ID

23170

Description

GOG Pathology Form 2059039v3.0 Comparison of Four Combination Chemotherapy Regimens Using Cisplatin in Treating Patients With Stage IVB, Recurrent, or Persistent Cancer of the Cervix https://clinicaltrials.gov/ct2/show/NCT00064077

Link

https://clinicaltrials.gov/ct2/show/NCT00064077

Keywords

Versions (2)
  1. 8/27/12 8/27/12 -
  2. 6/26/17 6/26/17 - Martin Dugas
Uploaded on

June 26, 2017

DOI

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License

Creative Commons BY 4.0
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Cervical Cancer Cisplatin NCT00064077 GOG

English

FORM F

1 forms  
  1. StudyEvent: GOG Pathology Form
    1. FORM F
Header Module
Description

Header Module

Alias
UMLS CUI-1
C1320722
Form completion date, original
Description

Form Completion Date

Data type

date

Alias
UMLS CUI [1]
C1549507
Date form amended
Description

Form Completion Date, amended

Data type

date

Alias
UMLS CUI [1,1]
C0680532
UMLS CUI [1,2]
C0011008
Person amending form, last name
Description

Responsible Person Reporting Change LastName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ObjectClass
C25190
NCI Thesaurus Property
C25364
UMLS CUI [1,1]
C0680532
UMLS CUI [1,2]
C1547383
Patient Name, Last
Description

Last Name

Data type

text

Alias
UMLS CUI [1]
C1301584
Patient Name, First
Description

First Name

Data type

text

Alias
UMLS CUI [1]
C1443235
Patient Study ID
Description

Patient Study ID

Data type

text

Alias
UMLS CUI [1]
C2348585
Person Completing Form, Last Name
Description

Person Completing Form Last Name

Data type

text

Alias
UMLS CUI [1,1]
C1550483
UMLS CUI [1,2]
C1301584
Participating Group Code
Description

Participating Group Code

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI [1]
C2986314
Participating Group Protocol No.
Description

Participating Group Protocol Number

Data type

text

Alias
UMLS CUI [1,1]
C3274381
UMLS CUI [1,2]
C2347449
Participating Patient Study ID
Description

Patient Participating Identifier Number

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
UMLS CUI [1,1]
C2348585
UMLS CUI [1,2]
C2347449
Primary Disease Assessment
Description

Primary Disease Assessment

Alias
UMLS CUI-1
C0421175
Primary site
Description

Primary Site

Data type

integer

Alias
UMLS CUI [1]
C0475447
Other (Primary Site), specify
Description

Primary Site, Other

Data type

text

Alias
UMLS CUI [1]
C0475447
Histologic type (check one)
Description

Histologic Type

Data type

integer

Alias
UMLS CUI [1]
C0449574
Other (Histologic Type), specify
Description

Histologic Type, Other

Data type

text

Alias
UMLS CUI [1]
C0449574
Histologic grade (Differentiation)
Description

HistologicGrade

Data type

text

Method of evaluation
Description

Assessment Type

Data type

integer

Alias
UMLS CUI [1]
C2911685
Date of evaluation
Description

Assessment Date

Data type

date

Measurement units
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
ID # of the blocks/slides
Description

Specimen ID

Data type

text

Alias
UMLS CUI [1]
C1299222
Specimen site
Description

Specimen Site

Data type

integer

Alias
UMLS CUI [1]
C0449705
Lymph node(s), specify (Specimen Site)
Description

Specimen Site, LymphNode

Data type

text

Alias
UMLS CUI [1,1]
C0449705
UMLS CUI [1,2]
C0024204
Metastatic site, specify (Specimen Site)
Description

Specimen Site, Metastatic

Data type

text

Alias
UMLS CUI [1]
C0280457
Other (Specimen Site), specify
Description

Specimen Site, Other

Data type

text

Alias
UMLS CUI [1]
C0449705
Secondary Disease Assessment
Description

Secondary Disease Assessment

Method of evaluation
Description

AssessmentMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
Date of evaluation
Description

Assessment Date

Data type

date

Measurement units
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
ID # of the blocks/slides
Description

Specimen ID

Data type

text

Alias
UMLS CUI [1]
C1299222
Specimen site
Description

Specimen Site

Data type

integer

Alias
UMLS CUI [1]
C0449705
Lymph node(s), specify (Specimen Site)
Description

Specimen Site, LymphNode

Data type

text

Alias
UMLS CUI [1,1]
C0449705
UMLS CUI [1,2]
C0024204
Metastatic site, specify (Specimen Site)
Description

