English

6 months post treatment Clinical Form

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Indicate the patient's medical record number
Description

This number will not be shared with ICHOM. In the case patient-level data is submitted to ICHOM for benchmarking or research purposes, a separate ICHOM Patient Identifier will be created and cross-linking between the ICHOM Patient Identifier and the medical record number will only be known at the treating institution INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical RESPONSE OPTIONS: According to institution

Data type

integer

Alias
UMLS CUI [1]
C1269815
Patient's last name:
Description

The patients' name will not be shared with ICHOM.  INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical

Data type

text

Alias
UMLS CUI [1]
C1299487
Treatment variables
Description

Treatment variables

Alias
UMLS CUI-1
C0087111
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 0 = No treatment
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C4086728
UMLS CUI [1,2]
C0746919
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 1 = Surgery
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C0543467
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 2 = Radiotherapy
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C1522449
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 3 = Chemotherapy
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C0392920
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 4 = Targeted therapy
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C2985566
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 5 = Best supportive care
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C0344211
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 999 = Unknown
Description

INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C4086728
UMLS CUI [1,3]
C0439673
Indicate whether the patient received surgery during the last year:
Description

INCLUSION CRITERIA: If answered "surgery" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0543467
Indicate the method of the surgical procedure:
Description

INCLUSION CRITERIA: If yes answered "yes" on surgery [SURGERY] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0543467
UMLS CUI [1,2]
C0332307
Provide the date of surgery:
Description

INCLUSION CRITERIA: If yes answered "yes" on surgery [SURGERY] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1]
C1628561
DD/MM/YYYY
Indicate whether the patient received radiotherapy during the last year
Description

INCLUSION CRITERIA: If answered "radiotherapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1522449
UMLS CUI [1,2]
C4086728
Indicate what type of radiotherapy:
Description

INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

integer

Alias
UMLS CUI [1,1]
C1522449
UMLS CUI [1,2]
C0332307
Provide the start date of radiotherapy:
Description

INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C0808070
UMLS CUI [1,2]
C1522449
DD/MM/YYYY
Provide the stop date of radiotherapy:
Description

INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C1522449
UMLS CUI [1,2]
C0806020
DD/MM/YYYY
Indicate whether the patient received chemotherapy during the last year:
Description

INCLUSION CRITERIA: If answered "chemotherapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0392920
UMLS CUI [1,2]
C4086728
Provide the start date of chemotherapy:
Description

INCLUSION CRITERIA: If answered "chemotherapy" on treatment TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C0392920
UMLS CUI [1,2]
C0808070
DD/MM/YYYY
Provide the stop date of chemotherapy, if applicable:
Description

INCLUSION CRITERIA: If answered "chemotherapy" on treatment TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C0392920
UMLS CUI [1,2]
C0806020
DD/MM/YYYY
Indicate whether the patient received targeted therapy during the last year:
Description

INCLUSION CRITERIA: If answered "targeted therapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single Answer

Data type

integer

Alias
UMLS CUI [1,1]
C2985566
UMLS CUI [1,2]
C4086728
Provide the start date of targeted therapy:
Description

INCLUSION CRITERIA: If answered "yes on targeted therapy [TARGETTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C2985566
UMLS CUI [1,2]
C0808070
DD/MM/YYYY
Provide the stop date of targeted therapy, if applicable:
Description

INCLUSION CRITERIA: If answered "yes on targeted therapy [TARGETTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C2985566
UMLS CUI [1,2]
C0806020
DD/MM/YYYY
Survival and disease control
Description

Survival and disease control

Alias
UMLS CUI-1
C1148433
UMLS CUI-2
C4304384
Indicate whether there is a complete response
Description

In case of pathologic evaluation: a pathologic complete response is defined as no evidence of residual invasive cancer of the complete resected specimen and all sampled regional lymph nodes. In case of diagnostic evaluation only: a clinical complete response is defined when there is no sign of tumor after all diagnostic tests (e.g. MRI/endoscopy) INCLUSION CRITERIA: Only if patient received neo-adjuvant therapy for rectal cancer. TIMING: Update at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0242594
UMLS CUI [2]
C1275810
Indicate whether there is evidence of circumferential margin involvement:
Description

INCLUSION CRITERIA: Only if the patient received surgery for rectal cancer. TIMING: Update at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0728940
UMLS CUI [1,2]
C0229985
UMLS CUI [1,3]
C0449438
Disutility of care
Description

Disutility of care

Alias
UMLS CUI-1
C4062984
Indicate whether the patient received a stoma (ileostomy/colostomy):
Description

INCLUSION CRITERIA: Only if the patient received surgery. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1]
C1955856
Provide the date of stoma surgery:
Description

INCLUSION CRITERIA: If answered "yes" on stoma [STOMA] TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1,1]
C1955856
UMLS CUI [1,2]
C0011008
DD/MM/YYYY
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  0 = No complication
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0549184
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  1 = Complication requiring intervention (surgical, radiological, endoscopic)
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0184661
UMLS CUI [1,3]
C1514873
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  2 = Complication leading to prolonged hospitalization ( >14days)
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0745041
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  3 = Complication leading to unplanned readmission
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0600290
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  4 = Complication leading to ICU admission
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0583239
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  5 = Complication leading to discontinuing of treatment
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0457454
UMLS CUI [1,3]
C0087111
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  6 = Complication leading to reduced dosing
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C1707814
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  7 = Complication leading to death
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0011065
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  8 = Complication, but did not result in any of the above mentioned
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C1274040
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  999 = Unknown
Description

These response options are based on the Clavien-Dindo classification for surgical complications and the Common Terminology Criteria version 4 (CTCAE v4). To collect the most severe complications, grade 3 -5 of both classification systems are included in the Standard Set. INCLUSION CRITERIA: Only if the patient received treatment. TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0439673
Provide the date of death:
Description

INCLUSION CRITERIA: If answered "Complication leading to death" on experience of complication [COMPLIMPACT] TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

Data type

date

Measurement units
  • DD/MM/YYYY
Alias
UMLS CUI [1]
C1148348
DD/MM/YYYY
Indicate whether the complication is attributable to colorectal cancer treatment:
Description

INCLUSION CRITERIA: If answered "yes" on experience of complication [COMPLIMPACT] TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0009566
UMLS CUI [1,2]
C0596130
UMLS CUI [1,3]
C0920425
Please indicate the type of complication:
Description

INCLUSION CRITERIA: If answered "yes" on complication attributable to colorectal cancer treatment [COMPLTX] TIMING: Updated at least 6 months after treatment REPORTING SOURCE: Clinical TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1]
C3258281
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Similar models

6 months post treatment Clinical Form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Indicate the patient's medical record number
integer
C1269815 (UMLS CUI [1])
Patient's last name
Item
Patient's last name:
text
C1299487 (UMLS CUI [1])
Item Group
Treatment variables
C0087111 (UMLS CUI-1)
Treatment: None
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 0 = No treatment
boolean
C4086728 (UMLS CUI [1,1])
C0746919 (UMLS CUI [1,2])
Treatment: Surgery
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 1 = Surgery
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C0543467 (UMLS CUI [1,3])
Treatment: Radiotherapy
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 2 = Radiotherapy
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C1522449 (UMLS CUI [1,3])
Treatment: Chemotherapy
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 3 = Chemotherapy
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C0392920 (UMLS CUI [1,3])
Treatment: Targeted Therapy
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 4 = Targeted therapy
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C2985566 (UMLS CUI [1,3])
Treatment: Best supportive care
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 5 = Best supportive care
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C0344211 (UMLS CUI [1,3])
Treatment: Unknown
Item
Indicate whether the patient received one of the following treatment during the last year: (select all that apply) 999 = Unknown
boolean
C0087111 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
Item
Indicate whether the patient received surgery during the last year:
integer
C0543467 (UMLS CUI [1])
Treatment
Code List
Indicate whether the patient received surgery during the last year:
CL Item
Hemicolectomy right (1)
C0192861 (UMLS CUI-1)
(Comment:en)
CL Item
Extended colectomy right (2)
C0400043 (UMLS CUI-1)
(Comment:en)
CL Item
Transverse resection (3)
C0192863 (UMLS CUI-1)
(Comment:en)
CL Item
Hemicolectomy left (4)
C0192865 (UMLS CUI-1)
C0546535 (UMLS CUI-2)
(Comment:en)
CL Item
Subtotal colectomy (5)
C0149750 (UMLS CUI-1)
C0728939 (UMLS CUI-2)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
CL Item
Total colectomy (6)
C0192871 (UMLS CUI-1)
(Comment:en)
CL Item
Sigmoid resection (7)
C0192866 (UMLS CUI-1)
(Comment:en)
CL Item
Anterior resection (8)
C0193083 (UMLS CUI-1)
(Comment:en)
CL Item
Low anterior resection (LAR) (9)
C1282272 (UMLS CUI-1)
(Comment:en)
CL Item
Abdomino-perineal resection (APR) (10)
C2004459 (UMLS CUI-1)
(Comment:en)
CL Item
Proctectomy with coloanal (11)
C0193062 (UMLS CUI-1)
C2985529 (UMLS CUI-2)
(Comment:en)
CL Item
Other (12)
C0205394 (UMLS CUI-1)
(Comment:en)
Item
Indicate the method of the surgical procedure:
integer
C0543467 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Treatment
Code List
Indicate the method of the surgical procedure:
CL Item
Endoscopic (for colon tumors) (1)
C0282493 (UMLS CUI-1)
(Comment:en)
CL Item
Transabdominal open (2)
C0348025 (UMLS CUI-1)
C0198482 (UMLS CUI-2)
(Comment:en)
CL Item
Transabdominal minimally invasive (laparoscopic/robotic) (3)
C0198482 (UMLS CUI-1)
C0282624 (UMLS CUI-2)
(Comment:en)
CL Item
Transanal open (4)
C0543467 (UMLS CUI-1)
C0589371 (UMLS CUI-2)
C0348025 (UMLS CUI-3)
(Comment:en)
CL Item
Transanal endoscopic (TEMS/SPTS)/minimally invasive (TAMIS) (5)
C0543467 (UMLS CUI-1)
C0589371 (UMLS CUI-2)
C0282624 (UMLS CUI-3)
C0282493 (UMLS CUI-4)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
CL Item
Other (6)
C0205394 (UMLS CUI-1)
(Comment:en)
Surgery date
Item
Provide the date of surgery:
date
C1628561 (UMLS CUI [1])
Item
Indicate whether the patient received radiotherapy during the last year
integer
C1522449 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
Radiotherapy
Code List
Indicate whether the patient received radiotherapy during the last year
CL Item
Neoadjuvant  (1)
C1298676 (UMLS CUI-1)
(Comment:en)
CL Item
Adjuvant  (2)
C1298675 (UMLS CUI-1)
(Comment:en)
CL Item
Definitive (3)
C2986592 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Indicate what type of radiotherapy:
integer
C1522449 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Radiotherapy
Code List
Indicate what type of radiotherapy:
CL Item
Long course without chemotherapy  (1)
C1522449 (UMLS CUI-1)
C0443252 (UMLS CUI-2)
(Comment:en)
CL Item
Long course chemoradiation  (2)
C0443252 (UMLS CUI-1)
C0436307 (UMLS CUI-2)
(Comment:en)
CL Item
Brachytherapy  (3)
C0006098 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
C1522449 (UMLS CUI-2)
(Comment:en)
CL Item
Short course  (0)
C0443303 (UMLS CUI-1)
C1522449 (UMLS CUI-2)
(Comment:en)
CL Item
Intraoperative radiation therapy (ORT)  (4)
C0338240 (UMLS CUI-1)
(Comment:en)
CL Item
Other  (5)
C1522449 (UMLS CUI-1)
C0205394 (UMLS CUI-2)
(Comment:en)
Start of radiotherapy
Item
Provide the start date of radiotherapy:
date
C0808070 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
End of radiotherapy
Item
Provide the stop date of radiotherapy:
date
C1522449 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item
Indicate whether the patient received chemotherapy during the last year:
integer
C0392920 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
Chemotherapy
Code List
