ID

2732

Beschreibung

Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4051BFF-CFA4-2D00-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4051BFF-CFA4-2D00-E034-0003BA3F9857

Stichworte

Hochgeladen am

19. September 2012

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy

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On-Study - Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients - 2292713v3.0

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StudyEvent: Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients
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Name

Typ

Description | Question | Decode (Coded Value)

Datentyp

Alias

CRF Header

Item Group

Crf Header

ProtocolCoordinatingIdentifierNumber

Item

Coordinating Group Protocol No.

text

C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

CoordinatingGroupIdentifierCode

Item

Coordinating Group Code

text

C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus ObjectClass)
C0700114 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

ProtocolTitleName

Item

Protocol Title

text

C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)

PatientCoordinatingIdentifierNumber

Item

Patient Study ID

text

C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

CombinedInstitutionName

Item

Institution/Affiliate

text

C25454 (NCI Thesaurus ObjectClass)
C0205195 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)

PatientParticipatingIdentifierNumber

Item

Other Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25608 (NCI Thesaurus Property)
C0679823 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

ParticipatingGroupIdentifierCode

Item

Participating Group Code

text

C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

PatientName

Item

Patient Name (initials acceptable)

text

C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)

Sarcoma: Form Administration

Item Group

Sarcoma: Form Administration

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)

DataAmendedInd-3

Item

Are data amended (If data are amended, please circle in red when using paper form)

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

Are data amended (If data are amended, please circle in red when using paper form)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

Pediatric Soft Tissue Sarcoma: Disease Description

Item Group

Pediatric Soft Tissue Sarcoma: Disease Description

CancerInitialDiagnosisDate

Item

Date of Initial Pathologic Diagnosis (MM DD YYYY)

date

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)

BiopsyProcedure

Item

Biopsy Type

text

C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C25218 (NCI Thesaurus ValueDomain)
C1948041 (UMLS 2011AA ValueDomain)

CL.2

Code List

Biopsy Type

CL Item

Incisional (Incisional)

CL Item

Excisional (Excisional)

CL Item

Trucut Needle (TruCut needle)

CL Item

Large Bore Needle (Large bore needle)

CL Item

Other, Specify (Other specify)

BiopsyDescriptionSpecify

Item

Other specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)

PediatricSoftTissueSarcomaPrimarySite

Item

Primary Site

text

C9306 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C39299 (NCI Thesaurus ObjectClass)
C0231335 (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.3

Code List

Primary Site

CL Item

Eye And Orbit (Eye and orbit)

CL Item

Parameningeal (Parameningeal)

CL Item

Non-parameningeal Head And Neck (Non-parameningeal head and neck)

CL Item

Thorax (Thorax)

C12799 (NCI Thesaurus)
C0817096 (UMLS 2011AA)

CL Item

Trunk (Trunk)

C33816 (NCI Thesaurus)
C0460005 (UMLS 2011AA)

CL Item

Perineum/anus (Perineum/anus)

CL Item

Retroperitoneum (Retroperitoneum)

C12298 (NCI Thesaurus)
C0035359 (UMLS 2011AA)

CL Item

Intra-abdominal, Nos (Intra-abdominal)

CL Item

Bladder (Bladder)

C12414 (NCI Thesaurus)
C0005682 (UMLS 2011AA)

CL Item

Prostate (Prostate)

C12410 (NCI Thesaurus)
C0033572 (UMLS 2011AA)

CL Item

Genitourinary, Nos (Genitourinary NOS)

CL Item

Upper Extremity (Upper extremity)

C12671 (NCI Thesaurus)
C1140618 (UMLS 2011AA)

CL Item

Lower Extremity (Lower extremity)

C12742 (NCI Thesaurus)
C0023216 (UMLS 2011AA)

CL Item

Other Specify (Other)

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)

SarcomaTumorOrganSideType

Item

Tumor Location, Side

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C13018 (NCI Thesaurus Property)
C0178784 (UMLS 2011AA Property)
C25306 (NCI Thesaurus Property)
C0441987 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.4

Code List

Tumor Location, Side

CL Item

Left (Left)

C25229 (NCI Thesaurus)
C0205091 (UMLS 2011AA)

CL Item

Right (Right)

C25228 (NCI Thesaurus)
C0205090 (UMLS 2011AA)

CL Item

Both (Both)

C49636 (NCI Thesaurus)
C1706086 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

IntracranialTumorExtensionType

Item

Intracranial Tumor Extension (check all that apply)

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C38236 (NCI Thesaurus ObjectClass)
C1522213 (UMLS 2011AA ObjectClass)

CL.5

Code List

Intracranial Tumor Extension (check all that apply)

