Norwegian openEHR Repository
Name
FNCLCC grading system
Description
The histological grading of soft tissue sarcoma using the FNCLCC grading system.
Comment
FNCLCC - Fédération Nationale des Centres de Lutte Contre le Cancer.
Keywords
sarcoma soft tissue tumour cancer neoplasia oncology malignancy tumor differentiation tumor necrosis mitotic count grading grade FNCLCC
Purpose
To record the histological grading of soft tissue sarcoma using the FNCLCC grading system.
Use
Use to record the histological grading of soft tissue sarcoma using the FNCLCC grading system.

The archetype is designed to be used in an ENTRY archetype that will provide the clinical or pathological context. For example: In the "Specific Details" SLOT in the EVALUATION.problem_diagnose (Problem/Diagnosis) archetype, or nested in a relevant pathology-related CLUSTER archetype which is again nested in the laboratory response archetype (OBSERVATION.laboratory_test_result). This will also allow for documentation of body site.
References
Kumar R, Ludwig JA, Madewell JE. Soft Tissue Sarcomas. In: Oncologic Imaging: A Multidisciplinary Approach 2 ed. Elselvier: Saunders; 2022. Chapter 38; p.656-669.
Jean-Michel Coindre; Grading of Soft Tissue Sarcomas: Review and Update. Arch Pathol Lab Med 1 October 2006; 130 (10): 1448–1453. doi: https://doi.org/10.5858/2006-130-1448-GOSTSR
https://emedicine.medscape.com/article/2006584-overview?form=fpf
https://www.cancer.org/cancer/types/soft-tissue-sarcoma/detection-diagnosis-staging/staging.html
Norwegian translation: Helsedirektoratet. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av sarkom. [revised 2022 February]. [Internet]. 2022 February. Available from: https://www.helsedirektoratet.no/retningslinjer/sarkomer-handlingsprogram
Archetype Id
openEHR-EHR-CLUSTER.fnclcc.v1
Copyright
Licencing
This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
Original Author
Kanika Kuwelker
Helse Vest IKT
Date Originally Authored
2024-03-19
Language Details
Norwegian Bokmal
Kanika Kuwelker, John Tore Valand
Helse Vest IKT
Name Card Type Description
Tumour differentiation
0..1 DV_ORDINAL
Constraint for DV_ORDINAL
  • 1 : Sarcoma closely resembling normal adult mesenchymal tissue (e.g., low-grade liposarcoma).
  • 2 : Sarcomas for which histological typing is certain (e.g., myxoid/round cell liposarcoma).
  • 3 : Embryonal and undifferentiated sarcomas, sarcomas of doubtful type, synovial sarcomas, soft tissue osteosarcoma, Ewing sarcoma/primitive neuroectodermal tumor (PNET) of soft tissue.
Mitotic count
0..1 DV_ORDINAL
Constraint for DV_ORDINAL
  • 1 : 0-9 mitoses per 1,7 mm2
  • 2 : 10-19 mitoses per 1.7 mm2
  • 3 : ≥20 mitoses per 1.7 mm2
Tumour necrosis
0..1 DV_ORDINAL
Constraint for DV_ORDINAL
  • 0 : No necrosis
  • 1 : <50% tumor necrosis
  • 2 : ≥50% tumor necrosis
Total score
0..1 DV_COUNT The total sum of each component parameter for the FNCLCC grading system.
Constraint for DV_COUNT
min: >= 2; max: <= 8
Histological grade
0..1 DV_CODED_TEXT Assessment of histological grade based on the total score in the FNCLCC grading system.
Comment
In clinical practice for soft tissue sarcomas, the 'Histological grade' result from this archetype is commonly reused to populate the 'Histopathological grade (G)' data element within the CLUSTER.tnm and CLUSTER.tnm-pathological archetypes. In that situation, this grading may be recorded within this archetype and also copied to the TNM archetypes.
Constraint for DV_CODED_TEXT
  • GX
    [Grade cannot be assessed.]
  • Grade 1
    [Total score 2 or 3.]
  • Grade 2
    [Total score 4 or 5.]
  • Grade 3
    [Total score 6, 7 or 8.]
archetype (adl_version=1.4; uid=2dbbc3a7-1871-4566-ab95-5171337dda20)
	openEHR-EHR-CLUSTER.fnclcc.v1

