ID

6930

Descrição

Prostate Cancer - Pathology Form - Transurethral Resection Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=198056F5-3A1B-10BC-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=198056F5-3A1B-10BC-E044-0003BA3F9857

Palavras-chave

  1. 20/09/2012 20/09/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
Transferido a

8 de janeiro de 2015

DOI

Para um pedido faça login.

Licença

Creative Commons BY-NC 3.0 Legacy

Comentários do modelo :

Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.

Comentários do grupo de itens para :

Comentários do item para :

Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.

Pathology - Prostate Cancer - Pathology Form - Transurethral Resection - 2020192v3.0

No Instruction available.

  1. StudyEvent: Prostate Cancer - Pathology Form - Transurethral Resection
    1. No Instruction available.
Crf Header
Descrição

Crf Header

Coordinating Group Protocol Number
Descrição

CoordinatingGroupProtocolNumber

Tipo de dados

text

Coordinating Group Code
Descrição

CoordinatingGroupCode

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Protocol Title
Descrição

Protocol Title

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C25320
UMLS CUI-1
C2986303
NCI Thesaurus Property
C42774
Patient Study ID, Coordinating Group
Descrição

PatientStudyID,CoordinatingGroup

Tipo de dados

text

Patient Study ID, Participating Group
Descrição

PatientStudyID,ParticipatingGroup

Tipo de dados

text

Participating Group Code
Descrição

ParticipatingGroupCode

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Institution Name
Descrição

InstitutionName

Tipo de dados

text

Affiliate Name
Descrição

AffiliateName

Tipo de dados

text

Patient Name, Last
Descrição

PatientName,Last

Tipo de dados

text

Patient Name, First
Descrição

PatientName,First

Tipo de dados

text

Patient Name, Middle
Descrição

PatientName,Middle

Tipo de dados

text

Prostate Pathology: Form Administration
Descrição

Prostate Pathology: Form Administration

Person Completing Form, Last Name
Descrição

PersonCompletingForm,LastName

Tipo de dados

text

Person Completing Form, First Name
Descrição

PersonCompletingForm,FirstName

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Amended Data Ind
Descrição

AmendedDataInd

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Pathology: Transurethral Resection (tur)
Descrição

Pathology: Transurethral Resection (tur)

Data Source
Descrição

DataSource

Tipo de dados

text

Therapeutic Effect Ind
Descrição

TherapeuticEffectInd

Tipo de dados

text

Therapy Name
Descrição

TherapyName

Tipo de dados

text

Other Therapy Name
Descrição

OtherTherapyName

Tipo de dados

text

Surgical Procedure Type
Descrição

SurgicalProcedureType

Tipo de dados

text

Surgical Procedure Other Type
Descrição

SurgicalProcedureOtherType

Tipo de dados

text

Surgery Date
Descrição

SurgeryDate

Tipo de dados

date

Specimen, Resection Weight
Descrição

Specimen,ResectionWeight

Tipo de dados

float

Specimen, Examined Tumor Percentage
Descrição

Specimen,ExaminedTumorPercentage

Tipo de dados

float

Alias
NCI Thesaurus Property
C25500
UMLS 2011AA Property
C0332128
NCI Thesaurus ObjectClass
C12801
UMLS 2011AA ObjectClass
C0040300
Specimen, Cancer Chips Count
Descrição

