ID

2716

Beschrijving

Histopathologic Evaluation (HE) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122BFC7-B32C-4DBD-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122BFC7-B32C-4DBD-E034-0003BA12F5E7

Trefwoorden

Versies (2)
  1. 19-09-12 19-09-12 -
  2. 09-01-15 09-01-15 - Martin Dugas
Geüploaded op

19 september 2012

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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Melanoma (Skin) null Registration - Histopathologic Evaluation (HE) - 2073503v3.0

Engels

No Instruction available.

1 Formulieren  
  1. StudyEvent: Histopathologic Evaluation (HE)
    1. No Instruction available.
Histopathologic Stage:
Beschrijving

Histopathologic Stage:

Tumor:
Beschrijving

TStage,Pathologic

Datatype

text

Nodes
Beschrijving

NStage,Pathologic

Datatype

text

Alias
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
Metastisis
Beschrijving

MStage,Pathologic

Datatype

text

Alias
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
Completed by:
Beschrijving

CompletedBy

Datatype

text

Date: (Year Month Day)
Beschrijving

FormCompletionDate,Original

Datatype

date

Ccrr Module For Histopathologic Evaluation (he)
Beschrijving

Ccrr Module For Histopathologic Evaluation (he)

Patient ID (Pt. ID issued during registration or previously issued patient ID)
Beschrijving

Pt.ID

Datatype

text

Institution ID:
Beschrijving

InstitutionNo.

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Initials: (F ML)
Beschrijving

PatientInitialsName

Datatype

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
Institution:
Beschrijving

InstitutionName

Datatype

text

Date of Histopathologic Evaluation (Year Month Day)
Beschrijving

AssessmentDate

Datatype

date

Source of Specimen (Mark all that apply)
Beschrijving

AssessmentType,Diagnostic

Datatype

text

If residual tumor present, indicate tumor thickness: (mm)
Beschrijving

Ifresidualtumorpresent,indicatetumorthickness:

Datatype

text

Total # of tumor-positive sentinel nodes (SNs) identified by pathologist (total for all basins):
Beschrijving

SentinelNode(s)PositiveNumber

Datatype

double

Basin location(s) of tumor-positive Sentinel Nodes:
Beschrijving

DiseaseSite,LymphNodes

Datatype

text

Total # of tumor-positive lymph nodes (LNs) identified by pathologist (total for all basins):
Beschrijving

LymphNode(s)PositiveNumber

Datatype

double

Alias
NCI Thesaurus Property
C25246
UMLS 2011AA Property
C1446409
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
Final margin after re-excision:
Beschrijving

SurgicalMarginStatus

Datatype

text

Final margin after re-excision:
Beschrijving

SurgicalMarginStatus

Datatype

text

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Similar models

No Instruction available.

1 Formulieren
  1. StudyEvent: Histopathologic Evaluation (HE)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Histopathologic Stage:
Item
Tumor:
text
CL.1
Code List
Tumor:
CL Item
Tumor Invades Subepithelial Connective Tissue (T1)
CL Item
T2 (T2)
CL Item
T3 (T3)
CL Item
Inflammatory Carcinoma (T4)
C0334385 (NCI Metathesaurus)
Item
Nodes
text
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.2
Code List
Nodes
CL Item
N0 (N0)
CL Item
Metastasis In A Single Lymph Node, 2 Cm Or Less In Greatest Dimension (N1)
CL Item
Metastasis In A Single Lymph Node, More Than 2 Cm But Not More Than 5 Cm In Greatest Dimension; Or Multiple Lymph Nodes, None More Than 5 Cm In Greatest Dimension (N2)
CL Item
Metastasis In A Lymph Node More Than 5 Cm In Greatest Dimension (N3)
Item
Metastisis
text
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
CL.3
Code List
Metastisis
CL Item
M0, According To Ajcc Staging Definitions (M0)
CL Item
M1, According To Ajcc Staging Definitions (M1)
CompletedBy
Item
Completed by:
text
FormCompletionDate,Original
Item
Date: (Year Month Day)
date
Item Group
Ccrr Module For Histopathologic Evaluation (he)
Pt.ID
Item
Patient ID (Pt. ID issued during registration or previously issued patient ID)
text
InstitutionNo.
Item
Institution ID:
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
PatientInitialsName
Item
Patient Initials: (F ML)
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)
InstitutionName
Item
Institution:
text
AssessmentDate
Item
Date of Histopathologic Evaluation (Year Month Day)
date
Item
Source of Specimen (Mark all that apply)
text
CL.4
Code List
Source of Specimen (Mark all that apply)
CL Item
Excision/Sentinel Node Biopsy (Excision/Sentinel Node Biopsy)
CL Item
Completion Lymphadenectomy (Completion Lymphadenectomy)
CL Item
Re-excision (Re-excision)
Ifresidualtumorpresent,indicatetumorthickness:
Item
If residual tumor present, indicate tumor thickness: (mm)
text
SentinelNode(s)PositiveNumber
Item
Total # of tumor-positive sentinel nodes (SNs) identified by pathologist (total for all basins):
double
DiseaseSite,LymphNodes
Item
Basin location(s) of tumor-positive Sentinel Nodes:
text
LymphNode(s)PositiveNumber
Item
Total # of tumor-positive lymph nodes (LNs) identified by pathologist (total for all basins):
double
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
Item
Final margin after re-excision:
text
CL.6
Code List
Final margin after re-excision:
CL Item
Positive (Positive)
CL Item
Negative (Negative)
Item
Final margin after re-excision:
text
CL.6
Code List
Final margin after re-excision:
CL Item
Positive (Positive)
CL Item
Negative (Negative)
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