Specimen Site, Metastatic

Data type

text

Alias
UMLS CUI [1]
C0280457
Other (Specimen Site), specify
Description

Specimen Site, Other

Data type

text

Alias
UMLS CUI [1]
C0449705
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Similar models

FORM F

1 forms
  1. StudyEvent: GOG Pathology Form
    1. FORM F
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
C1320722 (UMLS CUI-1)
Form Completion Date
Item
Form completion date, original
date
C1549507 (UMLS CUI [1])
Form Completion Date, amended
Item
Date form amended
date
C0680532 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Responsible Person Reporting Change LastName
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C0680532 (UMLS CUI [1,1])
C1547383 (UMLS CUI [1,2])
Last Name
Item
Patient Name, Last
text
C1301584 (UMLS CUI [1])
First Name
Item
Patient Name, First
text
C1443235 (UMLS CUI [1])
Patient Study ID
Item
Patient Study ID
text
C2348585 (UMLS CUI [1])
Person Completing Form Last Name
Item
Person Completing Form, Last Name
text
C1550483 (UMLS CUI [1,1])
C1301584 (UMLS CUI [1,2])
Participating Group Code
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C2986314 (UMLS CUI [1])
Participating Group Protocol Number
Item
Participating Group Protocol No.
text
C3274381 (UMLS CUI [1,1])
C2347449 (UMLS CUI [1,2])
Patient Participating Identifier Number
Item
Participating Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI [1,1])
C2347449 (UMLS CUI [1,2])
Item Group
Primary Disease Assessment
C0421175 (UMLS CUI-1)
Item
Primary site
integer
C0475447 (UMLS CUI [1])
CL.1
Code List
Primary site
CL Item
Cervix (1)
C0007874 (UMLS CUI-1)
CL Item
Endometrium (2)
C0014180 (UMLS CUI-1)
CL Item
Fallopian Tube (3)
C0015560 (UMLS CUI-1)
CL Item
Gestational Trophoblastic Disease (4)
C2931618 (UMLS CUI-1)
CL Item
Ovary (5)
C0029939 (UMLS CUI-1)
CL Item
Peritoneum (6)
C0031153 (UMLS CUI-1)
CL Item
Uterine Sarcoma (7)
C2959547 (UMLS CUI-1)
CL Item
Vagina (8)
C0042232 (UMLS CUI-1)
CL Item
Vulva (9)
C0042993 (UMLS CUI-1)
CL Item
Other, Specify (10)
C3845569 (UMLS CUI-1)
Primary Site, Other
Item
Other (Primary Site), specify
text
C0475447 (UMLS CUI [1])
Item
Histologic type (check one)
integer
C0449574 (UMLS CUI [1])
CL.2
Code List
Histologic type (check one)
CL Item
Adenocarcinoma, Unspecified (1)
C0001418 (UMLS CUI-1)
C0205370 (UMLS CUI-2)
CL Item
Adenocarcinoma With Squamous Differentiation (2)
C0001418 (UMLS CUI-1)
C1519494 (UMLS CUI-2)
CL Item
Adenosquamous carcinoma (3)
C0206623 (UMLS CUI-1)
CL Item
Clear cell carcinoma (4)
C1265994 (UMLS CUI-1)
CL Item
Endometrioid adenocarcinoma (5)
C0206687 (UMLS CUI-1)
CL Item
Mixed Epithelial Carcinoma (6)
C0007097 (UMLS CUI-1)
C1881874 (UMLS CUI-2)
CL Item
Mucinous adenocarcinoma (7)
C0007130 (UMLS CUI-1)
CL Item
Serous adenocarcinoma (8)
C0206701 (UMLS CUI-1)
CL Item
Small cell carcinom (9)
C0262584 (UMLS CUI-1)
CL Item
Squamous cell carcinoma, invasive (10)
C0007137 (UMLS CUI-1)
C0205281 (UMLS CUI-2)
CL Item
Transitional cell carcinoma (11)
