ID

10074

Beschreibung

I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form Adjuvant Radiation Therapy Plus Hormone Therapy Compared With Radiation Therapy Alone in Treating Patients With Stage II or Stage III Prostate Cancer NCT00023829 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A4E26ACF-75E7-25EA-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A4E26ACF-75E7-25EA-E034-080020C9C0E0

Stichworte

Versionen (2)
  1. 19.09.12 19.09.12 -
  2. 23.03.15 23.03.15 - Martin Dugas
Hochgeladen am

23. März 2015

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0 Legacy
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

Prostate Cancer NCT00023829

Englisch

INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.

1 Formulare  
  1. StudyEvent: I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form
    1. INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.
Header
Beschreibung

Header

RTOG Study
Beschreibung

RTOGStudy

Datentyp

text

Case #
Beschreibung

Case#

Datentyp

text

Institution Name
Beschreibung

InstitutionName

Datentyp

text

Institution No.
Beschreibung

InstitutionNo.

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Name, Last
Beschreibung

PatientName,Last

Datentyp

text

Patient Name, First
Beschreibung

Patient Name, First

Datentyp

text

AMENDED DATA
Beschreibung

AmendedData

Datentyp

text

COMMENTS
Beschreibung

Comments

Datentyp

text

Signature
Beschreibung

Signature

Datentyp

text

Date
Beschreibung

Date

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Patient data
Beschreibung

Patient data

PATIENT BIRTH DATE (2)
Beschreibung

PatientBirthDate

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
PERFORMANCE STATUS (3)
Beschreibung

PERFORMANCESTATUS

Datentyp

text

HAS PATIENT HAD ANOTHER MALIGNANCY (other than study site)
Beschreibung

HASPATIENTHADANOTHERMALIGNANCY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Specify Site (malignancy other than study site)
Beschreibung

SpecifySite(malignancyotherthanstudysite)

Datentyp

text

DATE ERADICATED (mm/yyyy If not NED from second malignancy, leave date blank.)
Beschreibung

DATEERADICATED

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20985
UMLS 2011AA Property
C0547070
DATE OF INITIAL DIAGNOSIS OF PRIMARY TUMOR (5 HISTOPATHOLOGIC TYPE)
Beschreibung

FirstPositiveBiopsyDate

Datentyp

date

HISTOLOGIC TYPE
Beschreibung

HistologicType

Datentyp

text

Other, specify (histologic type) (B)
Beschreibung

Other,specify(histologictype)

Datentyp

text

GLEASON SCORE, PRIMARY PATTERN ([most frequently seen] 1-5, 9=unknown)
Beschreibung

GleasonScore,PrimaryPattern

Datentyp

float

GLEASON SCORE, SECONDARY PATTERN ([second most frequently seen] 1-5, 9=unknown)
Beschreibung

GleasonScore,SecondaryPattern

Datentyp

float

GLEASON SCORE, WORST PATTERN ([worst pathological grade seen in any specimen] 1-5, 9=unknown)
Beschreibung

GleasonScore,WorstPattern

Datentyp

float

GLEASON SCORE, COMBINED ([sum of the primary and secondary, unless unknown] 99=Unknown)
Beschreibung

GleasonScore,Combined

Datentyp

float

ALKALINE PHOSPHATASE
Beschreibung

ALKALINEPHOSPHATASE

Datentyp

text

Alk Phos Value
Beschreibung

AlkPhosValue

Datentyp

float

SPECIFY (unit of measure)
Beschreibung

SPECIFY(unitofmeasure)

Datentyp

text

Lab normal range (alkaline phosphatase) (B)
Beschreibung

Labnormalrange(alkalinephosphatase)

Datentyp

text

ALT (SGPT)
Beschreibung

ALT(SGPT)

Datentyp

text

ALT Value
Beschreibung

ALTValue

Datentyp

float

Lab normal range (ALT) (C)
Beschreibung

LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultNormalRangeText

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C25293
NCI Thesaurus ValueDomain
C25704
NCI Thesaurus ValueDomain-2
C14165
NCI Thesaurus ValueDomain-3
C38013
UMLS CUI-1
C0376147
UMLS CUI-2
C0086715
TOTAL BILIRUBIN
Beschreibung

