ID

11812

Beschrijving

Paclitaxel, Cisplatin, and Radiation Therapy With or Without Cetuximab in Treating Patients With Locally Advanced Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

Trefwoorden

Esophageal Neoplasms

Klinische Studie [Dokumenttyp]

Baseline

Geüploaded op

4 augustus 2015

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0 Legacy

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Initial Evaluation Form Esophageal Cancer RTOG NCT00655876

model
Details

No Instruction available.

1 Formulieren

StudyEvent: I1: Radiation Therapy Oncology Group Phase III Esophagus Initial Evaluation Form
1. No Instruction available.

Name

Type

Description | Question | Decode (Coded Value)

Datatype

Alias

MODULE 1

Item Group

Module 1

Protocol ID RTOG

Item

RTOG Study No.

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

RTOG Case number

Item

RTOG Case #

text

C16960 (NCI Thesaurus ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C49152 (NCI Thesaurus Property-2)
C25337 (NCI Thesaurus ValueDomain)
C1514695 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])

Institution Name

Item

Institution Name

text

C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)

Institution Number

Item

Institution No.

text

C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)

Patient Initials

Item

Patient Initials

text

C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)

Trial subject ID RTOG

Item

RTOG Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

Data amended

Item

AMENDED DATA

boolean

C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)

Patient status assessment

Item Group

Patient status assessment

Age

Item

Age

integer

C16960 (NCI Thesaurus ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS CUI [1])

ZubrodPerformanceStatusScore

Item

Performance Status (Zubrod)

text

C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)

CL.2

Code List

Performance Status (Zubrod)

CL Item

Normal Activity (0)

CL Item

Symptoms, But Nearly Fully Ambulatory (1)

CL Item

Some Bed Time, But Needs To Be In Bed <50% Of Normal Daytime (2)

CL Item

Needs To Be In Bed > 50% Of Normal Daytime (3)

CL Item

Unable To Get Out Of Bed (4)

PatientPriorMalignantNeoplasmHistoryInd-2

Item

History of Prior Malignancy (except non melanomatous skin cancer)

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PriorCancerDiagnosisSite

Item

Site of Prior Cancer

text

C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)

CancerAblationDate

Item

Prior cancer date eradicated

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)

Patient Weight

Item

Weight

float

C25209 (NCI Thesaurus ValueDomain)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)

DysphagiaExtentStatus

Item

Extent of Dysphagia

text

C2980 (NCI Thesaurus ObjectClass)
C0011168 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C25332 (NCI Thesaurus Property)
C0439792 (UMLS 2011AA Property)

CL.4

Code List

Extent of Dysphagia

CL Item

Asymptomatic (Asymptomatic)

C3833 (NCI Thesaurus)
C0231221 (UMLS 2011AA)

CL Item

Cannot Swallow (Cannot swallow)

CL Item

Symptomatic, Liquids Only (Symptomatic, liquids only)

CL Item

Symptomatic, Soft Foods Only (Symptomatic, soft foods only)

CL Item

Symptomatic, Unrestricted Diet (Symptomatic, unrestricted diet)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

NutritionalSupportOralRouteofAdministrationAdministeredInd-3

Item

Oral alimentation

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38288 (NCI Thesaurus Property)
C1527415 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)

CL.5

Code List

Oral alimentation

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

NutritionalSupportNasogastricRouteofAdministrationTubeAdministeredInd-3

Item

Nasogastric tube feeding

text

C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
C38285 (NCI Thesaurus Property)
C0694637 (UMLS 2011AA Property)
C41277 (NCI Thesaurus Property-2)
C1561954 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

CL.6

Code List

Nasogastric tube feeding

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

NutritionalSupportOstomyTubeAdministeredInd-3

Item

Ostomy feeding

text

C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)
C41277 (NCI Thesaurus Property)
C1561954 (UMLS 2011AA Property)
C15290 (NCI Thesaurus Property-2)
C0029473 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

CL.7

Code List

Ostomy feeding

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

NutritionalSupportIntravenousRouteofAdministrationAdministeredind-3

Item

Intravenous hyperalimentation

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38276 (NCI Thesaurus Property)
C1522726 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C15433 (NCI Thesaurus ObjectClass)
C0242739 (UMLS 2011AA ObjectClass)

CL.8

Code List

Intravenous hyperalimentation

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

NutritionalSupportOtherAdministeredInd-3

Item

Other

text

C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25597 (NCI Thesaurus ObjectClass-2)
C1521739 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

