ID

1771

Description

Radiation Therapy Oncology Group Follow-up Form Phase III Recurrent Head and Neck Study Initial Evaluation Form Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EC4F6FCB-F88D-02BE-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EC4F6FCB-F88D-02BE-E034-0003BA3F9857

Keywords

Versions (4)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 8/4/15 8/4/15 - Martin Dugas
  4. 9/20/21 9/20/21 -
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT00113399 Pre-Study - Radiation Therapy Oncology Group Follow-up Form Phase III Recurrent Head and Neck Study Initial Evaluation Form - 2300314v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Radiation Therapy Oncology Group Follow-up Form Phase III Recurrent Head and Neck Study Initial Evaluation Form
    1. No Instruction available.
Unnamed1
Description

Unnamed1

RTOG Study
Description

ProtocolRTOGIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Case #
Description

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C19778
UMLS 2011AA ObjectClass
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C49152
UMLS 2011AA Property
C1706256
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Institution Name
Description

InstitutionName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution No.
Description

InstitutionIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Participant's Initials
Description

PatientInitialsName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Participant's ID No.
Description

PatientRadiationTherapyOncologyGroupIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C19778
UMLS 2011AA Property
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Amended data
Description

DataAmendedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
AGE
Description

PatientAgeYearCount

Data type

double

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
PERFORMANCE STATUS (ZUBROD)
Description

ZubrodPerformanceStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25361
UMLS 2011AA ObjectClass
C0597198
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
ANC (c/mm^3)
Description

LaboratoryProcedureNeutrophilResultTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C12533
UMLS 2011AA Property
C0027950
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
PLATELETS (c/mm^3)
Description

LaboratoryProcedurePlateletResultUnspecifiedValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C12520
UMLS 2011AA Property
C0005821
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
HEMOGLOBIN (g/dl)
Description

LaboratoryProcedureHemoglobinResultUnspecifiedValue

Data type

double

Alias
NCI Thesaurus Property
C16676
UMLS 2011AA Property
C0019046
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
BILIRUBIN (mg/dl)
Description

HepaticBilirubinLabValue

Data type

double

Measurement units
  • mg/dL
Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C305
UMLS 2011AA Property
C0005437
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
mg/dL
BILIRUBIN ULN
Description

HepaticBilirubinLabUpperLimitNormalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C305
UMLS 2011AA Property
C0005437
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
AST (I.U./ml)
Description

HepaticSGOT(AST)LabUnspecifiedValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C13308
UMLS 2011AA ObjectClass
C0205054
NCI Thesaurus Property
C25202
UMLS 2011AA Property
C0242192
NCI Thesaurus Property
C37984
UMLS 2011AA Property
C0022877
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
AST ULN
Description

LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25202
UMLS 2011AA Property
C0242192
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
ALT (I.U./ml)
Description

HepaticSGPT(ALT)LabUnspecifiedValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C13308
UMLS 2011AA ObjectClass
C0205054
NCI Thesaurus Property
C37984
UMLS 2011AA Property
C0022877
NCI Thesaurus Property
C25293
UMLS 2011AA Property
C0376147
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
ALT ULN
Description

LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C25293
UMLS 2011AA Property
C0376147
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
ALKALINE PHOSPHATASE (I.U./ml)
Description

HepaticAlkalinePhosphataseLabValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C13308
UMLS 2011AA ObjectClass
C0205054
NCI Thesaurus Property
C37984
UMLS 2011AA Property
C0022877
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property
C16276
UMLS 2011AA Property
C0002059
ALKALINE PHOSPHATASE
Description

LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C16276
UMLS 2011AA Property
C0002059
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
CREATININE CLEARANCE (LITERS/24HR)
Description

LaboratoryProcedureCreatinineClearanceOutcomeValue

Data type

double

Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C25747
UMLS 2011AA Property
C0373595
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
SERUM CALCIUM (mg/dl)
Description

LaboratoryProcedureCalciumElectrolytesOutcomeValue

Data type

double

Measurement units
  • mg/dL
Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C331
UMLS 2011AA Property
C0006675
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C464
UMLS 2011AA Property
C0013832
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
mg/dL
CORRECTED SERUM CALCIUM (mg/dl)
Description

LaboratoryProcedureCorrectedSerumCalciumMeasurementOutcomeValue

Data type

double

Measurement units
  • mg/dL
Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property
C74950
UMLS 2011AA Property
C0455288
mg/dL
CT OR MRI OF TUMOR SITE
Description