TOTALBILIRUBIN

Datentyp

text

Total Bilirubin Value
Beschreibung

Total Bilirubin Value

Datentyp

float

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C1278039
Lab normal range (total bilirubin) (11 BASELINE PSA VALUE)
Beschreibung

Labnormalrange(totalbilirubin)

Datentyp

text

Baseline PSA Date
Beschreibung

BaselinePSADate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Baseline PSA Value
Beschreibung

Baseline PSA Value

Datentyp

float

Alias
UMLS CUI-1
C0138741
TIME POINT (12 GU DYSFUNCTION AT STUDY ENTRY Use CTC 2.0 to code severity)
Beschreibung

TIMEPOINT

Datentyp

text

URINARY INCONTINENCE, Severity Grade (0-3)
Beschreibung

URINARYINCONTINENCE,SeverityGrade

Datentyp

text

URINARY INCONTINENCE, Attribution
Beschreibung

URINARYINCONTINENCE,Attribution

Datentyp

text

Other (attribution, urinary incontinence)
Beschreibung

Other(attribution,urinaryincontinence)

Datentyp

text

URINARY FREQUENCY/URGENCY, Severity Grade (0-3)
Beschreibung

URINARYFREQUENCY/URGENCY,SeverityGrade

Datentyp

text

URINARY FREQUENCY/URGENCY, Attribution
Beschreibung

URINARYFREQUENCY/URGENCY,Attribution

Datentyp

text

Other (attribution, urinary frequency/urgency)
Beschreibung

Other(attribution,urinaryfrequency/urgency)

Datentyp

text

ERECTILE IMPOTENCE, Severity Grade (0-3)
Beschreibung

ERECTILEIMPOTENCE,SeverityGrade

Datentyp

text

ERECTILE IMPOTENCE, Attribution
Beschreibung

ERECTILEIMPOTENCE,Attribution

Datentyp

text

Other (erectile impotence) (13)
Beschreibung

Other(erectileimpotence)

Datentyp

text

T STAGE, PATHOLOGIC (14A)
Beschreibung

TStage,Pathologic

Datentyp

text

N STAGE, PATHOLOGIC (SURGICAL)
Beschreibung

NStage,Pathologic

Datentyp

text

N STAGE, CLINICAL (RADIOGRAPHIC)
Beschreibung

NStage,Clinical

Datentyp

text

ROACH RISK CALCULATION (15)
Beschreibung

ROACHRISKCALCULATION

Datentyp

text

M STAGE, CLINICAL
Beschreibung

MStage,Clinical

Datentyp

text

Prostate: Prior Treatment
Beschreibung

Prostate: Prior Treatment

Alias
UMLS CUI-1
C1514463
PRIOR PROSTATECTOMY
Beschreibung

PriorProstatectomyInd

Datentyp

boolean

Prior prostatectomy date
Beschreibung

PriorProstatectomyDate

Datentyp

date

POSITIVE SURGICAL MARGINS
Beschreibung

POSITIVESURGICALMARGINS

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
SEMINAL VESICLE INVASION (pathologic)
Beschreibung

SEMINALVESICLEINVASION

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
PRIOR RADIATION THERAPY
Beschreibung

PRIORRADIATIONTHERAPY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Specify (prior radiation therapy) (8)
Beschreibung

Specify(priorradiationtherapy)

Datentyp

text

PRIOR CHEMOTHERAPY (for any reason)
Beschreibung

PRIOR CHEMOTHERAPY (for any reason)

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1514457
Prior chemotherapy end date (9)
Beschreibung

PriorChemotherapyEndDate

Datentyp

date

PRIOR HORMONAL THERAPY (A)
Beschreibung

PRIORHORMONALTHERAPY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
PRIOR HORMONAL THERAPY TYPE FINASTERIDE
Beschreibung