concept
	[at0000]	-- FNCLCC grading system
language
	original_language = <[ISO_639-1::en]>
	translations = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			author = <
				["name"] = <"Kanika Kuwelker,  John Tore Valand">
				["organisation"] = <"Helse Vest IKT">
				["email"] = <"kanika.kuwelker@helse-vest-ikt.no, , john.tore.valand@helse-vest-ikt.no">
			>
		>
	>
description
	original_author = <
		["name"] = <"Kanika Kuwelker">
		["organisation"] = <"Helse Vest IKT">
		["email"] = <"kanika.kuwelker@helse-vest-ikt.no">
		["date"] = <"2024-03-19">
	>
	details = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			purpose = <"For å registrere histologisk grad av bløtvevssarkom ved bruk av FNCLCC sitt graderingssystem.">
			use = <"Brukes for å registrere histologisk grad av bløtvevssarkom ved bruk av FNCLCC sitt graderingssystem.

Arketypen er utviklet for å brukes i en ENTRY-arketype som vil gi den kliniske eller patologiske konteksten for registreringen. For eksempel: I SLOTet \"Spesifikke detaljer\" i arketypen Problem/diagnose (EVALUATION.problem_diagnosis), i en relevant patologirelatert CLUSTER-arketype som igjen nøstes i arketypen Laboratorieresultat (OBSERVATION.laboratory_test_result). Dette gir også mulighet for å registrere kroppssted.">
			keywords = <"sarkom, bløtvev, kreft, neoplasi, malignitet, onkologi, tumordifferensiering, tumornekrose, mitotosetall, grad, FNCLCC", ...>
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record the histological grading of soft tissue sarcoma using the FNCLCC grading system.">
			use = <"Use to record the histological grading of soft tissue sarcoma using the FNCLCC grading system.

The archetype is designed to be used in an ENTRY archetype that will provide the clinical or pathological context. For example: In the \"Specific Details\" SLOT in the EVALUATION.problem_diagnose (Problem/Diagnosis) archetype, or nested in a relevant pathology-related CLUSTER archetype which is again nested in the laboratory response archetype (OBSERVATION.laboratory_test_result). This will also allow for documentation of body site.">
			keywords = <"sarcoma, soft tissue, tumour, cancer, neoplasia, oncology, malignancy, tumor differentiation, tumor necrosis, mitotic count, grading, grade, FNCLCC", ...>
			misuse = <"">
		>
	>
	lifecycle_state = <"published">
	other_contributors = <"Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør)", "Silje Ljosland Bakke, Helse Vest IKT AS, Norway (Nasjonal IKT redaktør)", "SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India", "Hanne Marte Bårholm, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "Mona Didriksen, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "Heather Grain, Llewelyn Grain Informatics, Australia", "Hans Kristian Haugland, Helse Bergen, Norway", "Evelyn Hovenga, EJSH Consulting, Australia", "Nina Louise Jebsen, Haukeland Universitetssykehus, Norway", "June Marie Knappskog, Helse Nord IKT AS, Norway (Nasjonal IKT redaktør), Norway", "Anjali Kulkarni, Karkinos, India", "Kanika Kuwelker, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "Jörgen Kuylenstierna, eWeave AB, Sweden", "Liv Laugen, Oslo universitetssykehus, Norway (Nasjonal IKT redaktør)", "Heather Leslie, Atomica Informatics, Australia (openEHR Editor)", "June Marie Nepstad Knappskog, Helse Nord IKT AS, Norway (openEHR Editor)", "Ian McNicoll, freshEHR Clinical Informatics, United Kingdom", "Olha Nikolaieva, University Hospital Basel, Switzerland", "Terje Nordberg, Helse Bergen, Norway", "Mikael Nyström, Cambio Healthcare Systems AB, Sweden", "Bjørn Næss, DIPS ASA, Norway", "Terje Sagmyr, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "John Tore Valand, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "Marit Alice Venheim, Helse Vest IKT, Norway (Nasjonal IKT redaktør)", "Olga Zaikova, OUS, Radiumhospitalet, Norway">
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["references"] = <"Kumar R, Ludwig JA, Madewell JE. Soft Tissue Sarcomas. In: Oncologic Imaging: A Multidisciplinary Approach 2 ed. Elselvier: Saunders; 2022. Chapter 38; p.656-669.

