Person with cancer—extraprostatic extension focality, code N

Identifying and definitional attributes

Metadata item type:Data Element
Short name:EPE focality
METeOR identifier:495232
Registration status:Health, Standard 14/05/2015
Definition:

The focality of extraprostatic extension (EPE) on the prostate of a person with prostate cancer, as represented by a code.

Context:Extraprostatic extension is a prognostic indicator in prostate cancer.

Data element concept attributes

Identifying and definitional attributes

Data element concept:Person with cancer—extraprostatic extension focality
METeOR identifier:495228
Registration status:Health, Standard 14/05/2015
Definition:

The focality of extraprostatic extension (EPE) on the prostate of a person with prostate cancer.

Object class:Person with cancer
Property:Extraprostatic extension focality

Source and reference attributes

Submitting organisation:Cancer Australia

Value domain attributes

Identifying and definitional attributes

Value domain:Extraprostatic extension focality code N
METeOR identifier:495230
Registration status:Health, Standard 14/05/2015
Definition:A code set outlining the focality of extraprostatic extension.

Representational attributes

Representation class:Code
Data type:Number
Format:N
Maximum character length:1
Permissible values:
ValueMeaning
1Focal
2Extensive
Supplementary values:
9Not stated/inadequately described

Collection and usage attributes

Guide for use:

Use this code set to record the focality of extraprostatic extension.

The degree of extraprostatic extension can be classified as focal or extensive (also referred to as ‘established’ or ‘nonfocal’). Focal is defined as extraprostatic glands which occupy no more than one high power field on no more than two sections, often described as "established". Extensive EPE represents anything more than this and is often described as "non-focal".

Source and reference attributes

Submitting organisation:Cancer Australia
Reference documents:

Royal College of Pathologists of Australasia 2014. Prostate cancer (radical prostatectomy) structured reporting protocol 2nd edition. RCPA, Sydney. Viewed 21 December 2014, http://www.rcpa.edu.au/getattachment/f506078a-3bd4-4a1c-8b8c-85d2f2dfcf61/Protocol-prostate-cancer-radical-prostatectomy.aspx

Data element attributes

Collection and usage attributes

Guide for use:

Record the focality of extraprostatic extension in a person with prostate cancer. This should be recorded in conjunction with Person with cancer—extraprostatic extension, yes/no/unknown/not stated/inadequately described code N. This item should be completed both after diagnostic testing/imaging is completed and after surgery.

The assessment of EPE can be difficult, as the prostate is not surrounded by a discrete, well defined fibrous capsule. Adding to the difficulty, there is often a fibrotic reaction in the vicinity of EPE, and the neoplastic extraprostatic glands are often seen in fibrous tissue, not fat.

Therefore, EPE can be identified in several different situations and can be diagnosed by one of the following:

  • The presence of neoplastic glands abutting or within periprostatic fat (most useful at the lateral, posterolateral and posterior aspects of the gland).
  • Neoplastic glands surrounding nerves in the neurovascular bundle (posterolaterally).
  • The presence of a nodular extension of tumour beyond the periphery of the prostate. This latter situation is best identified at low power magnification. In this assessment, the edge of the prostate is defined as the plane between fat and the condensed fibromuscular prostatic stroma which is best initially determined in a region without distortion by tumour.

Tracking along the edge of the prostate at low power, EPE is present when there is bulging of the tumour beyond the normal rounded contour of the prostate gland.

Collection methods:Collect from pathology reports or systems.

Source and reference attributes

Submitting organisation:Cancer Australia
Reference documents:

Royal College of Pathologists of Australasia 2014. Prostate cancer (radical prostatectomy) structured reporting protocol 2nd edition. RCPA, Sydney. Viewed 21 December 2014, http://www.rcpa.edu.au/getattachment/f506078a-3bd4-4a1c-8b8c-85d2f2dfcf61/Protocol-prostate-cancer-radical-prostatectomy.aspx

Relational attributes

Related metadata references:

See also Person with cancer—extraprostatic extension indicator, present/indeterminate/not identified code N Health, Standard 14/05/2015

Implementation in Data Set Specifications:

Prostate cancer (clinical) NBPDS Health, Standard 14/05/2015

DSS specific attributes +