Specimen,CancerChipsCount

Tipo de dados

float

Specimen, Cancer Present Percentage
Descrição

Specimen,CancerPresentPercentage

Tipo de dados

float

PIN Ind, High Grade
Descrição

PINInd,HighGrade

Tipo de dados

text

Extraprostatic Extension Ind
Descrição

ExtraprostaticExtensionInd

Tipo de dados

text

Extraprostatic Extension Type
Descrição

ExtraprostaticExtensionType

Tipo de dados

text

Extraprostatic Extension Laterality
Descrição

ExtraprostaticExtensionLaterality

Tipo de dados

text

Extraprostatic Extension Extent, Vertical
Descrição

ExtraprostaticExtensionExtent,Vertical

Tipo de dados

float

Extraprostatic Extension Extent, Horizontal
Descrição

ExtraprostaticExtensionExtent,Horizontal

Tipo de dados

float

Lymphovascular Invasion Ind
Descrição

LymphovascularInvasionInd

Tipo de dados

text

Lymphovascular Invasion Description
Descrição

LymphovascularInvasionDescription

Tipo de dados

text

Perineural Involvement Ind
Descrição

PerineuralInvolvementInd

Tipo de dados

text

Perineural Invasion Description
Descrição

PerineuralInvasionDescription

Tipo de dados

text

Gleason Score, Primary Pattern
Descrição

GleasonScore,PrimaryPattern

Tipo de dados

float

Gleason Score, Secondary Pattern
Descrição

GleasonScore,SecondaryPattern

Tipo de dados

float

Gleason Score, Combined
Descrição

GleasonScore,Combined

Tipo de dados

float

Gleason Score, Worst Pattern
Descrição

GleasonScore,WorstPattern

Tipo de dados

float

Pathology: Disease Assessment
Descrição

Pathology: Disease Assessment

Histologic Type
Descrição

HistologicType

Tipo de dados

text

Histologic Type, Other Name
Descrição

HistologicType,OtherName

Tipo de dados

text

Histologic Type, Variant
Descrição

HistologicType,Variant

Tipo de dados

text

Histologic Type, Other Variant
Descrição

HistologicType,OtherVariant

Tipo de dados

text

Histologic Type, Variant Percent
Descrição

HistologicType,VariantPercent

Tipo de dados

float

Histologic Type, Variant Percent
Descrição

HistologicType,VariantPercent

Tipo de dados

float

T Stage, Pathologic
Descrição

TStage,Pathologic

Tipo de dados

text

N Stage, Pathologic
Descrição

NStage,Pathologic

Tipo de dados

text

Similar models

No Instruction available.