CL Item

Intracranial Extension (Intracranial extension)

CL Item

Cranial Nerve Palsy (Cranial nerve palsy)

CL Item

Base Of Skull Erosion (Base of skull erosion)

CL Item

Other, Specify (Other specify)

IntracranialTumorExtensionSpecify

Item

Other specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C38236 (NCI Thesaurus ObjectClass)
C1522213 (UMLS 2011AA ObjectClass)

SarcomaMalignantNeoplasmMetastaticInvolvementSite

Item

Metastatic Site (s - For high risk/advanced studies, - check all that apply)

text

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)

CL.6

Code List

Metastatic Site (s - For high risk/advanced studies, - check all that apply)

CL Item

Bone (Bone)

C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)

CL Item

Bone Marrow (Bone marrow)

C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)

CL Item

Cns/brain (CNS/Brain)

CL Item

Liver (Liver)

C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)

CL Item

Lung (Lung)

C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)

CL Item

Pleural Nodules (Pleural nodules)

CL Item

Peritoneal Nodules (Peritoneal nodules)

CL Item

Soft Tissue (Soft tissue)

C12471 (NCI Thesaurus)
C0225317 (UMLS 2011AA)

CL Item

Pleural Effusion (Pleural effusion)

C3331 (NCI Thesaurus)
C0021071 (UMLS 2011AA)

CL Item

Ascites (Ascites)

C2885 (NCI Thesaurus)
C0003962 (UMLS 2011AA)

CL Item

Cerebrospinal Fluid (csf) (Cerebrospinal fluid (CSF))

CL Item

Distant Nodes, Specify (Distant Nodes)

CL Item

Other Specify (Other)

MalignantNeoplasmDistantLymphNodeMetastaticInvolvementSpecify

Item

Distant nodes specify

text

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C12745 (NCI Thesaurus Property)
C0024204 (UMLS 2011AA Property)
C25321 (NCI Thesaurus Property)
C0443203 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)

MalignantNeoplasmMetastaticInvolvementSpecify

Item

Other specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)

RegionalLymphNodeExaminedCount

Item

Number of Regional Lymph Nodes Examined

double

C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25643 (NCI Thesaurus ObjectClass)
C0205147 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)

LymphNodePositiveCount

Item

Number of Positive Lymph Nodes

double

C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)

TumorLargestDimensionMeasurement

Item

Dimension 1 (Longest)

double

C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25550 (NCI Thesaurus Property)
C0443228 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property)
C0439534 (UMLS 2011AA Property)

TumorSecondDimensionMeasurement

Item

Dimension 2 (cm)

double

C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25666 (NCI Thesaurus Property)
C0205436 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property)
C0439534 (UMLS 2011AA Property)

TumorThirdDimensionMeasurement

Item

Dimension 3 (cm)

double

C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25260 (NCI Thesaurus Property)
C0205437 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property)
C0439534 (UMLS 2011AA Property)

PrimaryTumorResectionType

Item

Status of Primary Tumor

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25251 (NCI Thesaurus ObjectClass)
C0205225 (UMLS 2011AA ObjectClass)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)

CL.7

Code List

Status of Primary Tumor

CL Item

Unresected (Unresected)

CL Item

Not Recurrent, Resected, No Residual Tumor (Not recurrent, resected, no residual tumor)

CL Item

Not Recurrent, Resected, Residual Tumor (Not recurrent, resected, residual tumor)

CL Item

Recurrent (Recurrent)

C14173 (NCI Thesaurus)
C2945760 (UMLS 2011AA)

SarcomaHistologicCategory

Item

Histologic Type (check all that apply)

text

C9118 (NCI Thesaurus ObjectClass)
C1261473 (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.8

Code List

Histologic Type (check all that apply)

CL Item

Embryonal Rhabdomyosarcoma (Embryonal rhabdomyosarcoma)

CL Item

Botryoid Rhabdomyosarcoma (Botryoid rhabdomyosarcoma)

CL Item

Spindle Cell Rhabdomyosarcoma (Spindle cell rhabdomyosarcoma)

CL Item

Alveolar Rhabdomyosarcoma (Alveolar rhabdomyosarcoma)

CL Item

Pleomorphic Rhabdomyosarcoma (Pleomorphic rhabdomyosarcoma)

CL Item

Rhabdomyosarcoma Nos (Rhabdomyosarcoma NOS)

CL Item

Extraskeletal Ewing's/pnet (Extraskeletal Ewing's/PNET)

CL Item

Synovial Sarcoma (Synovial sarcoma)

C3400 (NCI Thesaurus)
C0039101 (UMLS 2011AA)

