ID
10084
Descrição
S1011 Pre-Randomization Off-Study Form (#52060) Standard or Extended Pelvic Lymphadenectomy in Treating Patients Undergoing Surgery for Invasive Bladder Cancer NCT01224665 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9399F2B7-7E68-06C0-E040-BB89AD436952
Link
Palavras-chave
Versões (3)
- 26/08/2012 26/08/2012 -
- 08/01/2015 08/01/2015 - Martin Dugas
- 24/03/2015 24/03/2015 - Martin Dugas
Transferido a
24 de março de 2015
DOI
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Licença
Creative Commons BY-NC 3.0 Legacy
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Bladder Cancer NCT01224665
Instructions: For registration step 1, submit this form within 2 weeks after going off study, if patient is off study without randomization to extended vs. standard LND. List treatments that the patient received. Systemic Therapy: List regimens, start and end dates. For multidrug regimens, do not list individual drugs separately; end date would be the date all drugs in the regimen were discontinued. Surgery: List type of surgery, and in the "end date" column, the date of surgery. Radiation: List sites, start and end dates (inclusive of boosts and implants)
Descrição
Treatment Information
Alias
- UMLS CUI-1
- C0087111
Descrição
ProtocolTreatmentAdministeredInd-3
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C42651
- NCI Thesaurus Property
- C25382
- UMLS CUI-1
- C0087111
Descrição
Treatment Begin Date
Tipo de dados
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25431
- UMLS CUI-1
- C3173309
- NCI Thesaurus Property-2
- C25275
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Descrição
Treatment End Date
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1531784
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25275
- NCI Thesaurus Property-2
- C25496
Descrição
ProcedureLocationText
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25341
- UMLS 2011AA Property
- C0450429
- NCI Thesaurus ObjectClass
- C25218
- UMLS 2011AA ObjectClass
- C1948041
Descrição
Off Treatment Reason
Alias
- UMLS CUI-1
- C1518544
- UMLS CUI-2
- C0566251
Descrição
Off Study Reason (select one)
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25196
- NCI Thesaurus ObjectClass-2
- C25601
- NCI Thesaurus ObjectClass-3
- C25629
- NCI Thesaurus Property
- C25365
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1518544
- UMLS CUI-2
- C0566251
Descrição
Off-TreatmentAdverseEventReasonSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C25638
- UMLS 2011AA Property
- C0392360
- NCI Thesaurus Property-2
- C41331
- UMLS 2011AA Property-2
- C0877248
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
Descrição
Off-TreatmentPatientReasonSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C25638
- UMLS 2011AA Property
- C0392360
- NCI Thesaurus Property-2
- C16960
- UMLS 2011AA Property-2
- C0030705
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
Descrição
Off-TreatmentDiseaseProgressionAnatomicSiteSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C13717
- UMLS 2011AA Property
- C1515974
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
- NCI Thesaurus ObjectClass-2
- C17747
- UMLS 2011AA ObjectClass-2
- C0242656
Descrição
Off Treatment Reason, specify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1518544
- NCI Thesaurus ObjectClass
- C25601
- UMLS CUI-2
- C0566251
- NCI Thesaurus Property
- C25365
- UMLS CUI-3
- C1521902
Descrição
Off-TreatmentStudyFollow-UpEndDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
- NCI Thesaurus ObjectClass-2
- C15206
- UMLS 2011AA ObjectClass-2
- C0008972
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Descrição
Additional Treatment
Alias
- UMLS CUI-1
- C1706712
Descrição
FurtherTreatmentAdministeredInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25519
- UMLS 2011AA ObjectClass
- C1517331
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrição
FurtherTreatmentSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25519
- UMLS 2011AA ObjectClass
- C1517331
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrição
Vital Status
Alias
- UMLS CUI-1
- C1148433
Descrição
Date last contact
Tipo de dados
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Descrição
Vital Status
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
- UMLS CUI-1
- C3846084
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Instructions: For registration step 1, submit this form within 2 weeks after going off study, if patient is off study without randomization to extended vs. standard LND. List treatments that the patient received. Systemic Therapy: List regimens, start and end dates. For multidrug regimens, do not list individual drugs separately; end date would be the date all drugs in the regimen were discontinued. Surgery: List type of surgery, and in the "end date" column, the date of surgery. Radiation: List sites, start and end dates (inclusive of boosts and implants)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C15368 (NCI Thesaurus ObjectClass)
C42651 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C0087111 (UMLS CUI-1)
C25431 (NCI Thesaurus Property)
C3173309 (UMLS CUI-1)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C1531784 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C25496 (NCI Thesaurus Property-2)
C1527021 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25218 (NCI Thesaurus ObjectClass)
C1948041 (UMLS 2011AA ObjectClass)
C25601 (NCI Thesaurus ObjectClass-2)
C25629 (NCI Thesaurus ObjectClass-3)
C25365 (NCI Thesaurus Property)
C25638 (NCI Thesaurus ValueDomain)
C1518544 (UMLS CUI-1)
C0566251 (UMLS CUI-2)
C1521902 (UMLS 2011AA ValueDomain)
C25638 (NCI Thesaurus Property)
C0392360 (UMLS 2011AA Property)
C41331 (NCI Thesaurus Property-2)
C0877248 (UMLS 2011AA Property-2)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C1521902 (UMLS 2011AA ValueDomain)
C25638 (NCI Thesaurus Property)
C0392360 (UMLS 2011AA Property)
C16960 (NCI Thesaurus Property-2)
C0030705 (UMLS 2011AA Property-2)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C1521902 (UMLS 2011AA ValueDomain)
C13717 (NCI Thesaurus Property)
C1515974 (UMLS 2011AA Property)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C17747 (NCI Thesaurus ObjectClass-2)
C0242656 (UMLS 2011AA ObjectClass-2)
C1518544 (UMLS CUI-1)
C25601 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
C1521902 (UMLS CUI-3)
C0011008 (UMLS 2011AA ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C15206 (NCI Thesaurus ObjectClass-2)
C0008972 (UMLS 2011AA ObjectClass-2)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C1512699 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25519 (NCI Thesaurus ObjectClass-2)
C1517331 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25519 (NCI Thesaurus ObjectClass-2)
C1517331 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
C3846084 (UMLS CUI-1)