SiteofPrimaryTumorScanPerformedStatus

Data type

text

Alias
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property
C17999
UMLS 2011AA Property
C0441633
NCI Metathesaurus ObjectClass
CL228352
CHEST CT
Description

ChestComputedTomographyPerformedStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C17204
UMLS 2011AA ObjectClass
C0040405
NCI Thesaurus ObjectClass
C25389
UMLS 2011AA ObjectClass
C0817096
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
ABDOMINAL CT
Description

AbdomenComputedTomographyPerformedStatus

Data type

text

Alias
NCI Thesaurus Property
C17204
UMLS 2011AA Property
C0040405
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Metathesaurus ObjectClass
C0000726
BIOPSY OF TUMOR OR NEEDLE ASPIRATE/BIOPSY OF METASTATIC LYMPH NODE
Description

BiopsyPerformedStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
PHYSICAL ASSESSMENT OF CAROTID
Description

CarotidArteryPhysicalExamInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C12687
UMLS 2011AA ObjectClass
C0007272
DOPPLER ULTRASOUND
Description

CarotidArteryUltrasoundDopplerAssessmentInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C12687
UMLS 2011AA ObjectClass
C0007272
NCI Metathesaurus Property
C0162481
CT OR MR ANGIOGRAM
Description

CarotidArteryAngiogramInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C12687
UMLS 2011AA ObjectClass
C0007272
NCI Thesaurus Property
C16290
UMLS 2011AA Property
C0002978
CIRCUMFERENTIAL TUMOR INVOLVEMENT OF CAROTID SHEATH
Description

CircumferentialTumorCarotidSheathInvolvementInd-2

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Metathesaurus ObjectClass
CL124270
NCI Thesaurus Property
C25548
UMLS 2011AA Property
C1314939
NCI Metathesaurus Property
C0225220
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
WAS CAROTID ARTERY STENT PLACED?
Description

CarotidArteryStentInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C12687
UMLS 2011AA ObjectClass
C0007272
NCI Thesaurus Property
C17168
UMLS 2011AA Property
C0038257
IV ANTIBIOTICS AT TIME OF REGISTRATION
Description

IntravenousAntibioticAtRegistrationInd-2

Data type

text

Alias
NCI Thesaurus ObjectClass
C13346
UMLS 2011AA ObjectClass
C0348016
NCI Thesaurus ObjectClass
C258
UMLS 2011AA ObjectClass
C0003232
NCI Thesaurus Property
C25646
UMLS 2011AA Property
C1514821
NCI Thesaurus Property
C25427
UMLS 2011AA Property
C1516077
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
HOSPITALIZED FOR COPD OR OTHER RESPIRATORY ILLNESS IN LAST 6 MONTHS
Description

ChronicObstructiveAirwaysDiseaseHospitalizationInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25179
UMLS 2011AA Property
C0019993
NCI Thesaurus ObjectClass
C3199
UMLS 2011AA ObjectClass
C0024117
PREEXISTING GRADE > 2 PERIPHERAL SENSORY NEUROPATHY
Description

Grade2PeripheralSensoryNeuropathyHistoryInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C3501
UMLS 2011AA ObjectClass
C0151313
NCI Thesaurus ObjectClass
C28078
UMLS 2011AA ObjectClass
C1522446
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
SYMPTOMATIC OR UNCONTROLLED CARDIAC DISEASE
Description

SymptomaticChronicHeartDiseasePresentInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus ObjectClass
C25269
UMLS 2011AA ObjectClass
C0231220
NCI Metathesaurus ObjectClass
CL299150
NEW YORK HEART ASSOCIATION CLASSIFICATION (If yes,)
Description

CardiacFunctionClassificationType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C13306
UMLS 2011AA ObjectClass
C1522601
NCI Thesaurus ObjectClass
C25518
UMLS 2011AA ObjectClass
C0542341
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
PRIOR SURGERY (FOR HEAD AND NECK CANCER)
Description

PriorSurgeryPerformedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
PRIOR SURGERY DATE (MOST RECENT)
Description

PriorSurgeryDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
PRIOR CHEMOTHERAPY (FOR OTHER REASONS)
Description

PriorChemotherapyAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15632
UMLS 2011AA ObjectClass
C0392920
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
PRIOR CHEMOTHERAPY (FOR OTHER REASONS)
Description

PriorChemotherapyAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15632
UMLS 2011AA ObjectClass
C0392920
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
PRIOR CHEMOTHERAPY END DATE
Description

PriorChemotherapyAdministeredEndDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15632
UMLS 2011AA ObjectClass
C0392920
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
PRIOR CHEMOTHERAPY END DATE
Description

PriorChemotherapyAdministeredEndDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15632
UMLS 2011AA ObjectClass
C0392920
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
PRIOR DOSE TO THE RECURRENT / NEW PRIMARY SITE
Description

RadiationTherapyRecurrenceAdministeredPriorDose

Data type

double

Alias
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus Property
C3352
UMLS 2011AA Property
C0034897
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C25629
UMLS 2011AA ValueDomain
C0332152
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
PRIOR DOSE TO THE SPINAL CORD
Description

RadiationTherapySpinalCordAdministeredPriorDose

Data type

double

Alias
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus Property
C12464
UMLS 2011AA Property
C0037925
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C25629
UMLS 2011AA ValueDomain
C0332152
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
PRIOR RADIATION THERAPY END DATE
Description

PriorRTEndDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C25496
UMLS 2011AA Property
C2746065
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
TYPE OF PATIENT DISEASE (CURRENT PRESENTATION)
Description

CurrentDiseaseDiagnosisStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25471
UMLS 2011AA ObjectClass
C0521116
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
T STAGE (of new primary only)
Description

HeadandNeckTumorClinicalTStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property
C25728
UMLS 2011AA Property
C0475455
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
N STAGE (of new primary only)
Description

HeadandNeckTumorClinicalNStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property
C25580
UMLS 2011AA Property
C0456532
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
PRIMARY SITE (CURRENT PRESENTATION)
Description

HeadandNeckTumorPrimaryLocation

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property
C25251
UMLS 2011AA Property
C0205225
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
OTHER, SPECIFY
Description

PrimaryDiseaseSiteSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus ObjectClass
C25251
UMLS 2011AA ObjectClass
C0205225
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
HISTOLOGIC DIAGNOSIS (CURRENT PRESENTATION)
Description

HeadandNeckTumorHistologicCategory

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ValueDomain
C25526
UMLS 2011AA ValueDomain
C0205462
HOW MANY RECURRENCES / NEW PRIMARIES HAS THE PATIENT HAD SINCE TREATMENT OF THE ORIGINAL HEAD AND NECK CANCER?
Description

HeadandNeckTumorRecurrencePresentCount

Data type

double

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property
C3352
UMLS 2011AA Property
C0034897
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
DATE OF FIRST RECURRENCE (OR NEW PRIMARY)
Description

LymphomaFirstRecurrenceDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C3352
UMLS 2011AA Property
C0034897
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
NCI Thesaurus Property
C25509
UMLS 2011AA Property
C1279901
LARGEST MEASURABLE LESION
Description

BaselineMalignantNeoplasmLongestDiameterMeasurement

Data type

double

Measurement units
  • cm
Alias
NCI Thesaurus ObjectClass
C25213
UMLS 2011AA ObjectClass
C1442488
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25285
UMLS 2011AA Property
C1301886
NCI Thesaurus Property
C25558
UMLS 2011AA Property
C1522425
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ValueDomain
C25285
UMLS 2011AA ValueDomain
C1301886
cm
DISTANT METASTASES PRESENT?
Description

DistantMetastasisPresentInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus ObjectClass
C25321
UMLS 2011AA ObjectClass
C0443203
NCI Thesaurus ObjectClass
C19151
UMLS 2011AA ObjectClass
C0027627
DOES THE PATIENT HAVE A HISTORY OF PRIOR CANCER OTHER THAN THE UPPER AERO-DIGESTIVE TRACT?
Description

PriorCancerNotHeadandNeckInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus Property
C12418
UMLS 2011AA Property
C0460004
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
SITE OF PRIOR CANCER
Description

PriorCancerDiagnosisSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
PRIOR CANCER DATE ERADICATED
Description

CancerAblationDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C20985
UMLS 2011AA Property
C0547070
WEIGHT LOSS IN PREVIOUS SIX MONTHS
Description

PatientWeightLossPercentageScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C3445
UMLS 2011AA Property
C0043096
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
DOES THE PATIENT HAVE A PAST HISTORY OF SWALLOWING PROBLEMS?
Description

SwallowingFunctionPriorDeficitInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25518
UMLS 2011AA ObjectClass
C0542341
NCI Thesaurus ObjectClass
C38028
UMLS 2011AA ObjectClass
C0011167
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
HOW LONG WERE SWALLOWING PROBLEMS APPARENT? (If yes,)
Description

SwallowingFunctionPriorDeficitDuration

Data type

text

Alias
NCI Thesaurus ObjectClass
C25518
UMLS 2011AA ObjectClass
C0542341
NCI Thesaurus ObjectClass
C38028
UMLS 2011AA ObjectClass
C0011167
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus ValueDomain
C25330
UMLS 2011AA ValueDomain
C0449238
DOES THE PATIENT CURRENTLY HAVE SWALLOWING PROBLEMS?
Description

SwallowingFunctionCurrentDeficitInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25518
UMLS 2011AA ObjectClass
C0542341
NCI Thesaurus ObjectClass
C38028
UMLS 2011AA ObjectClass
C0011167
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
HOW LONG HAVE SWALLOWING PROBLEMS BEEN PRESENT? (If yes,)
Description

SwallowingFunctionCurrentDeficitDuration

Data type

text

Alias
NCI Thesaurus ObjectClass
C25518
UMLS 2011AA ObjectClass
C0542341
NCI Thesaurus ObjectClass
C38028
UMLS 2011AA ObjectClass
C0011167
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus ValueDomain
C25330
UMLS 2011AA ValueDomain
C0449238
DOES THE PATIENT HAVE A PAST HISTORY OF TUBE FEEDINGS?
Description

GavagePriorAdministrationInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus ObjectClass
C73430
UMLS 2011AA ObjectClass
C0041281
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
HOW LONG WERE TUBE FEEDINGS GIVEN? (If yes,)
Description

GavagePriorAdministrationDuration

Data type

text

Alias
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus ObjectClass
C73430
UMLS 2011AA ObjectClass
C0041281
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ValueDomain
C25330
UMLS 2011AA ValueDomain
C0449238
DOES THE PATIENT CURRENTLY REQUIRE TUBE FEEDING?
Description

GavageCurrentAdministrationInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus ObjectClass
C73430
UMLS 2011AA ObjectClass
C0041281
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
IS PATIENT DEPENDENT ON TUBE FEEDING FOR >50% OF NUTRITIONAL SUPPORT? (If yes,)
Description

GavagePrimaryAdministrationInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25251
UMLS 2011AA Property
C0205225
NCI Thesaurus ObjectClass
C73430
UMLS 2011AA ObjectClass
C0041281
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
Comments
Description

Comments

COMMENTS
Description

ResearchCommentsText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
Person completing form
Description

ResponsiblePersonName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Form completion date, original
Description

FormOriginalCompleteDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25604
UMLS 2011AA Property
C0205313
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
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1 forms
  1. StudyEvent: Radiation Therapy Oncology Group Follow-up Form Phase III Recurrent Head and Neck Study Initial Evaluation Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Unnamed1
ProtocolRTOGIdentifierNumber
Item
RTOG Study
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
Item
Case #
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass)
C1514695 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property)
C1706256 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
InstitutionIdentifierNumber
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Participant's Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PatientRadiationTherapyOncologyGroupIdentifierNumber
Item
Participant's ID No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus Property)
C1514695 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Amended data
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Amended data
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PatientAgeYearCount
Item
AGE
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
Item
PERFORMANCE STATUS (ZUBROD)
text
C25361 (NCI Thesaurus ObjectClass)
C0597198 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
CL.2
Code List
PERFORMANCE STATUS (ZUBROD)
CL Item
Completely Disabled (Completely disabled)
CL Item
Ambulatory And Capable Of All Selfcare But Unable To Carry Out Any Work Activities (Ambulatory and capable of all selfcare but unable to carry out any work activities)
CL Item
Capable Of Limited Selfcare, Confined To Bed Or Chair More Than 50% Of Waking Hours (Capable of limited selfcare, confined to bed or chair more than 50% of waking hours)
CL Item
Fully Active, Able To Carry On All Pre-disease Performance Without Restriction (Fully active, able to carry on all pre-disease performance without restriction)
CL Item
Restricted In Physically Strenuous Activity But Ambulatory (Restricted in physically strenuous activity but ambulatory)
LaboratoryProcedureNeutrophilResultTotalValue
Item
ANC (c/mm^3)
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12533 (NCI Thesaurus Property)
C0027950 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePlateletResultUnspecifiedValue
Item
PLATELETS (c/mm^3)
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureHemoglobinResultUnspecifiedValue
Item
HEMOGLOBIN (g/dl)
double
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
HepaticBilirubinLabValue
Item
BILIRUBIN (mg/dl)
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
HepaticBilirubinLabUpperLimitNormalValue
Item
BILIRUBIN ULN
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
HepaticSGOT(AST)LabUnspecifiedValue
Item
AST (I.U./ml)
double
C13308 (NCI Thesaurus ObjectClass)
C0205054 (UMLS 2011AA ObjectClass)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue
Item
AST ULN
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
HepaticSGPT(ALT)LabUnspecifiedValue
Item
ALT (I.U./ml)
double
C13308 (NCI Thesaurus ObjectClass)
C0205054 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25293 (NCI Thesaurus Property)
C0376147 (UMLS 2011AA Property)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue
Item
ALT ULN
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25293 (NCI Thesaurus Property)
C0376147 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
HepaticAlkalinePhosphataseLabValue
Item
ALKALINE PHOSPHATASE (I.U./ml)
double
C13308 (NCI Thesaurus ObjectClass)
C0205054 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C16276 (NCI Thesaurus Property)
C0002059 (UMLS 2011AA Property)
LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue
Item
ALKALINE PHOSPHATASE
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C16276 (NCI Thesaurus Property)
C0002059 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
LaboratoryProcedureCreatinineClearanceOutcomeValue
Item
CREATININE CLEARANCE (LITERS/24HR)
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25747 (NCI Thesaurus Property)
C0373595 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureCalciumElectrolytesOutcomeValue
Item
SERUM CALCIUM (mg/dl)
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property)
C0013832 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureCorrectedSerumCalciumMeasurementOutcomeValue
Item
CORRECTED SERUM CALCIUM (mg/dl)
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C74950 (NCI Thesaurus Property)
C0455288 (UMLS 2011AA Property)
Item
CT OR MRI OF TUMOR SITE
text
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C17999 (NCI Thesaurus Property)
C0441633 (UMLS 2011AA Property)
CL228352 (NCI Metathesaurus ObjectClass)
CL.3
Code List
CT OR MRI OF TUMOR SITE
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
CHEST CT
text
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C25389 (NCI Thesaurus ObjectClass)
C0817096 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.4
Code List
CHEST CT
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
ABDOMINAL CT
text
C17204 (NCI Thesaurus Property)
C0040405 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0000726 (NCI Metathesaurus ObjectClass)
CL.5
Code List
ABDOMINAL CT
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
BIOPSY OF TUMOR OR NEEDLE ASPIRATE/BIOPSY OF METASTATIC LYMPH NODE
text
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.6
Code List
BIOPSY OF TUMOR OR NEEDLE ASPIRATE/BIOPSY OF METASTATIC LYMPH NODE
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
PHYSICAL ASSESSMENT OF CAROTID
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C12687 (NCI Thesaurus ObjectClass)
C0007272 (UMLS 2011AA ObjectClass)
CL.7
Code List
PHYSICAL ASSESSMENT OF CAROTID
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
DOPPLER ULTRASOUND
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C12687 (NCI Thesaurus ObjectClass)
C0007272 (UMLS 2011AA ObjectClass)
C0162481 (NCI Metathesaurus Property)
CL.8
Code List
DOPPLER ULTRASOUND
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
CT OR MR ANGIOGRAM
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C12687 (NCI Thesaurus ObjectClass)
C0007272 (UMLS 2011AA ObjectClass)
C16290 (NCI Thesaurus Property)
C0002978 (UMLS 2011AA Property)
CL.9
Code List
CT OR MR ANGIOGRAM
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
CIRCUMFERENTIAL TUMOR INVOLVEMENT OF CAROTID SHEATH
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
CL124270 (NCI Metathesaurus ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C0225220 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.10
Code List
CIRCUMFERENTIAL TUMOR INVOLVEMENT OF CAROTID SHEATH
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
WAS CAROTID ARTERY STENT PLACED?
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C12687 (NCI Thesaurus ObjectClass)
C0007272 (UMLS 2011AA ObjectClass)
C17168 (NCI Thesaurus Property)
C0038257 (UMLS 2011AA Property)
CL.11
Code List
WAS CAROTID ARTERY STENT PLACED?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
IV ANTIBIOTICS AT TIME OF REGISTRATION
text
C13346 (NCI Thesaurus ObjectClass)
C0348016 (UMLS 2011AA ObjectClass)
C258 (NCI Thesaurus ObjectClass)
C0003232 (UMLS 2011AA ObjectClass)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25427 (NCI Thesaurus Property)
C1516077 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.12
Code List
IV ANTIBIOTICS AT TIME OF REGISTRATION
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
HOSPITALIZED FOR COPD OR OTHER RESPIRATORY ILLNESS IN LAST 6 MONTHS
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C3199 (NCI Thesaurus ObjectClass)
C0024117 (UMLS 2011AA ObjectClass)
CL.13
Code List
HOSPITALIZED FOR COPD OR OTHER RESPIRATORY ILLNESS IN LAST 6 MONTHS
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
PREEXISTING GRADE > 2 PERIPHERAL SENSORY NEUROPATHY
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C3501 (NCI Thesaurus ObjectClass)
C0151313 (UMLS 2011AA ObjectClass)
C28078 (NCI Thesaurus ObjectClass)
C1522446 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
CL.14
Code List
PREEXISTING GRADE > 2 PERIPHERAL SENSORY NEUROPATHY
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
SYMPTOMATIC OR UNCONTROLLED CARDIAC DISEASE
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25269 (NCI Thesaurus ObjectClass)
C0231220 (UMLS 2011AA ObjectClass)
CL299150 (NCI Metathesaurus ObjectClass)
CL.15
Code List
SYMPTOMATIC OR UNCONTROLLED CARDIAC DISEASE
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
NEW YORK HEART ASSOCIATION CLASSIFICATION (If yes,)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C13306 (NCI Thesaurus ObjectClass)
C1522601 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
CL.16
Code List
NEW YORK HEART ASSOCIATION CLASSIFICATION (If yes,)
CL Item
No Symptoms With Ordinary Physical Activity (I)
CL Item
Symptoms With Ordinary Physical Activity; Slight Limitation Of Activity (II)
CL Item
Symptoms With Less Than Ordinary Physical Activity; Marked Limitation Of Activity (III)
CL Item
Symptoms With Any Physical Activity Or Even At Rest (IV)
Item
PRIOR SURGERY (FOR HEAD AND NECK CANCER)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
CL.17
Code List
PRIOR SURGERY (FOR HEAD AND NECK CANCER)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PriorSurgeryDate
Item
PRIOR SURGERY DATE (MOST RECENT)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
PriorChemotherapyAdministeredInd-3
Item
PRIOR CHEMOTHERAPY (FOR OTHER REASONS)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
PriorChemotherapyAdministeredInd-3
Item
PRIOR CHEMOTHERAPY (FOR OTHER REASONS)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
PriorChemotherapyAdministeredEndDate
Item
PRIOR CHEMOTHERAPY END DATE
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
PriorChemotherapyAdministeredEndDate
Item
PRIOR CHEMOTHERAPY END DATE
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
