rad
Prostate Core
TUR
Testis
Penis
RPLND
Wilms

29. 2016 2017 2018 2019 2020
Timelines
8th Ed TNM
H & N
Endocrine
Eye
4th Ed
Skin
Haem
CNS
Skin
Haem
CNS
H & N
Endocrine Eye
CNS
GIT suite
Breast
Soft Tissue
Bone
UPDATE
ALL EXISTING
TO 8th Ed. TNM
Colorectal
Breast
Cervix
5th Ed CNS
GIT
Breast
Soft Tissue
Bone

31. www.iccr-cancer.org

35. ICCR Steering Committee

36. Clinical Benefit
Population Health
TNM Tumour Profile
Education,
Standardisation
Research
Strategic partnerships
International Cancer Organisations:
UICC, IARC, IACR, EORTC, WHO, NCI, AJCC
Discipline specific entities:
FIGO, IASLC,
Discipline specific pathology organisations:
ISUP, ISGYP, ETC.
International pathology entities:
ILPP
IAP - Central and Divisions, WASPaLM,
Regional Cancer organisations:
RINC, SLAP, AORTIC, ASAP

37. Narrative / Prose Structured data
Word Processing Database

38. Biochemistry
6th January 2012, 9.05am, 449379957
The fasting sodium has a value of 141mmol per litre with a reference range
of 135 to 145mmol per litre. The fasting potassium has a value of 4.9mmol
per litre with a reference range of 3.5 to 5.5mmol per litre. The fasting
chloride has a value of 102mmol per litre with a reference range of 95 to
110mmol per litre. The fasting bicarbonate has a value of 32mmol per litre
with a reference range of 20 to 32mmol per litre. The fasting urea has a
value of 7.0mmol per litre with a reference range of 3.5 to 9.5mmol per
litre. The fasting potassium has a value of 4.9mmol per litre with a
reference range of 3.5 to 5.5mmol per litre. The fasting creatinine has a
value of 70mmol per litre with a reference range of 60 to 115mmol per
litre. The fasting eGFR has a value of >90ml per minute with a reference
range of >59ml per minute. The fasting uric acid has a value of 0.33mmol
per litre with a reference range of 0.20 to 0.50mmol per litre. The
fasting calcium has a value of 2.32mmol per litre with a reference range
of 2.15 to 2.55mmol per litre. The fasting corrected calcium has a value
of 2.34mmol per litre with a reference range of 2.15 to 2.55mmol per
litre. The fasting phosphate has a value of 0.90mmol per litre with a
reference range of 0.8 to 1.5mmol per litre. The fasting total bilirubin
has a value of 9mmol per litre with a reference range of 4 to 20mmol per
litre. The fasting alkaline phosphatase has a value of 70 Units per litre
with a reference range of 35 to 110 Units per litre. The fasting gamma
glutamyl transpeptidase has a value of 24 Units per litre with a reference
range of 5 to 50 Units per litre. The fasting lactic dehydrogenase has a
value of 193 Units per litre with a reference range of 120 to 250 Units
per litre. The fasting aspartate aminotransferase has a value of 25 Units
per litre with a reference range of 10 to 40 Units per litre. The fasting
alanine aminotransferase has a value of 30 Units per litre with a
reference range of 5 to 40 Units per litre. The fasting serum protein has
a value of 71 grams per litre with a reference range of 63 to 80 grams per
litre. The fasting serum albumin has a value of 42 grams per litre with a
reference range of 36 to 47 grams per litre. The fasting serum globulin
has a value of 29 grams per litre with a reference range of 21 to 39 grams
per litre. The fasting serum cholesterol has a value of 5.3 mmol per litre
with a reference range of 3.5 to 5.5 mmol per litre. The fasting serum
glucose has a value of 4.6 mmol per litre with a reference range of 3.6 to
6.0 mmol per litre.
Ghengis Khan
Who

39. Structured
Reporting
Synoptic
Reporting

40. Success will be:
• Unified global language for reporting all
cancers (50+ datasets)
• Improved consistency/quality of reports
• Improved patient management and outcomes
• Demonstrated by:
• International audits of pathology practice
• Adoption of ICCR pathology datasets by
national oncology teams
• Genuinely comparative data on cancer
incidence and outcomes