SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)
PatientInitials
Item
Patient Initials (L, F,M)
text
Institution/Affiliate
Item
Institution / Affiliate
text
Physician
Item
Physician
text
GroupName
Item
Group Name (Groups other than SWOG )
text
StudyNo.
Item
Study No. (Groups other than SWOG )
double
Pt.ID
Item
Pt. ID (Groups other than SWOG )
text
Dateoflastcontactordeath:
Item
Date of last contact or death (If vital status is Dead, complete and submit Notice of Death form.)
text
Item
Has the patient had a documented clinical assessment for this cancer since submission of the previous follow-up form?
text
Code List
Has the patient had a documented clinical assessment for this cancer since submission of the previous follow-up form?
IfYes,DateofLastClinicalAssessment:
Item
If Yes, Date of Last Clinical Assessment
text
Item
Has the patient developed a first relapse or progression that has not been previously reported?
text
Code List
Has the patient developed a first relapse or progression that has not been previously reported?
IfYes,DateofRelapseorProgression:
Item
If Yes, Date of Relapse or Progression
text
Ifyes,pleasesubmittheLungCarcinomaFirstSite(s)ofProgressionorRelapseForm.
Item
If yes, please submit the Lung Carcinoma First Site(s) of Progression or Relapse Form.
text
Item
Has a new primary cancer or myelodysplastic syndrome (MDS) been diagnosed that has not been previously reported?
text
Code List
Has a new primary cancer or myelodysplastic syndrome (MDS) been diagnosed that has not been previously reported?
IfYes,DateofDiagnosis:
Item
If Yes, Date of Diagnosis
text
NewPrimarySite:
Item
New Primary Site
text
Item
Has the patient received any non-protocol cancer therapy (prior to progression/relapse) not previously reported?
text
Code List
Has the patient received any non-protocol cancer therapy (prior to progression/relapse) not previously reported?
IfYes,DateofFirstNon-ProtocolTherapy:
Item
If Yes, Date of First Non-Protocol Therapy
text
Item
Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade =>3) long term toxicity that has not been previously reported?
text
Code List
Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade =>3) long term toxicity that has not been previously reported?
IfYes,ToxicitiesandGrades:
Item
If Yes, Toxicities and Grades
text