Patient—diagnosis date of first recurrence as distant metastasis, DDMMYYYY

Guide for use:

Record the date the first recurrence as distant metastasis is diagnosed.

The term recurrence defines the return, reappearance or metastasis of cancer (of the same histology) after a disease-free intermission or remission.

Distant metastasis refers to the spread of cancer of the same histology as the original (primary) tumour to distant organs or distant lymph nodes.

The date is based on the most definitive diagnostic information available and ideally will correspond to the date of the investigation recorded in data element Person with cancer—most valid basis of diagnosis of the first recurrence, code N. For instance, record the date of the first histological or, if unavailable, cytological investigation confirming the diagnosis of recurrence. If these investigations have not been performed, record the date of confirmation by clinical investigation.

This information should be obtained from the patient's medical record. In the first instance, the diagnosis date should be derived from the relevant investigation report; for example, tissue diagnosis from the pathology report and imaging from the imaging reports.

If the diagnosis is made on the basis of clinical examination, record the date this is performed. For example, this may be the date of a consultation, an outpatient appointment or the date the patient is admitted to hospital.

If the patient was diagnosed by clinical examination and/or investigations performed elsewhere, the date may be found in a letter of referral from a recognised medical practitioner or dentist. Usually the relevant test result, if applicable, will be attached to this.

In some cases, the date the patient states they were diagnosed with recurrence will be the only date available and should be recorded here. For example, the patient may have been diagnosed whilst overseas.

If components of the date are not known, an estimate should be provided where possible with an estimated date flag to indicate that it is estimated. If an estimated date is not possible, a standard date of 15 June 1900 should be used with a flag to indicate the date is not known.

Origin:
Commission on Cancer, American College of Surgeons

Comments:
This data item is used to measure the efficacy of the initial course of treatment through evaluating the time interval from diagnosis to recurrence, treatment to recurrence and recurrence to death.