PRIORHORMONALTHERAPYTYPEFINASTERIDE

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Prior hormonal therapy end date (C)
Beschreibung

PriorHormonalTherapyEndDate

Datentyp

date

PRIOR HORMONAL THERAPY TYPE TESTOSTERONE
Beschreibung

PRIORHORMONALTHERAPYTYPETESTOSTERONE

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
PRIOR OTHER HORMONAL THERAPY
Beschreibung

PRIOROTHERHORMONALTHERAPY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Specify (prior other hormonal therapy)
Beschreibung

Specify(priorotherhormonaltherapy)

Datentyp

text

Date prior other hormonal therapy started (D)
Beschreibung

PriorOtherHormonalTherapyBeginDate

Datentyp

date

ORCHIECTOMY
Beschreibung

ORCHIECTOMY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0029189
Orchiectomy date
Beschreibung

Orchiectomy date

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C15288
NCI Thesaurus Property
C25275
UMLS CUI-1
C0029189
UMLS CUI-2
C0011008
PRIOR OR CURRENT COMPLEMENTARY ALTERNATIVE MEDICINE (CAM) THERAPY
Beschreibung

PRIORORCURRENTCOMPLEMENTARYALTERNATIVEMEDICINE(CAM)THERAPY

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0002346
Specify (prior or current complementary alternative medicine therapy)
Beschreibung

Specify(priororcurrentcomplementaryalternativemedicinetherapy)

Datentyp

text

Date prior or current CAM therapy started
Beschreibung

DatepriororcurrentCAMtherapystarted

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Prior CAM therapy end date (if continuing leave blank)
Beschreibung

PriorCAMtherapyenddate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Zum Seitenanfang zurückkehren

Ähnliche Modelle

INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.