RadiationTherapyRecurrenceAdministeredPriorDose
Item
PRIOR DOSE TO THE RECURRENT / NEW PRIMARY SITE
double
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C3352 (NCI Thesaurus Property)
C0034897 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
RadiationTherapySpinalCordAdministeredPriorDose
Item
PRIOR DOSE TO THE SPINAL CORD
double
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C12464 (NCI Thesaurus Property)
C0037925 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
PriorRTEndDate
Item
PRIOR RADIATION THERAPY END DATE
date
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25496 (NCI Thesaurus Property)
C2746065 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
TYPE OF PATIENT DISEASE (CURRENT PRESENTATION)
text
C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.19
Code List
TYPE OF PATIENT DISEASE (CURRENT PRESENTATION)
CL Item
Locally Recurrent (Locally recurrent)
CL Item
Regionally Recurrent (Regionally recurrent)
CL Item
Locally And Regionally Recurrent (Locally and regionally recurrent)
CL Item
New Primary (New primary)
Item
T STAGE (of new primary only)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property)
C0475455 (UMLS 2011AA Property)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.20
Code List
T STAGE (of new primary only)
CL Item
T0, According To Ajcc Criteria (T0)
CL Item
T1, According To Ajcc Criteria (T1)
CL Item
T2, According To Ajcc Criteria (T2)
CL Item
T3, According To Ajcc Criteria (T3)
CL Item
T4, According To Ajcc Criteria (T4)
CL Item
Tis, According To Ajcc Criteria (Tis)
CL Item
Tx, According To Ajcc Criteria (TX)
Item
N STAGE (of new primary only)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property)
C0456532 (UMLS 2011AA Property)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.21
Code List
N STAGE (of new primary only)
CL Item
N0, According To Ajcc Guidelines (N0)
CL Item
N1, According To Ajcc Criteria (N1)
CL Item
N2a, According To Ajcc Guidelines (N2a)
CL Item
N2b, According To Ajcc Guidelines (N2b)
CL Item
N2c, According To Ajcc Guidelines (N2c)
CL Item
N3, According To Ajcc Guidelines (N3)
CL Item
Nx, According To Ajcc Guidelines (NX)
Item
PRIMARY SITE (CURRENT PRESENTATION)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property)
C0205225 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.22
Code List
PRIMARY SITE (CURRENT PRESENTATION)
CL Item
Oral Cavity Nos (ORAL CAVITY, NOS)
CL Item
Oral Tongue (Oral tongue)
CL Item
Floor Of Mouth (Floor of mouth)
C0026638 (NCI Metathesaurus)
CL Item
Buccal Mucosa (Buccal mucosa)
C12505 (NCI Thesaurus)
C1578559 (UMLS 2011AA)
CL Item
Lower Gingiva (Lower gingiva)
CL Item
Upper Gingiva (Upper gingiva)
CL Item
Retromolar Trigone (Retromolar trigone)
CL Item
Hard Palate (Hard palate)
C12230 (NCI Thesaurus)
C0226901 (UMLS 2011AA)
CL Item
Nasopharynx Nos (NASOPHARYNX, NOS)
CL Item
Posterior Superior Wall (Posterior superior wall)
CL Item
Lateral Wall (Lateral wall)
CL Item
Oropharynx Nos (OROPHARYNX, NOS)
CL Item
Faucial Arch (Faucial arch)
CL Item
Tonsillar Fossa Tonsil (Tonsillar fossa, tonsil)
CL Item
Base Of Tongue (Base of tongue)
C0226958 (NCI Metathesaurus)
CL Item
Pharyngeal Oropharynx (Pharyngeal Oropharynx)
CL Item
Soft Palate (Soft Palate)
C12231 (NCI Thesaurus)
C0030219 (UMLS 2011AA)
CL Item
Hypopharynx Nos (HYPOPHARYNX, NOS)
CL Item
Pyriform Fossa (Pyriform fossa)
CL Item
Postcricoid Area (Postcricoid area)
CL Item
Posterior Wall (Posterior wall)
CL Item
Supraglottic Larynx (SUPRAGLOTTIC LARYNX, NOS)
CL Item
Ventricular Band (Ventricular band)
CL Item
Arytenoid (Arytenoid)
CL Item
Suprahyoid Epiglottis (Suprahyoid epiglottis)
CL Item
Infrahyoid Epiglottis (Infrahyoid epiglottis)
CL Item
Aryepiglottic Fold (Aryepiglottic fold)
CL Item
Glottic Larynx (GLOTTIC LARYNX, NOS)
CL Item
Vocal Cords (Vocal cords)
CL Item
Subglottic (SUBGLOTTIC LARYNX, NOS)
CL Item
Subglottic (Subglottic)
CL Item
Other (OTHER)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
PrimaryDiseaseSiteSpecify
Item
OTHER, SPECIFY
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25251 (NCI Thesaurus ObjectClass)
C0205225 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
Item
HISTOLOGIC DIAGNOSIS (CURRENT PRESENTATION)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain)
C0205462 (UMLS 2011AA ValueDomain)
CL.23
Code List
HISTOLOGIC DIAGNOSIS (CURRENT PRESENTATION)
CL Item
Squamous Cell Carcinoma, Including Variants (Squamous cell carcinoma, including variants)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
HOW MANY RECURRENCES / NEW PRIMARIES HAS THE PATIENT HAD SINCE TREATMENT OF THE ORIGINAL HEAD AND NECK CANCER?
double
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C3352 (NCI Thesaurus Property)
C0034897 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
CL.24
Code List
HOW MANY RECURRENCES / NEW PRIMARIES HAS THE PATIENT HAD SINCE TREATMENT OF THE ORIGINAL HEAD AND NECK CANCER?
CL Item
One (One)
CL Item
Two (Two)
CL Item
Three Or More (Three or more)
CL Item
Unknown (Unknown)