CL Item

Maligant Peripheral Nerve Sheath Tumor (Malignant peripheral nerve sheath tumor)

CL Item

Infantile Fibrosarcoma (Infantile fibrosarcoma)

CL Item

Fibrosacoma, Nos (Fibrosacoma NOS)

CL Item

Dermatofibrosarcoma Protuberans (Dermatofibrosarcoma protuberans)

CL Item

Myxofibrosarcoma (Myxofibrosarcoma)

CL Item

Solitary Fibrous Tumor/hemangiopericytoma (Solitary fibrous tumor/hemangiopericytoma)

CL Item

Undifferentiated Pleomorphic Sarcoma/"mfh" (Undifferentiated pleomorphic sarcoma/"MFH")

CL Item

Well Differentiated Liposarcoma (Well differentiated liposarcoma)

CL Item

Dedifferentiated Liposarcoma (Dedifferentiated liposarcoma)

CL Item

Myxoid Liposarcoma (Myxoid liposarcoma)

CL Item

Pleomorphic Liposarcoma (Pleomorphic liposarcoma)

CL Item

Liposarcoma Nos (Liposarcoma NOS)

CL Item

Leiomyosarcoma (Leiomyosarcoma)

C3158 (NCI Thesaurus)
C0023269 (UMLS 2011AA)

CL Item

Gastrointestinal Stromal Tumor (gist) (Gastrointestinal stromal tumor (GIST))

CL Item

Extraskeletal Myxoid Chondrosarcoma (Extraskeletal myxoid chondrosarcoma)

CL Item

Extraskeletal Mesenchymal Chondrosarcoma (Extraskeletal mesenchymal chondrosarcoma)

CL Item

Extraskeletal Osteosarcoma (Extraskeletal osteosarcoma)

CL Item

Angiosarcoma (Angiosarcoma)

C3088 (NCI Thesaurus)
C0018923 (UMLS 2011AA)

CL Item

Kaposi Sarcoma (Kaposi sarcoma)

C9087 (NCI Thesaurus)
C0036220 (UMLS 2011AA)

CL Item

Epithelioid Sarcoma (Epithelioid sarcoma)

CL Item

Alveolar Soft Part Sarcoma (Alveolar soft part sarcoma)

CL Item

Clear Cell Sarcoma (mmsp) (Clear cell sarcoma (MMSP))

CL Item

Desmoplastic Small Cell Tumor (Desmoplastic small cell tumor)

CL Item

Malignant Mesenchymoma (Malignant mesenchymoma)

CL Item

Soft Tissue Sarcoma Nos (Soft tissue sarcoma NOS)

CL Item

Endometrial Stromal Sarcoma (Endometrial stromal sarcoma)

C8973 (NCI Thesaurus)
C0206630 (UMLS 2011AA)

CL Item

Uterine Leiomyosarcoma (Uterine leiomyosarcoma)

CL Item

Uterine Carcinosarcoma (mixed Mesodermal Sarcoma) (Uterine carcinosarcoma (mixed mesodermal sarcoma))

CL Item

Uterine Sarcoma Nos (Uterine sarcoma NOS)

CL Item

Undifferentiated Sarcoma (Undifferentiated sarcoma)

CL Item

Other Specify (Other specify)

TumorHistologicCategorySpecify

Item

Other specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)

SarcomaHistologicSubcategorySpecify

Item

Histologic Subtype (specify)

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25692 (NCI Thesaurus Property)
C1515010 (UMLS 2011AA Property)

SarcomaTumorFrenchClassificationHistologicGrade

Item

Histologic Grade, French System (check highest grade)

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C43854 (NCI Thesaurus Property)
C1556084 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C25526 (NCI Thesaurus ValueDomain)
C0205462 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)

CL.9

Code List

Histologic Grade, French System (check highest grade)

CL Item

Grade I (Grade I)

CL Item

Grade Ii (Grade II)

CL Item

Grade Iii (Grade III)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

SarcomaPathologicTStage

Item

Pathologic T Stage

text

C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25728 (NCI Thesaurus Property)
C0475455 (UMLS 2011AA Property)

CL.10

Code List

Pathologic T Stage

CL Item

Pt0 (pT0)

CL Item

Pt1 (pT1)

CL Item

Pt2 (pT2)

CL Item

Pt3 (pT3)

CL Item

Pt4 (pT4)

CL Item

Ptx (pTX)

SarcomaPathologicNStage

Item

Pathologic N Stage

text

C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25580 (NCI Thesaurus Property)
C0456532 (UMLS 2011AA Property)

CL.11

Code List

Pathologic N Stage

CL Item

Pn0 (pN0)