1 Formulare
  1. StudyEvent: I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form
    1. INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header
RTOGStudy
Item
RTOG Study
text
Case#
Item
Case #
text
InstitutionName
Item
Institution Name
text
InstitutionNo.
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
PatientName,Last
Item
Patient Name, Last
text
PatientName,First
Item
Patient Name, First
text
AmendedData
Item
AMENDED DATA
text
Comments
Item
COMMENTS
text
Signature
Item
Signature
text
Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item Group
Patient data
PatientBirthDate
Item
PATIENT BIRTH DATE (2)
date
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
PERFORMANCE STATUS (3)
text
CL.1
Code List
PERFORMANCE STATUS (3)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
CL Item
4 (4)
CL Item
-1 (-1)
HASPATIENTHADANOTHERMALIGNANCY
Item
HAS PATIENT HAD ANOTHER MALIGNANCY (other than study site)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
SpecifySite(malignancyotherthanstudysite)
Item
Specify Site (malignancy other than study site)
text
DATEERADICATED
Item
DATE ERADICATED (mm/yyyy If not NED from second malignancy, leave date blank.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)
FirstPositiveBiopsyDate
Item
DATE OF INITIAL DIAGNOSIS OF PRIMARY TUMOR (5 HISTOPATHOLOGIC TYPE)
date
Item
HISTOLOGIC TYPE
text
CL.3
Code List
HISTOLOGIC TYPE
CL Item
Adenocarcinoma_2005009 (Adenocarcinoma)
CL Item
Other_specify_2005013 (Other, specify)
CL Item
Unknown or not applicable (Unknown or not applicable)
Other,specify(histologictype)
Item
Other, specify (histologic type) (B)
text
GleasonScore,PrimaryPattern
Item
GLEASON SCORE, PRIMARY PATTERN ([most frequently seen] 1-5, 9=unknown)
float
GleasonScore,SecondaryPattern
Item
GLEASON SCORE, SECONDARY PATTERN ([second most frequently seen] 1-5, 9=unknown)
float
GleasonScore,WorstPattern
Item
GLEASON SCORE, WORST PATTERN ([worst pathological grade seen in any specimen] 1-5, 9=unknown)
float
GleasonScore,Combined
Item
GLEASON SCORE, COMBINED ([sum of the primary and secondary, unless unknown] 99=Unknown)
float
Item
ALKALINE PHOSPHATASE
text
CL.18
Code List
ALKALINE PHOSPHATASE
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal, Elevated (Abnormal, elevated)
CL Item
Abnormal, < Normal (Abnormal, < normal)
AlkPhosValue
Item
Alk Phos Value
float
Item
SPECIFY (unit of measure)
text
CL.19
Code List
SPECIFY (unit of measure)
CL Item
U/ml (u/ml)
CL Item
U/l (u/l)
Labnormalrange(alkalinephosphatase)
Item
Lab normal range (alkaline phosphatase) (B)
text
Item
ALT (SGPT)
text
CL.20
Code List
ALT (SGPT)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal, Elevated (Abnormal, elevated)
CL Item
Abnormal, < Normal (Abnormal, < normal)
ALTValue
Item
ALT Value
float
ALT Normal Range
Item
Lab normal range (ALT) (C)
text
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C25293 (NCI Thesaurus Property-2)
C25704 (NCI Thesaurus ValueDomain)
C14165 (NCI Thesaurus ValueDomain-2)
C38013 (NCI Thesaurus ValueDomain-3)
C0376147 (UMLS CUI-1)
C0086715 (UMLS CUI-2)
Item
TOTAL BILIRUBIN
text
CL.21
Code List
TOTAL BILIRUBIN
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal, Elevated (Abnormal, elevated)
CL Item
Abnormal, < Normal (Abnormal, < normal)
TotalBilirubinValue
Item
Total Bilirubin Value
float
C25209 (NCI Thesaurus ValueDomain)
C1278039 (UMLS CUI-1)
Labnormalrange(totalbilirubin)
Item
Lab normal range (total bilirubin) (11 BASELINE PSA VALUE)
text
BaselinePSADate
Item
Baseline PSA Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
BaselinePSAValue
Item
Baseline PSA Value
float
C0138741 (UMLS CUI-1)
Item
TIME POINT (12 GU DYSFUNCTION AT STUDY ENTRY Use CTC 2.0 to code severity)
text
CL.22
Code List
TIME POINT (12 GU DYSFUNCTION AT STUDY ENTRY Use CTC 2.0 to code severity)
CL Item
Pre-surgery (Pre-surgery)
CL Item
Post-surgery (Post-surgery)
CL Item
Study Entry (Study entry)
CL Item
Pre-hormone (Pre-hormone)
Item
URINARY INCONTINENCE, Severity Grade (0-3)
text
CL.23
Code List
URINARY INCONTINENCE, Severity Grade (0-3)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
Item
URINARY INCONTINENCE, Attribution
text
CL.24
Code List
URINARY INCONTINENCE, Attribution
CL Item
Not Applicable (Not applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Surgical (Surgical)
C25698 (NCI Thesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Other(attribution,urinaryincontinence)
Item
Other (attribution, urinary incontinence)
text
Item
URINARY FREQUENCY/URGENCY, Severity Grade (0-3)