  1. StudyEvent: Prostate Cancer - Pathology Form - Transurethral Resection
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Crf Header
CoordinatingGroupProtocolNumber
Item
Coordinating Group Protocol Number
text
CoordinatingGroupCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
Protocol Title
Item
Protocol Title
text
C25320 (NCI Thesaurus ObjectClass)
C2986303 (UMLS CUI-1)
C42774 (NCI Thesaurus Property)
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
PatientName,Last
Item
Patient Name, Last
text
PatientName,First
Item
Patient Name, First
text
PatientName,Middle
Item
Patient Name, Middle
text
Item Group
Prostate Pathology: Form Administration
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, First Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
Code List
Amended Data Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Pathology: Transurethral Resection (tur)
Item
Data Source
text
Code List
Data Source
CL Item
Outside Source (Outside source)
CL Item
Performed Outside, But With Internal Review (Performed outside, but with internal review)
CL Item
Performed Internally And Internally Reviewed (Performed internally and internally reviewed)
Item
Therapeutic Effect Ind
text
Code List
Therapeutic Effect Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Therapy Name
text
Code List
Therapy Name
CL Item
Hormonal Therapy (Hormonal therapy)
CL025695 (NCI Metathesaurus)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Radiation Therapy (Radiation therapy)
C15313 (NCI Thesaurus)
C1522449 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
OtherTherapyName
Item
Other Therapy Name
text
Item
Surgical Procedure Type
text
Code List
Surgical Procedure Type
CL Item
Fine Needle Aspiration (Fine needle aspiration)
CL Item
Needle Biopsy (Needle biopsy)
C15190 (NCI Thesaurus)
C0936232 (UMLS 2011AA)
CL Item
Open Biopsy (Open biopsy)
CL Item
Other, Specify (Other)
CL Item
Transurethral Resection (Transurethral resection)
C15705 (NCI Thesaurus)
C1519630 (UMLS 2011AA)
CL Item
Radical Prostatectomy, Laparoscopic (Radical prostatectomy, laparoscopic)
CL Item
Radical Prostatectomy, Perineal (Radical prostatectomy, perineal)
CL Item
Radical Prostatectomy, Retropubic (Radical prostatectomy, retropubic)
CL Item
Suprapubic Prostatectomy (Suprapubic prostatectomy)
C0194828 (NCI Metathesaurus)
CL Item
Radical Prostatectomy, Nos (Radical prostatectomy, NOS)
SurgicalProcedureOtherType
Item
Surgical Procedure Other Type
text
SurgeryDate
Item
Surgery Date
date
Specimen,ResectionWeight
Item
Specimen, Resection Weight
float
Specimen,ExaminedTumorPercentage
Item
Specimen, Examined Tumor Percentage
float
C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
Specimen,CancerChipsCount
Item
Specimen, Cancer Chips Count
float
Specimen,CancerPresentPercentage
Item
Specimen, Cancer Present Percentage
float
Item
PIN Ind, High Grade
text
Code List
PIN Ind, High Grade
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Extraprostatic Extension Ind
text
Code List
Extraprostatic Extension Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Extraprostatic Extension Type
text
Code List
Extraprostatic Extension Type
CL Item
Established (Established)
C0443211 (NCI Metathesaurus)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Focal </= 2 Hpf (Focal </= 2 hpf)
Item
Extraprostatic Extension Laterality
text
Code List
Extraprostatic Extension Laterality
CL Item
Bilateral (Bilateral)
C13332 (NCI Thesaurus)
C0238767 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Unilateral (Unilateral)
C28012 (NCI Thesaurus)
C0205092 (UMLS 2011AA)
ExtraprostaticExtensionExtent,Vertical
Item
Extraprostatic Extension Extent, Vertical
float
ExtraprostaticExtensionExtent,Horizontal
Item
Extraprostatic Extension Extent, Horizontal
float
Item
Lymphovascular Invasion Ind
text
Code List
Lymphovascular Invasion Ind
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
LymphovascularInvasionDescription
Item
Lymphovascular Invasion Description
text
Item
Perineural Involvement Ind
text
Code List
Perineural Involvement Ind
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
PerineuralInvasionDescription
Item
Perineural Invasion Description
text
GleasonScore,PrimaryPattern
Item
Gleason Score, Primary Pattern
float
GleasonScore,SecondaryPattern
Item
Gleason Score, Secondary Pattern
float
GleasonScore,Combined
Item
Gleason Score, Combined
float
GleasonScore,WorstPattern
Item
Gleason Score, Worst Pattern
float
Item Group