CL Item

Pn1 (pN1)

CL Item

Pn2 (pN2)

CL Item

Pn3 (pN3)

CL Item

Pnx (pNX)

SarcomaPathologicMStage

Item

Pathologic M Stage

text

C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25727 (NCI Thesaurus Property)
C0456533 (UMLS 2011AA Property)

CL.12

Code List

Pathologic M Stage

CL Item

Pm0 (pM0)

CL Item

Pm1 (pM1)

CL Item

Pmx (pMX)

SarcomaClinicalTStage

Item

Clinical T Stage

text

C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25728 (NCI Thesaurus Property)
C0475455 (UMLS 2011AA Property)

CL.13

Code List

Clinical T Stage

CL Item

T0 (T0)

CL Item

T1 (T1)

C1179687 (NCI Metathesaurus)

CL Item

T2 (T2)

CL Item

T3 (T3)

CL Item

T4 (T4)

CL Item

Tx (TX)

SarcomaClinicalNStage

Item

Clinical N Stage

text

C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25580 (NCI Thesaurus Property)
C0456532 (UMLS 2011AA Property)

CL.14

Code List

Clinical N Stage

CL Item

N0 (N0)

CL Item

N1 (N1)

CL Item

N2 (N2)

CL Item

N3 (N3)

CL Item

Nx (NX)

SarcomaClinicalMStage

Item

Clinical M Stage

text

C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25727 (NCI Thesaurus Property)
C0456533 (UMLS 2011AA Property)

CL.15

Code List

Clinical M Stage

CL Item

M0 (M0)

CL Item

M1 (M1)

CL Item

Mx (MX)

InvasiveTumorDepthMeasurement

Item

Depth (cm)

double

C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C14159 (NCI Thesaurus ObjectClass)
C0205281 (UMLS 2011AA ObjectClass)
C25333 (NCI Thesaurus Property)
C0205125 (UMLS 2011AA Property)

Pediatric Soft Tissue Sarcoma: Prior Health History

Item Group

Pediatric Soft Tissue Sarcoma: Prior Health History

ChronicDiseaseDiagnosisInd-3

Item

Does the patient have a chronic disease associated with this cancer?

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C14141 (NCI Thesaurus ObjectClass)
C0205191 (UMLS 2011AA ObjectClass)

CL.16

Code List

Does the patient have a chronic disease associated with this cancer?

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

PatientMedicalConditionCurrentType

Item

Current Medical Conditions (currently symptomatic or on medications for)

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS 2011AA Property)

CL.17

Code List

Current Medical Conditions (currently symptomatic or on medications for)

CL Item

Cerebrovascular Disease (Cerebrovascular disease)

CL Item

Cardiac Disease (Cardiac disease)

CL Item

High Blood Pressure (High blood pressure)

CL Item

Deep Vein Thrombosis (Deep vein thrombosis)

CL Item

Peripheral Vascular Disease (Peripheral vascular disease)

CL Item

Gastrointestinal Disease (Gastrointestinal disease)

CL Item

Diabetes (Diabetes)

CL Item

Neurologic Disease (Neurologic disease)

CL Item

Respiratory Problems (Respiratory problems)

CL Item

Other Malignancies, Specify (Other malignancies specify)

CL Item

Other, Specify (Other specify)

MalignantDiseaseOtherPresentSpecify

Item

Other malignancies specify

text

C14143 (NCI Thesaurus ObjectClass)
C0205282 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)

PatientMedicalConditionCurrentSpecify

Item

Other specify

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus ValueDomain)
C0521116 (UMLS 2011AA ValueDomain)

PatientCongenitalAbnormalityType

Item

Congenital abnormalities

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)

CL.18

Code List

Congenital abnormalities

CL Item

None (None)

C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)

CL Item

Downs Syndrome (Downs syndrome)

CL Item

Neurofibromatosis (Neurofibromatosis)

CL Item

Li-fraumeni Syndrome (Li-Fraumeni syndrome)

CL Item

Hemihypertrophy (Hemihypertrophy)

CL Item

Other, Specify (Other specify)

PatientCongenitalAbnormalitySpecify

Item

Other specify

text

C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)

NeurofibromatosisFamilyMedicalHistoryInd-3

Item

Family history of neurofibromatosis?

text

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C6727 (NCI Thesaurus ObjectClass)
C0162678 (UMLS 2011AA ObjectClass)
C17726 (NCI Thesaurus Property)
C0241889 (UMLS 2011AA Property)

CL.19

Code List

Family history of neurofibromatosis?

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

Comments

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)

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On-Study - Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients - 2292713v3.0

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