CL.9

Code List

Other

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

NutritionalSupportAdministeredSpecify

Item

Other Specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25597 (NCI Thesaurus ObjectClass-2)
C1521739 (UMLS 2011AA ObjectClass-2)

PersonEstimatedDailyCaloricIntakeAssessmentType

Item

Estimate of daily caloric intake

text

C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25473 (NCI Thesaurus Property-2)
C0332173 (UMLS 2011AA Property-2)
C25498 (NCI Thesaurus Property-3)
C0750572 (UMLS 2011AA Property-3)
C28135 (NCI Thesaurus Property-4)
C0006777 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.10

Code List

Estimate of daily caloric intake

CL Item

< 1500 Cal/day (< 1500 cal/day)

CL Item

>= 1500 Cal/day (>= 1500 cal/day)

Prior Treatment

Item Group

Prior Treatment

PatientEsophagealCarcinomaSurgicalProcedurePersonalMedicalHistoryInd-2

Item

Prior Surgery (for esophageal cancer excludes diagnostic biopsy)

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15329 (NCI Thesaurus Property)
C0543467 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus Property-3)
C0152018 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PatientEsophagealCarcinomaChemotherapyPersonalMedicalHistoryInd-2

Item

Prior chemotherapy (for study cancer)

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15632 (NCI Thesaurus Property)
C0392920 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus Property-3)
C0152018 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PatientChemotherapyPersonalMedicalHistoryInd-2

Item

Prior chemotherapy (for other reasons)

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15632 (NCI Thesaurus Property)
C0392920 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)

PatientChestRadiationTherapyPersonalMedicalHistoryInd-2

Item

Prior radiation therapy (to chest)

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15313 (NCI Thesaurus Property)
C1522449 (UMLS 2011AA Property)
C25389 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3

Item

Prior therapy that targeted EGFR pathway

boolean

C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C17068 (NCI Thesaurus ObjectClass-3)
C0034802 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

Prior platinum based and/or paclitaxel based therapy

Item

Prior platinum based and/or paclitaxel based therapy

boolean

C16960 (NCI Thesaurus ObjectClass)
C49236 (NCI Thesaurus Property)
C18772 (NCI Thesaurus Property-2)
C25620 (NCI Thesaurus Property-3)
C1490 (NCI Thesaurus Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1514463 (UMLS CUI [1,1])
C1514162 (UMLS CUI [1,2])
C0796419 (UMLS CUI [1,3])

Study Cancer

Item Group

Study Cancer

ClinicalStudyMalignantNeoplasmAnatomicSite

Item

Site of study cancer

text

C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C15206 (NCI Thesaurus ObjectClass-2)
C0008972 (UMLS 2011AA ObjectClass-2)

CL.17

Code List

Site of study cancer

CL Item

Upper Thoracic Esophagus (Upper thoracic esophagus)

C25355 (NCI Thesaurus)
C1282910 (UMLS 2011AA)
C12251 (NCI Thesaurus-3)
C0227188 (UMLS 2011AA-4)

CL Item

Mid Thoracic Esophagus (Mid thoracic esophagus)

CL Item

Lower Thoracic Excludes Ge Junction (Lower thoracic excludes GE junction)

CL Item

Cervical Esophagus (Cervical Esophagus)

C12250 (NCI Thesaurus)
C0227186 (UMLS 2011AA)

CL Item

Gastroesophageal Junction, Siewert Type I (Gastroesophageal junction, Siewert Type I)

CL Item

Gastroesophageal Junction, Siewert Type Ii (Gastroesophageal junction, Siewert Type II)

UpperGITumorHistologicClassificationCategory

Item

Histologic Type

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C17639 (NCI Thesaurus ObjectClass-2)
C0203057 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)

CL.18

Code List

Histologic Type

CL Item

Squamous Cell Carcinoma (Squamous cell carcinoma)

C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)

CL Item

Adenocarcinoma (Adenocarcinoma)

C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)

MalignantNeoplasmInitialHistologicDiagnosisDate

Item

Date of initial histologic diagnosis of malignancy

date

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C25526 (NCI Thesaurus Property-2)
C0205462 (UMLS 2011AA Property-2)
C15220 (NCI Thesaurus Property-3)
C0011900 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

EsophagealCarcinomaCervicalEsophagusInvasionInd-2

Item

Cervical esophagus

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C12250 (NCI Thesaurus Property)
C0227186 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C20625 (NCI Thesaurus Property-2)
C1269955 (UMLS 2011AA Property-2)