Pathology: Disease Assessment
Item
Histologic Type
text
Code List
Histologic Type
CL Item
Adenocarcinoma, Conventional, Not Otherwise Specified (Adenocarcinoma, conventional, NOS)
CL Item
Urothelial Primary In Prostate (Urothelial primary in prostate)
CL Item
Adenosquamous Carcinoma (Adenosquamous carcinoma)
C3727 (NCI Thesaurus)
C0206623 (UMLS 2011AA)
CL Item
Basaloid And Adenoid Cystic Carcinoma (Basaloid and adenoid cystic carcinoma)
CL Item
Lymphoepithelioma-like Carcinoma (Lymphoepithelioma-like carcinoma)
C27387 (NCI Thesaurus)
CL Item
Mucinous (colloid) Adenocarcinoma (Mucinous (colloid) adenocarcinoma)
CL Item
Other (Other, specify)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Prostatic Duct Adenocarcinoma (Prostatic duct adenocarcinoma)
CL Item
Sarcomatoid Carcinoma (Sarcomatoid carcinoma)
C27004 (NCI Thesaurus)
C0205697 (UMLS 2011AA)
CL Item
Signet Ring Cell Carcinoma (Signet ring cell carcinoma)
C3774 (NCI Thesaurus)
C0206696 (UMLS 2011AA)
CL Item
Small Cell Carcinoma (Small cell carcinoma)
C3915 (NCI Thesaurus)
C0262584 (UMLS 2011AA)
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Transitional Cell Carcinoma (Transitional cell carcinoma)
C2930 (NCI Thesaurus)
C0007138 (UMLS 2011AA)
CL Item
Undifferentiated Carcinoma, Not Otherwise Specified (Undifferentiated carcinoma, NOS)
CL Item
Adenocarcinoma/acinar (Adenocarcinoma/Acinar)
HistologicType,OtherName
Item
Histologic Type, Other Name
text
Item
Histologic Type, Variant
text
Code List
Histologic Type, Variant
CL Item
Adenosquamous Carcinoma (Adenosquamous carcinoma)
C3727 (NCI Thesaurus)
C0206623 (UMLS 2011AA)
CL Item
Prostatic Duct Adenocarcinoma (Ductal carcinoma)
CL Item
Mucinous (colloid) Adenocarcinoma (Mucinous adenocarcinoma)
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Sarcomatoid Carcinoma (Sarcomatoid carcinoma)
C27004 (NCI Thesaurus)
C0205697 (UMLS 2011AA)
CL Item
Signet Ring Cell Carcinoma (Signet ring cell carcinoma)
C3774 (NCI Thesaurus)
C0206696 (UMLS 2011AA)
CL Item
Small Cell Carcinoma (Small cell carcinoma)
C3915 (NCI Thesaurus)
C0262584 (UMLS 2011AA)
CL Item
Other, Specify (Other, specify)
HistologicType,OtherVariant
Item
Histologic Type, Other Variant
text
HistologicType,VariantPercent
Item
Histologic Type, Variant Percent
float
HistologicType,VariantPercent
Item
Histologic Type, Variant Percent
float
Item
T Stage, Pathologic
text
Code List
T Stage, Pathologic
CL Item
No Evidence Of Primary Tumor (T0)
CL Item
Invasion Of Bladder, Restum (pT4)
CL Item
T1a, Clinically Inapparent Tumor Not Palpable Or Visible By Imaging (see Ajcc Definition) (T1a)
CL Item
T1b, Clinically Inapparent Tumor Not Palpable Or Visible By Imaging (see Ajcc Definition) (T1b)
CL Item
T1c, Clinically Inapparent Tumor Not Palpable Or Visible By Imaging (see Ajcc Definition) (T1c)
CL Item
T2, Tumor Confined Within The Prostate (see Ajcc Definition) (T2, NOS)
CL Item
T2a, Tumor Confined Within The Prostate (see Ajcc Definition) (T2a)
CL Item
T2b, Tumor Confined Within The Prostate (see Ajcc Definition) (T2b)
CL Item
T3, Tumor Extends Through The Prostatic Capsule (see Ajcc Definition) (T3, NOS)
CL Item
T3a, Tumor Extends Through The Prostatic Capsule (see Ajcc Definition) (T3a)
CL Item
T3b, Tumor Extends Through The Prostatic Capsule (see Ajcc Definition) (T3b)
CL Item
T4, Tumor Is Fixed Or Invades Adjacent Structures (see Ajcc Definition) (T4, NOS)
CL Item
Primary Tumor Cannot Be Assessed (TX)
CL Item
Use The Ajcc Staging System Specified In The Protocol (Use the AJCC staging system specified in the protocol)
CL Item
Organ Confined (pT2)
CL Item
Unilateral (pT2a)
C28012 (NCI Thesaurus)
C0205092 (UMLS 2011AA)
CL Item
Bilateral (pT2b)
C13332 (NCI Thesaurus)
C0238767 (UMLS 2011AA)
CL Item
Extraprostatic Extension (pT3)
CL Item
Extraprostatic Extension (pT3a)
CL Item
Seminal Vesicle Invasion (pT3b)
CL Item
T1, Clinically Inapparent Tumor Not Palpable Or Visible By Imaging (see Ajcc Definition) (T1, NOS)
Item
N Stage, Pathologic
text
Code List
N Stage, Pathologic
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Use The Ajcc Staging System Specified In The Protocol (Use the AJCC staging system specified in the protocol)
CL Item
Regional Lymph Nodes Cannot Be Assessed (NX)
CL Item
Metastatis In Regional Lymph Node Or Nodes (see Ajcc Definition) (N1)

Use este formulário para feedback, perguntas e sugestões de aperfeiçoamento.

Campos marcados com * são obrigatórios.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial