NCDB-Generated Literature and the Staging of Cancer

Created in the late 1980s, the National Cancer Database (NCDB) was conceived by the American College of Surgeons Commission on Cancer (CoC) and the American Cancer Society as a national cancer registry that would ultimately capture patient information emanating from all CoC-accredited cancer treatment institutions in the United States. The NCDB for more than 30 years has proven to be a significant repository of cancer information that has spawned hundreds of scientific publications covering cancer trends, improved treatment strategies, and quality studies dealing with all types of solid tumors. In this centenary yearlong anniversary of the creation of the CoC, the NCDB stands out as a significant and shining by-product for evaluating cancer treatment sites in the United States and capturing demographic and outcomes data from those sites.

In addition, the staging world and especially the TNM system of the American Joint Committee on Cancer (AJCC), has utilized the robust data source of the NCDB to create, improve and refine clinical and pathological staging of cancer and to add prognostic and molecular prognostic factors to the anatomical taxonomy of the TNM system. While there are many examples of this in the cancer literature of the last 30 years, these five examples stand out:

Fleming ID, Phillips JL, Menck HR, Murphy GP, Winchester DP. The National Cancer Data Base report on recent hospital cancer program progress toward complete American Joint Committee on Cancer/TNM staging. Cancer. 1997;80:2305-2310.
Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol. 2010 Jan 10;28(2):264-71. doi: 10.1200/JCO.2009.24.0952. Epub 2009 Nov 30.
Fong Y, Wagman L, Gonen M, et al. Evidence-based gallbladder cancer staging: changing cancer staging by analysis of data from the National Cancer Database. Ann Surg. 2006 Jun;243(6):767-71; discussion 771-4. doi: 10.1097/01.sla.0000219737.81943.4e.
Chansky K, Detterbeck FC, Nicholson AG, Rusch VW, Vallieres E, et al. The IASLC Lung Cancer Staging Project: External Validation of the Revision of the TNM Stage Groupings in the Eighth Edition of the TNM Classification of Lung Cancer. J Thorac Oncol. 2017 Jul;12(7):1109-1121.
Swanson RS, Compton CC, Stewart AK, Bland KI. The prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined. Ann Surg Oncol. Jan-Feb 2003;10(1):65-71.

These important contributions to the cancer literature—individually and collectively—give an indication of the power of the NCDB in forging new and far-reaching data to enhance cancer staging. The creation of the NCDB during the first 100 years of the COC and the importance of this national database in developing cancer staging strategies cannot be overstated.

Frederick L. Greene, MD, FACS

Medical Director, Cancer Data Services

Levine Cancer Institute, Charlotte, NC

NCDB-Generated Literature on Cancer Disparities

As we mark the centennial celebration of the Commission on Cancer and one of its poster products, the National Cancer Database, the 10 most highly cited literature on disparities published using NCDB data are worthy of highlight.

Utilization of the National Cancer Database (NCDB) to Access Postmastectomy Breast Reconstruction

The treatment of breast cancer is a multidisciplinary effort. Breast surgical oncologists, medical oncologists, and radiation oncologists work to create a comprehensive cancer treatment plan specific for each patient.

The NCDB and Childhood Cancer

The National Cancer Database (NCDB) receives information from across the country and centers contribute their cancer patient information. While the majority of the NCDB comprises adults with cancer, the database also includes children that develop cancer.

Birthday Reflections: NCDB as a Tool for Fighting Structural Racism

The National Cancer Database (NCDB) is a hospital-based cancer registry, collecting standardized data on diagnostic, staging, treatment (including time to treatment), and outcomes for more than 70 percent of newly diagnosed cancer patients in the United States, and includes patients residing in all states.

The Impact of NCDB-Generated Literature on the Treatment of Urologic Malignancies

In the last 30 years, the National Cancer Database (NCDB) has offered important insights into the optimal management of urologic cancers. The NCDB is the largest cancer registry in the world, representing approximately 70 percent of cancer diagnoses in the United States.