EsophagealCarcinomaTracheaBronchusInvasionInd-2

Item

Invasion into the trachea or major bronchi

boolean

C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C12683 (NCI Thesaurus Property)
C0006255 (UMLS 2011AA Property)
C12428 (NCI Thesaurus Property-2)
C0040578 (UMLS 2011AA Property-2)
C20625 (NCI Thesaurus Property-3)
C1269955 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

EsophagealCarcinomaTracheoesophagealFistulaInvasionInd-2

Item

Evidence of tracheoesophageal fistule

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C20625 (NCI Thesaurus Property)
C1269955 (UMLS 2011AA Property)
C35080 (NCI Thesaurus Property-2)
C0040588 (UMLS 2011AA Property-2)

Esophageal Tumor T Stage

Item

Esophageal Tumor Clinical T Stage

text

C3262 (NCI Thesaurus ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C25398 (NCI Thesaurus Property)
C25728 (NCI Thesaurus Property-2)
C16899 (NCI Thesaurus ValueDomain)
C0014859 (UMLS CUI [1,1])
C0475455 (UMLS CUI [1,2])

CL.22

Code List

Esophageal Tumor Clinical T Stage

CL Item

Tumor Invades Lamina Propria Or Submucosa (T1)

CL Item

Tumor Invades Muscularis Propria (T2)

CL Item

Tumor Invades Adventitia (T3)

CL Item

Tumor Invades Adjacent Structures (T4)

MalignantNeoplasmProximalChestAnatomicSiteInd-2

Item

Is the tumor proximal thoracic

boolean

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C13717 (NCI Thesaurus Property)
C1515974 (UMLS 2011AA Property)
C25389 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C25236 (NCI Thesaurus Property-3)
C0205107 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

EsophagealTumorClinicalNStage

Item

Clinical N Stage

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)

CL.24

Code List

Clinical N Stage

CL Item

No Regional Lymph Node Metastasis (N0)

CL Item

Regional Lymph Node Metastasis (N1)

EsophagealTumorClinicalMStage

Item

Clinical M Stage

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)

CL.25

Code List

Clinical M Stage

CL Item

No Distant Metastasis (M0)

CL Item

Metastases Present - See Figo And Ajcc Staging For Complete Details (M1a)

EsophagealCarcinomaCeliacLymphNodeMetastasisInd-2

Item

Celiac lymph nodes

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C65166 (NCI Thesaurus Property-2)
C0229766 (UMLS 2011AA Property-2)

EsophagealCarcinomaCervicalLymphNodeMetastasisInd-2

Item

Cervical lymph nodes

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)
C32298 (NCI Thesaurus Property-2)
C0588054 (UMLS 2011AA Property-2)

EsophagealCarcinomaSupraclavicularLymphNodeMetastasisInd-2

Item

Supraclavicular lymph nodes

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C12903 (NCI Thesaurus Property-2)
C0229730 (UMLS 2011AA Property-2)
C3513 (NCI Thesaurus ObjectClass)
C0152018 (UMLS 2011AA ObjectClass)

Laboratory Tests

Item Group

Laboratory Tests

Hemoglobin

Item

Hemoglobin

float

C16676 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0019046 (UMLS CUI [1])

Neutrophil count

Item

ANC

float

C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C63321 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0200633 (UMLS CUI [1])

Platelets

Item

Peripheral Platelet Count

float

C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C12520 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI [1])

Creatinine, Serum

Item

Serum creatinine

float

C16960 (NCI Thesaurus ObjectClass)
C13325 (NCI Thesaurus Property)
C399 (NCI Thesaurus Property-2)
C0201976 (UMLS CUI [1])

AST

Item

AST (SGOT)

float

C13308 (NCI Thesaurus ObjectClass)
C25202 (NCI Thesaurus Property)
C37984 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0201899 (UMLS CUI [1])

AST ULN

Item

AST (SGOT) ULN

float

C25294 (NCI Thesaurus ObjectClass)
C25202 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0242192 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])

Bilirubin, total

Item

Bilirubin, total

float

C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0201913 (UMLS CUI [1])

Bilirubin, Total ULN

Item

Total bilirubin ULN

float

C25294 (NCI Thesaurus ObjectClass)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C25706 (NCI Thesaurus ValueDomain-3)

Laboratory Procedure Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)