text
CL.25
Code List
URINARY FREQUENCY/URGENCY, Severity Grade (0-3)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
Item
URINARY FREQUENCY/URGENCY, Attribution
text
CL.26
Code List
URINARY FREQUENCY/URGENCY, Attribution
CL Item
Not Applicable (Not applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Surgical (Surgical)
C25698 (NCI Thesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Other(attribution,urinaryfrequency/urgency)
Item
Other (attribution, urinary frequency/urgency)
text
Item
ERECTILE IMPOTENCE, Severity Grade (0-3)
text
CL.27
Code List
ERECTILE IMPOTENCE, Severity Grade (0-3)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
Item
ERECTILE IMPOTENCE, Attribution
text
CL.28
Code List
ERECTILE IMPOTENCE, Attribution
CL Item
Not Applicable (Not applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Surgical (Surgical)
C25698 (NCI Thesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Other(erectileimpotence)
Item
Other (erectile impotence) (13)
text
Item
T STAGE, PATHOLOGIC (14A)
text
CL.29
Code List
T STAGE, PATHOLOGIC (14A)
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)
CL Item
Primary Tumor Cannot Be Assessed (TX)
Item
N STAGE, PATHOLOGIC (SURGICAL)
text
CL.30
Code List
N STAGE, PATHOLOGIC (SURGICAL)
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Metastatis In Regional Lymph Node Or Nodes (see Ajcc Definition) (N1)
CL Item
No node sampling (No node sampling)
Item
N STAGE, CLINICAL (RADIOGRAPHIC)
text
CL.31
Code List
N STAGE, CLINICAL (RADIOGRAPHIC)
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Metastasis To Movable Ipsilateral Axillary Lymph Node(s) (N1)
CL Item
Regional Lymph Nodes Cannot Be Assessed (e.g., Previously Removed) (NX)
Item
ROACH RISK CALCULATION (15)
text
CL.32
Code List
ROACH RISK CALCULATION (15)
CL Item
<15% (<15%)
CL Item
>=15% (>=15%)
Item
M STAGE, CLINICAL
text
CL.33
Code List
M STAGE, CLINICAL
CL Item
No Distant Metastasis (M0)
CL Item
Distant Metastasis (M1)
C18206 (NCI Thesaurus)
C1269798 (UMLS 2011AA)
CL Item
Nonregional Lymph Node(s) (M1a)
CL Item
Bone(s) (M1b)
CL Item
Other Site(s) (M1c)
CL Item
Distant Metastsis Cannot Be Assessed (MX)
Item Group
Prostate: Prior Treatment
C1514463 (UMLS CUI-1)
PriorProstatectomyInd
Item
PRIOR PROSTATECTOMY
boolean
PriorProstatectomyDate
Item
Prior prostatectomy date
date
POSITIVESURGICALMARGINS
Item
POSITIVE SURGICAL MARGINS
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
SEMINALVESICLEINVASION
Item
SEMINAL VESICLE INVASION (pathologic)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
PRIORRADIATIONTHERAPY
Item
PRIOR RADIATION THERAPY
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Specify(priorradiationtherapy)
Item
Specify (prior radiation therapy) (8)
text
PRIORCHEMOTHERAPY
Item
PRIOR CHEMOTHERAPY (for any reason)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1514457 (UMLS CUI-1)
PriorChemotherapyEndDate
Item
Prior chemotherapy end date (9)
date
PRIORHORMONALTHERAPY
Item
PRIOR HORMONAL THERAPY (A)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
PRIORHORMONALTHERAPYTYPEFINASTERIDE
Item
PRIOR HORMONAL THERAPY TYPE FINASTERIDE
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
PriorHormonalTherapyEndDate
Item
Prior hormonal therapy end date (C)
date
PRIORHORMONALTHERAPYTYPETESTOSTERONE
Item
PRIOR HORMONAL THERAPY TYPE TESTOSTERONE
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
PRIOROTHERHORMONALTHERAPY
Item
PRIOR OTHER HORMONAL THERAPY
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Specify(priorotherhormonaltherapy)
Item
Specify (prior other hormonal therapy)
text
PriorOtherHormonalTherapyBeginDate
Item
Date prior other hormonal therapy started (D)
date
ORCHIECTOMY
Item
ORCHIECTOMY
boolean
C25180 (NCI Thesaurus ValueDomain)
C0029189 (UMLS CUI-1)
OrchiectomyDate
Item
Orchiectomy date
date
C25164 (NCI Thesaurus ValueDomain)
C15288 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C0029189 (UMLS CUI-1)
C0011008 (UMLS CUI-2)
Alternative medicine
Item
PRIOR OR CURRENT COMPLEMENTARY ALTERNATIVE MEDICINE (CAM) THERAPY
boolean
C25180 (NCI Thesaurus ValueDomain)
C0002346 (UMLS CUI-1)
Alternative medicine, specify
Item
Specify (prior or current complementary alternative medicine therapy)
text
DatepriororcurrentCAMtherapystarted
Item
Date prior or current CAM therapy started
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
PriorCAMtherapyenddate
Item
Prior CAM therapy end date (if continuing leave blank)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video