ID

6930

Description

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

Keywords

  1. 9/20/12 9/20/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
Uploaded on

January 8, 2015

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy

Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

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
Description

Crf Header

Coordinating Group Protocol Number
Description

CoordinatingGroupProtocolNumber

Data type

text

Coordinating Group Code
Description

CoordinatingGroupCode

Data type

text

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

Protocol Title

Data type

text

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

PatientStudyID,CoordinatingGroup

Data type

text

Patient Study ID, Participating Group
Description

PatientStudyID,ParticipatingGroup

Data type

text

Participating Group Code
Description

ParticipatingGroupCode

Data type

text

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

InstitutionName

Data type

text

Affiliate Name
Description

AffiliateName

Data type

text

Patient Name, Last
Description

PatientName,Last

Data type

text

Patient Name, First
Description

PatientName,First

Data type

text

Patient Name, Middle
Description

PatientName,Middle

Data type

text

Prostate Pathology: Form Administration
Description

Prostate Pathology: Form Administration

Person Completing Form, Last Name
Description

PersonCompletingForm,LastName

Data type

text

Person Completing Form, First Name
Description

PersonCompletingForm,FirstName

Data type

text

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

AmendedDataInd

Data type

text

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

Pathology: Transurethral Resection (tur)

Data Source
Description

DataSource

Data type

text

Therapeutic Effect Ind
Description

TherapeuticEffectInd

Data type

text

Therapy Name
Description

TherapyName

Data type

text

Other Therapy Name
Description

OtherTherapyName

Data type

text

Surgical Procedure Type
Description

SurgicalProcedureType

Data type

text

Surgical Procedure Other Type
Description

SurgicalProcedureOtherType

Data type

text

Surgery Date
Description

SurgeryDate

Data type

date

Specimen, Resection Weight
Description

Specimen,ResectionWeight

Data type

float

Specimen, Examined Tumor Percentage
Description

Specimen,ExaminedTumorPercentage

Data type

float

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

Specimen,CancerChipsCount

Data type

float

Specimen, Cancer Present Percentage
Description

Specimen,CancerPresentPercentage

Data type

float

PIN Ind, High Grade
Description

PINInd,HighGrade

Data type

text

Extraprostatic Extension Ind
Description

ExtraprostaticExtensionInd

Data type

text

Extraprostatic Extension Type
Description

ExtraprostaticExtensionType

Data type

text

Extraprostatic Extension Laterality
Description

ExtraprostaticExtensionLaterality

Data type

text

Extraprostatic Extension Extent, Vertical
Description

ExtraprostaticExtensionExtent,Vertical

Data type

float

Extraprostatic Extension Extent, Horizontal
Description

ExtraprostaticExtensionExtent,Horizontal

Data type

float

Lymphovascular Invasion Ind
Description

LymphovascularInvasionInd

Data type

text

Lymphovascular Invasion Description
Description

LymphovascularInvasionDescription

Data type

text

Perineural Involvement Ind
Description

PerineuralInvolvementInd

Data type

text

Perineural Invasion Description
Description

PerineuralInvasionDescription

Data type

text

Gleason Score, Primary Pattern
Description

GleasonScore,PrimaryPattern

Data type

float

Gleason Score, Secondary Pattern
Description

GleasonScore,SecondaryPattern

Data type

float

Gleason Score, Combined
Description

GleasonScore,Combined

Data type

float

Gleason Score, Worst Pattern
Description

GleasonScore,WorstPattern

Data type

float

Pathology: Disease Assessment
Description

Pathology: Disease Assessment

Histologic Type
Description

HistologicType

Data type

text

Histologic Type, Other Name
Description

HistologicType,OtherName

Data type

text

Histologic Type, Variant
Description

HistologicType,Variant

Data type

text

Histologic Type, Other Variant
Description

HistologicType,OtherVariant

Data type

text

Histologic Type, Variant Percent
Description

HistologicType,VariantPercent

Data type

float

Histologic Type, Variant Percent
Description

HistologicType,VariantPercent

Data type

float

T Stage, Pathologic
Description

TStage,Pathologic

Data type

text

N Stage, Pathologic
Description

NStage,Pathologic

Data type

text

Similar models

No Instruction available.

  1. StudyEvent: Prostate Cancer - Pathology Form - Transurethral Resection
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
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)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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