Cancer Modifier. Staging and Grading

Rationale

The Staging/Grading Concept Class was designed as part of Cancer Modifier Vocabulary and was primerely developed to capture facts of staging related parameters and grading attributes of each cancer. We grouped the concepts itno the class based on their common logic nature: the entities similar to each other because they are approximations/derivations from other less frequently captured parameters (number, size, invasion depth, cell appearance and histoarhictecture, cellularity).

According to this, the class was enriched by entities describing the response to therapy.

Relationships

Hierarchy

The concepts in the Class are structurized in internal hierarchical relationships to ease querying. The hierarchy facilitate the phenotyping in cases where granular definition of Stage is not needed.

Utilization of concepts

Stages should be used as comprehensive and self-sufficient concept (by default no need to add any type of value)

1)Concepts designed to trigger the Extent Episode and Dynamic Episode

a) Episodes can not be defined by the Stage only for the entire cancer population. 4a stage in patient with tonsillar HPV-positive cancer is not the same as 4 stage Melanoma (4th stage is not always Metastatic)


b) general rule may be applicable only for TNM descriptors and may look like 


    i) N>=1 -> OMOP4997715 Invasive Disease


    ii) M>=1 -> OMOP4997716 Metastatic Disease