C0007138 (UMLS CUI-1)
CL Item
Undifferentiated carcinoma (12)
C0205698 (UMLS CUI-1)
CL Item
Villoglandular carcinoma (13)
C3839292 (UMLS CUI-1)
CL Item
Carcinosarcoma, homologous (14)
C0007140 (UMLS CUI-1)
C0301883 (UMLS CUI-2)
CL Item
Carcinosarcoma, heterologous (15)
C0007140 (UMLS CUI-1)
C0439860 (UMLS CUI-2)
CL Item
Endometrial Stromal Sarcoma (16)
C0206630 (UMLS CUI-1)
CL Item
Leiomyosarcoma (17)
C0023269 (UMLS CUI-1)
CL Item
Mucinous tumor of low malignant potential (18)
C0334365 (UMLS CUI-1)
CL Item
Serous tumor of low malignant potential (19)
C1407807 (UMLS CUI-1)
CL Item
Mixed serous/mucinous LMP (20)
C2960605 (UMLS CUI-1)
CL Item
Granulosa cell tumor (21)
C0018206 (UMLS CUI-1)
CL Item
Sex cord stromal tumor, unclassified (22)
C0206724 (UMLS CUI-1)
CL Item
Dysgerminoma (23)
C0013377 (UMLS CUI-1)
CL Item
Endodermal sinus tumor (24)
C0014145 (UMLS CUI-1)
CL Item
Germ cell tumor, mixed (25)
C0334524 (UMLS CUI-1)
CL Item
Teratoma, immature (26)
C0334520 (UMLS CUI-1)
CL Item
Teratoma, mature cystic (27)
C1368910 (UMLS CUI-1)
CL Item
Normal tissue (28)
C0332441 (UMLS CUI-1)
CL Item
Benign (29)
C0205183 (UMLS CUI-1)
CL Item
Fibroma (30)
C0016045 (UMLS CUI-1)
CL Item
Serous cystadenoma (31)
CL Item
Mucinous cystadenoma (32)
CL Item
Other, specify (33)
Histologic Type, Other
Item
Other (Histologic Type), specify
text
C0449574 (UMLS CUI [1])
Item
Histologic grade (Differentiation)
text
CL.3
Code List
Histologic grade (Differentiation)
CL Item
Grade 1-well Differentiated (1)
CL Item
Grade 2-moderately Differentiated (2)
CL Item
Grade 3-poorly Differentiated (3)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Grade Unknown (Unknown)
CL Item
Not Applicable (Not applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
Item
Method of evaluation
integer
C2911685 (UMLS CUI [1])
CL.4
Code List
Method of evaluation
CL Item
Biopsy (1)
C0005558 (UMLS CUI-1)
CL Item
Surgery (2)
C0543467 (UMLS CUI-1)
CL Item
Primary surgery (3)
C0543467 (UMLS CUI-1)
C0205225 (UMLS CUI-2)
CL Item
Cytology (4)
C0010819 (UMLS CUI-1)
CL Item
Staging surgery (5)
C0543467 (UMLS CUI-1)
C0332305 (UMLS CUI-2)
Assessment Date
Item
Date of evaluation
date
C2985720 (UMLS CUI [1])
Specimen ID
Item
ID # of the blocks/slides
text
C1299222 (UMLS CUI [1])
Item
Specimen site
integer
C0449705 (UMLS CUI [1])
CL.7
Code List
Specimen site
CL Item
Bladder peritoneum (1)
C0005682 (UMLS CUI-1)
C0031153 (UMLS CUI-2)
CL Item
Bowel peritoneum/serosa (2)
C0021853 (UMLS CUI-1)
C0031153 (UMLS CUI-2)
CL Item
Cervix (3)
C0007874 (UMLS CUI-1)
CL Item
Corpus (4)
C0227813 (UMLS CUI-1)
CL Item
Cul-de-sac (5)
C0013075 (UMLS CUI-1)
CL Item
Diaphragm (6)
C0011980 (UMLS CUI-1)
CL Item
Endometrium (7)
C0014180 (UMLS CUI-1)
CL Item
Fallopian tube (8)
C0015560 (UMLS CUI-1)
CL Item
Omentum (9)
C0028977 (UMLS CUI-1)
CL Item
Ovary (10)
C0029939 (UMLS CUI-1)
CL Item
Paracolic gutter left (11)
C3665376 (UMLS CUI-1)
C0205091 (UMLS CUI-2)
CL Item
Paracolic gutter right (12)
C3665376 (UMLS CUI-1)
C0205090 (UMLS CUI-2)
