ID
11089
Beschrijving
CALGB: 40601 POST-NEOADJUVANT CHEMOTHERAPY SURGICAL EVALUATION FORM NCT00770809 Paclitaxel and Trastuzumab With or Without Lapatinib in Treating Patients With Stage II or Stage III Breast Cancer That Can Be Removed by Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3A7CAEA0-52A1-0226-E044-0003BA3F9857
Link
Trefwoorden
Versies (3)
- 26-08-12 26-08-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 18-06-15 18-06-15 -
Geüploaded op
18 juni 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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CALGB: 40601 POST-NEOADJUVANT CHEMOTHERAPY SURGICAL EVALUATION FORM NCT00770809
INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB: 40601 POST-NEOADJUVANT CHEMOTHERAPY SURGICAL EVALUATION FORM
Beschrijving
Patient demographics
Beschrijving
Patient Initials
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beschrijving
Medical Record Number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Beschrijving
Institution Name
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25454
- UMLS CUI-1
- C1301943
- NCI Thesaurus ObjectClass-2
- C21541
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus ValueDomain-2
- C21541
Beschrijving
Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Beschrijving
Study Number Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beschrijving
Trial subject ID Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beschrijving
Breast Conserving Therapy
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyQualificationInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Thesaurus Property-2
- C15665
- UMLS 2011AA Property-2
- C0600558
- NCI Thesaurus Property-3
- C43608
- UMLS 2011AA Property-3
- C1709790
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyNotQualificationReason
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus Property-4
- C43608
- UMLS 2011AA Property-4
- C1709790
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyNotQualificationSpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus Property-4
- C43608
- UMLS 2011AA Property-4
- C1709790
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
BreastConservationTreatmentRadiationTherapyMedicalContraindicationReason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus ObjectClass-2
- C15280
- UMLS 2011AA ObjectClass-2
- C0917927
- NCI Thesaurus Property
- C50646
- UMLS 2011AA Property
- C1301624
Beschrijving
BreastConservationTreatmentRadiationTherapyConnectiveTissueDisorderMedicalContraindicationSpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus ObjectClass-2
- C15280
- UMLS 2011AA ObjectClass-2
- C0917927
- NCI Thesaurus Property
- C26729
- UMLS 2011AA Property
- C0009782
- NCI Thesaurus Property-2
- C50646
- UMLS 2011AA Property-2
- C1301624
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyAttemptInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Thesaurus Property-2
- C15665
- UMLS 2011AA Property-2
- C0600558
- NCI Thesaurus Property-3
- C39769
- UMLS 2011AA Property-3
- C1516084
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyNotAttemptReason
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Thesaurus Property-2
- C15665
- UMLS 2011AA Property-2
- C0600558
- NCI Thesaurus Property-3
- C39769
- UMLS 2011AA Property-3
- C1516084
- NCI Metathesaurus Property
- CL052458
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyNotAttemptSpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38008
- UMLS 2011AA Property
- C0687676
- NCI Thesaurus Property-2
- C15665
- UMLS 2011AA Property-2
- C0600558
- NCI Thesaurus Property-3
- C39769
- UMLS 2011AA Property-3
- C1516084
- NCI Metathesaurus Property
- CL052458
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyRefuse
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C49161
- UMLS 2011AA Property
- C1705116
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapySuccessPerformedInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus Property-4
- C25362
- UMLS 2011AA Property-4
- C0597535
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyFailedPerformedReason
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus Property-4
- C44281
- UMLS 2011AA Property-4
- C0231175
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschrijving
BreastConservationTreatmentPostNeoadjuvantTherapyFailedPerformedSpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15280
- UMLS 2011AA ObjectClass
- C0917927
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus Property-4
- C44281
- UMLS 2011AA Property-4
- C0231175
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
Axillary Node
Beschrijving
AxillaryLymphNodePostNeoadjuvantTherapyEvaluationInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C12904
- UMLS 2011AA ObjectClass
- C0729594
- NCI Thesaurus Property
- C25214
- UMLS 2011AA Property
- C0220825
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
Evaluation method
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2911685
- NCI Thesaurus ObjectClass
- C20989
- NCI Thesaurus Property
- C16847
Beschrijving
Evaluation method, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C2911685
- NCI Thesaurus ObjectClass
- C20989
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C16847
Beschrijving
AxillaryLymphNodePostNeoadjuvantTherapyEvaluationResult
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12904
- UMLS 2011AA ObjectClass
- C0729594
- NCI Thesaurus Property
- C25214
- UMLS 2011AA Property
- C0220825
- NCI Thesaurus Property-2
- C38008
- UMLS 2011AA Property-2
- C0687676
- NCI Thesaurus Property-3
- C15665
- UMLS 2011AA Property-3
- C0600558
- NCI Thesaurus ValueDomain
- C20200
- UMLS 2011AA ValueDomain
- C1274040
Beschrijving
LesionAssessmentDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C3824
- UMLS 2011AA ObjectClass
- C0221198
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
SentinelLymphNodeBiopsyBlueDyeUseInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C15667
- UMLS 2011AA ObjectClass
- C0796693
- NCI Thesaurus Property
- C461
- UMLS 2011AA Property
- C0013343
- NCI Thesaurus Property-2
- C25340
- UMLS 2011AA Property-2
- C0457083
- NCI Thesaurus Property-3
- C48333
- UMLS 2011AA Property-3
- C1260957
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
SentinelLymphNodeBiopsyTechnetium99mDextranUseInd-2
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C15667
- UMLS 2011AA ObjectClass
- C0796693
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus Property-2
- C1243
- UMLS 2011AA Property-2
- C0076028
Beschrijving
Footer Module
Beschrijving
Person Completing Form
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Beschrijving
Date Form Completed
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Research Comments
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
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INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB: 40601 POST-NEOADJUVANT CHEMOTHERAPY SURGICAL EVALUATION FORM
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C0011008 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0796693 (UMLS 2011AA ObjectClass)
C461 (NCI Thesaurus Property)
C0013343 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property-2)
C0457083 (UMLS 2011AA Property-2)
C48333 (NCI Thesaurus Property-3)
C1260957 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C15667 (NCI Thesaurus ObjectClass)
C0796693 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C1243 (NCI Thesaurus Property-2)
C0076028 (UMLS 2011AA Property-2)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)