Jean-Michel Coindre; Grading of Soft Tissue Sarcomas: Review and Update. Arch Pathol Lab Med 1 October 2006; 130 (10): 1448–1453. doi: https://doi.org/10.5858/2006-130-1448-GOSTSR

https://emedicine.medscape.com/article/2006584-overview?form=fpf

https://www.cancer.org/cancer/types/soft-tissue-sarcoma/detection-diagnosis-staging/staging.html

Norwegian translation: Helsedirektoratet. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av sarkom. [revised 2022 February]. [Internet]. 2022 February. Available from: https://www.helsedirektoratet.no/retningslinjer/sarkomer-handlingsprogram">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"786BE2D1B163CDEA68A5479743871456">
		["build_uid"] = <"eaa6fb15-74fb-4aeb-9f63-61766658180e">
		["revision"] = <"1.0.0">
	>

definition
	CLUSTER[at0000] matches {    -- FNCLCC grading system
		items cardinality matches {1..*; unordered} matches {
			ELEMENT[at0005] occurrences matches {0..1} matches {    -- Tumour differentiation
				value matches {
					1|[local::at0008],
					2|[local::at0009],
					3|[local::at0010]
				}
			}
			ELEMENT[at0006] occurrences matches {0..1} matches {    -- Mitotic count
				value matches {
					1|[local::at0011],
					2|[local::at0012],
					3|[local::at0013]
				}
			}
			ELEMENT[at0007] occurrences matches {0..1} matches {    -- Tumour necrosis
				value matches {
					0|[local::at0014],
					1|[local::at0015],
					2|[local::at0016]
				}
			}
			ELEMENT[at0021] occurrences matches {0..1} matches {    -- Total score
				value matches {
					DV_COUNT matches {
						magnitude matches {|2..8|}
					}
				}
			}
			ELEMENT[at0017] occurrences matches {0..1} matches {    -- Histological grade
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0022,    -- GX
							at0018,    -- Grade 1
							at0019,    -- Grade 2
							at0020]    -- Grade 3
						}
					}
				}
			}
		}
	}



ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"FNCLCC grading system">
					description = <"The histological grading of soft tissue sarcoma using the FNCLCC grading system.">
					comment = <"FNCLCC - Fédération Nationale des Centres de Lutte Contre le Cancer.">
				>
				["at0005"] = <
					text = <"Tumour differentiation">
					description = <"">
				>
				["at0006"] = <
					text = <"Mitotic count">
					description = <"">
				>
				["at0007"] = <
					text = <"Tumour necrosis">
					description = <"">
				>
				["at0008"] = <
					text = <"Sarcoma closely resembling normal adult mesenchymal tissue (e.g., low-grade liposarcoma).">
					description = <"">
				>
				["at0009"] = <
					text = <"Sarcomas for which histological typing is certain (e.g., myxoid/round cell liposarcoma).">
					description = <"">
				>
				["at0010"] = <
					text = <"Embryonal and undifferentiated sarcomas, sarcomas of doubtful type, synovial sarcomas, soft tissue osteosarcoma, Ewing sarcoma/primitive neuroectodermal tumor (PNET) of soft tissue.">
					description = <"">
				>
				["at0011"] = <
					text = <"0-9 mitoses per 1,7 mm2">
					description = <"">
				>
				["at0012"] = <
					text = <"10-19 mitoses per 1.7 mm2">
					description = <"">
				>
				["at0013"] = <
					text = <"≥20 mitoses per 1.7 mm2">
					description = <"">
				>
				["at0014"] = <
					text = <"No necrosis">
					description = <"">
				>
				["at0015"] = <
					text = <"<50% tumor necrosis">
					description = <"">
				>
				["at0016"] = <
					text = <"≥50% tumor necrosis">
					description = <"">
				>
				["at0017"] = <
					text = <"Histological grade">
					description = <"Assessment of histological grade based on the total score in the FNCLCC grading system.">
					comment = <"In clinical practice for soft tissue sarcomas, the 'Histological grade' result from this archetype is commonly reused to populate the 'Histopathological grade (G)' data element within the CLUSTER.tnm and CLUSTER.tnm-pathological archetypes. In that situation, this grading may be recorded within this archetype and also copied to the TNM archetypes.">
				>
				["at0018"] = <
					text = <"Grade 1">
					description = <"Total score 2 or 3.">
				>
				["at0019"] = <
					text = <"Grade 2">
					description = <"Total score 4 or 5.">
				>
				["at0020"] = <
					text = <"Grade 3">
					description = <"Total score 6, 7 or 8.">
				>
				["at0021"] = <
					text = <"Total score">
					description = <"The total sum of each component parameter for the FNCLCC grading system.">
				>
				["at0022"] = <
					text = <"GX">
					description = <"Grade cannot be assessed.">
				>
			>
		>
		["nb"] = <
			items = <
				["at0000"] = <
					text = <"FNCLCC graderingssystem">
					description = <"Histologisk gradering av bløtvevssarkom i henhold til FNCLCC sitt graderingssystem. ">
					comment = <"FNCLCC - Fédération Nationale des Centres de Lutte Contre le Cancer.">
				>
				["at0005"] = <
					text = <"Tumors differensiering">
					description = <"">
				>
				["at0006"] = <
					text = <"Mitosetall">
					description = <"">
				>
				["at0007"] = <
					text = <"Tumornekrose">
					description = <"">
				>
				["at0008"] = <
					text = <"Sarkom som ligner normalt og modent mesenkymalt vev">
					description = <"">
				>
				["at0009"] = <
					text = <"Sarkom der histologisk type er sikker">
					description = <"">
				>
				["at0010"] = <
					text = <"Embryonale og udifferensierte sarkomer">
					description = <"">
				>
				["at0011"] = <
					text = <"0-9 mitoser per 1,7 mm2">
					description = <"">
				>
				["at0012"] = <
					text = <"10-19 mitoser per 1,7 mm2">
					description = <"">
				>
				["at0013"] = <
					text = <"≥20 mitoser per 1,7 mm2">
					description = <"">
				>
				["at0014"] = <
					text = <"Ingen nekrose">
					description = <"">
				>
				["at0015"] = <
					text = <"< 50 % nekrose (også vurdert makroskopisk)">
					description = <"">
				>
				["at0016"] = <
					text = <"≥ 50 % nekrose (også vurdert makroskopisk)">
					description = <"">
				>
				["at0017"] = <
					text = <"Histologisk grad">
					description = <"Vurdering av histologisk grad basert på total skår i FNCLCC graderingssystem.">
					comment = <"I klinisk praksis for bløtvevssarkomer, blir 'Histologisk grad'-resultatet fra arketypen ofte gjenbrukt for å fylle ut dataelementet 'Histopatologisk gradering (G)' i arketypene TNM-klassifikasjon klinisk (CLUSTER.tnm) og TNM-klassifikasjon patologi (CLUSTER.tnm-pathological.v1).
">
				>
				["at0018"] = <
					text = <"Grad 1">
					description = <"Totalt 2 eller 3 poeng.">
				>
				["at0019"] = <
					text = <"Grad 2">
					description = <"Totalt 4 eller 5 poeng.">
				>
				["at0020"] = <
					text = <"Grad 3">
					description = <"Totalt 6, 7 eller 8 poeng.">
				>
				["at0021"] = <
					text = <"Total skår">
					description = <"Den totale summen av hver komponentparameter for FNCLCC graderingssystem.">
				>
				["at0022"] = <
					text = <"GX">
					description = <"Grad kan ikke vurderes.">
				>
			>
		>
	>