LymphomaFirstRecurrenceDate
Item
DATE OF FIRST RECURRENCE (OR NEW PRIMARY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C3352 (NCI Thesaurus Property)
C0034897 (UMLS 2011AA Property)
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
BaselineMalignantNeoplasmLongestDiameterMeasurement
Item
LARGEST MEASURABLE LESION
double
C25213 (NCI Thesaurus ObjectClass)
C1442488 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25285 (NCI Thesaurus Property)
C1301886 (UMLS 2011AA Property)
C25558 (NCI Thesaurus Property)
C1522425 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25285 (NCI Thesaurus ValueDomain)
C1301886 (UMLS 2011AA ValueDomain)
Item
DISTANT METASTASES PRESENT?
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25321 (NCI Thesaurus ObjectClass)
C0443203 (UMLS 2011AA ObjectClass)
C19151 (NCI Thesaurus ObjectClass)
C0027627 (UMLS 2011AA ObjectClass)
CL.25
Code List
DISTANT METASTASES PRESENT?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
DOES THE PATIENT HAVE A HISTORY OF PRIOR CANCER OTHER THAN THE UPPER AERO-DIGESTIVE TRACT?
text
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C12418 (NCI Thesaurus Property)
C0460004 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.26
Code List
DOES THE PATIENT HAVE A HISTORY OF PRIOR CANCER OTHER THAN THE UPPER AERO-DIGESTIVE TRACT?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
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)
C0332152 (UMLS 2011AA ObjectClass)
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)
Item
WEIGHT LOSS IN PREVIOUS SIX MONTHS
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3445 (NCI Thesaurus Property)
C0043096 (UMLS 2011AA Property)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
CL.27
Code List
WEIGHT LOSS IN PREVIOUS SIX MONTHS
CL Item
<5% Of Body Weight (< 5% of body weight)
CL Item
5 To <10% Of Body Weight (5 to < 10% of body weight)
CL Item
10 To <20% Of Body Weight (10 to < 20% of body weight)
CL Item
> Or = 20% Of Body Weight (> or = 20% of body weight)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
DOES THE PATIENT HAVE A PAST HISTORY OF SWALLOWING PROBLEMS?
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass)
C0011167 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.28
Code List
DOES THE PATIENT HAVE A PAST HISTORY OF SWALLOWING PROBLEMS?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
HOW LONG WERE SWALLOWING PROBLEMS APPARENT? (If yes,)
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass)
C0011167 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
CL.29
Code List
HOW LONG WERE SWALLOWING PROBLEMS APPARENT? (If yes,)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
1 To <7 Months (1 to <7 months)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
DOES THE PATIENT CURRENTLY HAVE SWALLOWING PROBLEMS?
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass)
C0011167 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.30
Code List
DOES THE PATIENT CURRENTLY HAVE SWALLOWING PROBLEMS?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
HOW LONG HAVE SWALLOWING PROBLEMS BEEN PRESENT? (If yes,)
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass)
C0011167 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
CL.31
Code List
HOW LONG HAVE SWALLOWING PROBLEMS BEEN PRESENT? (If yes,)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
1 To <7 Months (1 to <7 months)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
DOES THE PATIENT HAVE A PAST HISTORY OF TUBE FEEDINGS?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL.32
Code List
DOES THE PATIENT HAVE A PAST HISTORY OF TUBE FEEDINGS?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
HOW LONG WERE TUBE FEEDINGS GIVEN? (If yes,)
text
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
CL.33
Code List
HOW LONG WERE TUBE FEEDINGS GIVEN? (If yes,)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
1 To <7 Months (1 to <7 months)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
DOES THE PATIENT CURRENTLY REQUIRE TUBE FEEDING?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL.34
Code List
DOES THE PATIENT CURRENTLY REQUIRE TUBE FEEDING?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
IS PATIENT DEPENDENT ON TUBE FEEDING FOR >50% OF NUTRITIONAL SUPPORT? (If yes,)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25251 (NCI Thesaurus Property)
C0205225 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL.35
Code List
IS PATIENT DEPENDENT ON TUBE FEEDING FOR >50% OF NUTRITIONAL SUPPORT? (If yes,)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Comments
ResearchCommentsText
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
ResponsiblePersonName
Item
Person completing form
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
FormOriginalCompleteDate
Item
Form completion date, original
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property)
C0205313 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
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