Diagnosis Work-up

Item Group

Diagnosis Work-up

PersonalMedicalHistoryPhysicalExaminationPerformedInd-2

Item

History and Physical

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C18772 (NCI Thesaurus ObjectClass-2)
C0262926 (UMLS 2011AA ObjectClass-2)

CT scan or MRI of the chest or abdomen

Item

CT scan or MRI of the chest or abdomen

boolean

C16502 (NCI Thesaurus ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C16809 (NCI Thesaurus ObjectClass-3)
C20989 (NCI Thesaurus Property)
C25389 (NCI Thesaurus Property-2)
C12664 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0040405 (UMLS CUI [1,1])
C0024485 (UMLS CUI [1,2])
C0817096 (UMLS CUI [1,3])
C0230168 (UMLS CUI [1,4])

EndoscopicBiopsyDiagnosticProcedureEsophagealCarcinomaAssessmentInd-2

Item

Endoscopic biopsy of esophageal tumor

boolean

C18020 (NCI Thesaurus ObjectClass)
C0430022 (UMLS 2011AA ObjectClass)
C15389 (NCI Thesaurus ObjectClass-2)
C0184980 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3513 (NCI Thesaurus Property-2)
C0152018 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

ElectrocardiographyDiagnosticProcedureAssessmentInd-2

Item

EKG

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C18020 (NCI Thesaurus ObjectClass-2)
C0430022 (UMLS 2011AA ObjectClass-2)

Bronchoscopy

Item

Bronchoscopy

boolean

C38147 (NCI Thesaurus ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C38000 (NCI Thesaurus Property)
C0006290 (UMLS CUI [1])

PET/CT

Item

PET/CT

boolean

C17007 (NCI Thesaurus ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C18020 (NCI Thesaurus ObjectClass-3)
C20989 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C0032743 (UMLS CUI [1,1])
C0040405 (UMLS CUI [1,2])

Assessment Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)

Co-Morbidties

Item Group

Co-morbidties

UnstableAnginaHospitalizationInd-2

Item

Hospitalized for unstable angina and/or CHF in last 6 months

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C0002965 (NCI Metathesaurus ObjectClass)

TransmuralMyocardialInfarctionConfirmedInd-2

Item

Transmural MI in last 6 months

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C27996 (NCI Thesaurus ObjectClass)
C0027051 (UMLS 2011AA ObjectClass)
CL233186 (NCI Metathesaurus ObjectClass)

IntravenousAntibioticAtRegistrationInd-2

Item

IV antibiotics at time of registration

boolean

C13346 (NCI Thesaurus ObjectClass)
C0348016 (UMLS 2011AA ObjectClass)
C258 (NCI Thesaurus ObjectClass-2)
C0003232 (UMLS 2011AA ObjectClass-2)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25427 (NCI Thesaurus Property-2)
C1516077 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2

Item

COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C3199 (NCI Thesaurus ObjectClass)
C0024117 (UMLS 2011AA ObjectClass)
CL316903 (NCI Metathesaurus ObjectClass)

CisplatinPriorAllergicReactionInd-2

Item

Prior allergic reaction to cisplatin

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C376 (NCI Thesaurus ObjectClass)
C0008838 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)

CetuximabPriorAllergicReactionInd-3

Item

Prior allergic reaction to C225

boolean

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1723 (NCI Thesaurus ObjectClass)
C0879636 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)

PatientPaclitaxelHypersensitivityPersonalMedicalHistoryInd-3

Item

Prior allergic reaction to taxol

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C1411 (NCI Thesaurus Property)
C0144576 (UMLS 2011AA Property)
C3114 (NCI Thesaurus Property-2)
C0020517 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

PatientMonoclonalAntibodyInfusionHypersensitivityPersonalMedicalHistoryInd-2

Item

Prior severe infusion reaction to a monocolonal antibody

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3114 (NCI Thesaurus Property)
C0020517 (UMLS 2011AA Property)
C15388 (NCI Thesaurus Property-2)
C0574032 (UMLS 2011AA Property-2)
C20401 (NCI Thesaurus Property-3)
C0003250 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

Footer

Item Group

Footer

Research Comments

Item

Comments

text

C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)

Investigator Signature

Item

Investigator Signature (The reported case report information has been reviewed and confirmed by the principal investigator)

text

C25704 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)

Investigator Signature Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)

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Initial Evaluation Form Esophageal Cancer RTOG NCT00655876

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