Study Coordinating Center, Identification number
Item
Center number
integer
C2825181 (UMLS CUI [1,1])
C1300638 (UMLS CUI [1,2])
Patient number
Item
Patient Number
integer
C1830427 (UMLS CUI [1])
Person Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Item
Please mark the appropriate box to indicate month of report.
text
C1704685 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
Code List
Please mark the appropriate box to indicate month of report.
CL Item
Other, specify (9)
Follow-Up Report, Month
Item
Specify
text
C1704685 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
Patient Outcome, Cessation of life
Item
Has the patient died?
boolean
C1547647 (UMLS CUI [1,1])
C0011065 (UMLS CUI [1,2])
Patient Outcome, Date last contact
Item
If 'No', Date of last contact
date
C1547647 (UMLS CUI [1,1])
C0805839 (UMLS CUI [1,2])
Patient Outcome, Lost to follow-up
Item
Was the patient lost to follow-up?
boolean
C1547647 (UMLS CUI [1,1])
C1302313 (UMLS CUI [1,2])
Item
Has disease progressed?
text
C1547647 (UMLS CUI [1,1])
C0242656 (UMLS CUI [1,2])
Code List
Has disease progressed?
CL Item
N/A (if patient progressed on study) (3)
Patient Outcome, Disease Progression, Date in time
Item
Date of first documented disease progression since the Topotecan study conclusion
date
C1547647 (UMLS CUI [1,1])
C0242656 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Please mark box to indicate any post study cancer therapy received
text
C1547647 (UMLS CUI [1,1])
C0920425 (UMLS CUI [1,2])
Code List
Please mark box to indicate any post study cancer therapy received
CL Item
Immunotherapy (5)
Patient Outcome, Cancer treatment, Start Date
Item
Date treatment started
date
C1547647 (UMLS CUI [1,1])
C0920425 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Item
Cause of Death
text
C0007465 (UMLS CUI [1])
CL Item
Progressive Disease (1)
CL Item
Other, specify (2)
Cause of Death
Item
Specify
text
C0007465 (UMLS CUI [1])
Date of death
Item
Date of death
date
C1148348 (UMLS CUI [1])
Cessation of life, Autopsy
Item
Was an autopsy performed?
boolean
C0011065 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])
Cessation of life, Autopsy, Finding
Item
If 'Yes' please summarize findings (include diagnosis)
text
C0011065 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])
C0243095 (UMLS CUI [1,3])
Investigator Signature
Item
Investigator's Signature (I certify that I have reviewed the follow-up data and that all information is complete and accurate.)
text
C2346576 (UMLS CUI [1])
Investigator Signature, Date in time
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])