CL Item
Pelvic wall left (13)
C0230284 (UMLS CUI-1)
C0205091 (UMLS CUI-2)
CL Item
Pelvic wall right (14)
C0230284 (UMLS CUI-1)
C0205090 (UMLS CUI-2)
CL Item
Peritoneum/uterine serosa (15)
C0227824 (UMLS CUI-1)
CL Item
Lymph node(s), specify (16)
C0024204 (UMLS CUI-1)
CL Item
Metastatic site, specify (17)
C0280457 (UMLS CUI-1)
CL Item
Other, specify (18)
C3845569 (UMLS CUI-1)
Specimen Site, LymphNode
Item
Lymph node(s), specify (Specimen Site)
text
C0449705 (UMLS CUI [1,1])
C0024204 (UMLS CUI [1,2])
Specimen Site, Metastatic
Item
Metastatic site, specify (Specimen Site)
text
C0280457 (UMLS CUI [1])
Specimen Site, Other
Item
Other (Specimen Site), specify
text
C0449705 (UMLS CUI [1])
Item Group
Secondary Disease Assessment
Item
Method of evaluation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
CL.6
Code List
Method of evaluation
CL Item
Cytology (Cytology)
C16491 (NCI Thesaurus)
C0010819 (UMLS 2011AA)
CL Item
Other, Specify (Other, Specify)
CL Item
Surgery (Surgery)
C17173 (NCI Thesaurus)
C0038894 (UMLS 2011AA)
CL Item
Biopsy (Biopsy)
C15189 (NCI Thesaurus)
C0005558 (UMLS 2011AA)
C15189 (NCI Thesaurus-3)
C0005558 (UMLS 2011AA-4)
CL Item
Second look (Second look)
CL Item
Primary Gyn Disease Continues To Be Present Following Initial Treatment (Persistence)
CL Item
Recurrence Of Same Gyn Disease Previously Treated Successfully (Recurrence)
Assessment Date
Item
Date of evaluation
date
C2985720 (UMLS CUI [1])
Specimen ID
Item
ID # of the blocks/slides
text
C1299222 (UMLS CUI [1])
Item
Specimen site
integer
C0449705 (UMLS CUI [1])
CL.7
Code List
Specimen site
CL Item
Bladder peritoneum (1)
C0005682 (UMLS CUI-1)
C0031153 (UMLS CUI-2)
CL Item
Bowel peritoneum/serosa (2)
C0021853 (UMLS CUI-1)
C0031153 (UMLS CUI-2)
CL Item
Cervix (3)
C0007874 (UMLS CUI-1)
CL Item
Corpus (4)
C0227813 (UMLS CUI-1)
CL Item
Cul-de-sac (5)
C0013075 (UMLS CUI-1)
CL Item
Diaphragm (6)
C0011980 (UMLS CUI-1)
CL Item
Endometrium (7)
C0014180 (UMLS CUI-1)
CL Item
Fallopian tube (8)
C0015560 (UMLS CUI-1)
CL Item
Omentum (9)
C0028977 (UMLS CUI-1)
CL Item
Ovary (10)
C0029939 (UMLS CUI-1)
CL Item
Paracolic gutter left (11)
C3665376 (UMLS CUI-1)
C0205091 (UMLS CUI-2)
CL Item
Paracolic gutter right (12)
C3665376 (UMLS CUI-1)
C0205090 (UMLS CUI-2)
CL Item
Pelvic wall left (13)
C0230284 (UMLS CUI-1)
C0205091 (UMLS CUI-2)
CL Item
Pelvic wall right (14)
C0230284 (UMLS CUI-1)
C0205090 (UMLS CUI-2)
CL Item
Peritoneum/uterine serosa (15)
C0227824 (UMLS CUI-1)
CL Item
Lymph node(s), specify (16)
C0024204 (UMLS CUI-1)
CL Item
Metastatic site, specify (17)
C0280457 (UMLS CUI-1)
CL Item
Other, specify (18)
C3845569 (UMLS CUI-1)
Specimen Site, LymphNode
Item
Lymph node(s), specify (Specimen Site)
text
C0449705 (UMLS CUI [1,1])
C0024204 (UMLS CUI [1,2])
Specimen Site, Metastatic
Item
Metastatic site, specify (Specimen Site)
text
C0280457 (UMLS CUI [1])
Specimen Site, Other
Item
Other (Specimen Site), specify
text
C0449705 (UMLS CUI [1])
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