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Tumor Tip of the Week SSDI-LDH (Lactate Dehydrogenase) Pretreatment Lab Value

Tumor Tip Of The Week SSDI-LDH (Lactate Dehydrogenase) Pretreatment Lab Value

Scenario: 

1-17-2019 Excisional biopsy vulva lesion (all gross tumor removed): 11mm melanoma

1-30-2018 LD SerPI QN 154 Units/L

2-14-2019 LD SerPI QN 169 Units/L

2-18-2019 Radical left vulvectomy & sentinel lymph node & right lymph node dissection: focal residual melanoma in situ, tiny focus, margins free, 2 sentinel lymph nodes negative, 5 right inguinofemoral lymph nodes negative

Question:  How should the SDI-LDH (Lactate Dehydrogenase) Pretreatment Lab Value be assigned?

  • 154.0
  • 169.0
  • XXXXX.7 Test ordered, results not in chart
  • XXXXX.9 Not documented in medical record

Answer: 169.0

Rationale:  DO NOT RELY ON YOUR SOFTWARE DROPDOWNS.  Refer to Site-Specific Data Item (SSDI) Manual Version 1.7 & read the notes. Even though the name of the SSDI is pretreatment lab value and the patient’s first surgery was on 1-17-2019 Excisional Biopsy [Surgery Code of 27], Note 3 StatesRecord the lab value of the highest serum LDH test results documented in the medical record either before or after surgical resection of the primary tumor with or without regional lymph node dissection. The LDH must be taken prior to systemic (chemo, immunotherapy, hormone), radiation therapy or surgery to a metastatic site. The lab value may be recorded in a lab report, history and physical, or clinical statement in the pathology report. “ 

*Also be aware, the LDH may be listed in your facility’s EMR in various ways, i.e.  LD SerPI QN, LDH, Lactate dehydrogenase, lactase dehydrogenase, lactic acid dehydrogenase

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