Indicate whether the patient received chemotherapy during the last year:
CL Item
Neoadjuvant (1)
C1298676 (UMLS CUI-1)
(Comment:en)
CL Item
Adjuvant (2)
C1298675 (UMLS CUI-1)
(Comment:en)
CL Item
Definitive (3)
C2986592 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Start of chemotherapy
Item
Provide the start date of chemotherapy:
date
C0392920 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
End of chemotherapy
Item
Provide the stop date of chemotherapy, if applicable:
date
C0392920 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item
Indicate whether the patient received targeted therapy during the last year:
integer
C2985566 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
Targeted therapy
Code List
Indicate whether the patient received targeted therapy during the last year:
CL Item
Cetuximab (1)
C0995188 (UMLS CUI-1)
(Comment:en)
CL Item
Bevacizumab (2)
C0796392 (UMLS CUI-1)
(Comment:en)
CL Item
Panitumumab (3)
C0879427 (UMLS CUI-1)
(Comment:en)
CL Item
Ramucirumab (4)
C2742502 (UMLS CUI-1)
(Comment:en)
CL Item
Aflibercept (5)
C1134659 (UMLS CUI-1)
(Comment:en)
CL Item
Regorafenib (6)
C2980094 (UMLS CUI-1)
(Comment:en)
CL Item
Other (7)
C0205394 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Start of targeted therapy
Item
Provide the start date of targeted therapy:
date
C2985566 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
End of targeted therapy
Item
Provide the stop date of targeted therapy, if applicable:
date
C2985566 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item Group
Survival and disease control
C1148433 (UMLS CUI-1)
C4304384 (UMLS CUI-2)
Item
Indicate whether there is a complete response
integer
C0242594 (UMLS CUI [1])
C1275810 (UMLS CUI [2])
Residual invasive cancer
Code List
Indicate whether there is a complete response
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Indicate whether there is evidence of circumferential margin involvement:
integer
C0728940 (UMLS CUI [1,1])
C0229985 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,3])
Residual invasive cancer
Code List
Indicate whether there is evidence of circumferential margin involvement:
CL Item
Positive (<= 1mm) (0)
C1709603 (UMLS CUI-1)
(Comment:en)
CL Item
Negative (>1mm) (1)
C1709157 (UMLS CUI-1)
(Comment:en)
CL Item
Not reported (999)
C1549114 (UMLS CUI-1)
(Comment:en)
Item Group
Disutility of care
C4062984 (UMLS CUI-1)
Item
Indicate whether the patient received a stoma (ileostomy/colostomy):
integer
C1955856 (UMLS CUI [1])
Stoma
Code List
Indicate whether the patient received a stoma (ileostomy/colostomy):
CL Item
No (0)
C1298908 (UMLS CUI-1)
C1955856 (UMLS CUI-2)
(Comment:en)
CL Item
Temporary (1)
C0205374 (UMLS CUI-1)
C1955856 (UMLS CUI-2)
(Comment:en)
CL Item
Permanent (2)
C0205355 (UMLS CUI-1)
C1955856 (UMLS CUI-2)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Stoma date
Item
Provide the date of stoma surgery:
date
C1955856 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Complications: None
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  0 = No complication
boolean
C0009566 (UMLS CUI [1,1])
C0549184 (UMLS CUI [1,2])
Complications: Requiring intervention
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  1 = Complication requiring intervention (surgical, radiological, endoscopic)
boolean
C0009566 (UMLS CUI [1,1])
C0184661 (UMLS CUI [1,2])
C1514873 (UMLS CUI [1,3])
Complications: prolonged hospitalisation
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  2 = Complication leading to prolonged hospitalization ( >14days)
boolean
C0009566 (UMLS CUI [1,1])
C0745041 (UMLS CUI [1,2])
Complications: unplanned readmission
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  3 = Complication leading to unplanned readmission
boolean
C0009566 (UMLS CUI [1,1])
C0600290 (UMLS CUI [1,2])
Complications: ICU admission
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  4 = Complication leading to ICU admission
boolean
C0009566 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
Complications: discontinuation of treatment
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  5 = Complication leading to discontinuing of treatment
boolean
C0009566 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
Complications: Reduction of dosing
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  6 = Complication leading to reduced dosing
boolean
C0009566 (UMLS CUI [1,1])
C1707814 (UMLS CUI [1,2])
Complications: Death
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  7 = Complication leading to death
boolean
C0009566 (UMLS CUI [1,1])
C0011065 (UMLS CUI [1,2])
Complications: other result
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  8 = Complication, but did not result in any of the above mentioned
boolean
C0009566 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
Complications: Unknown
Item
Indicate whether the patient experienced a complication while on treatment or up to 90 days after initiation of treatment (multiple answers possible):  999 = Unknown
boolean
C0009566 (UMLS CUI [1,1])
C0439673 (UMLS CUI [1,2])
Date of death
Item
Provide the date of death:
date
C1148348 (UMLS CUI [1])
Item
Indicate whether the complication is attributable to colorectal cancer treatment:
integer
C0009566 (UMLS CUI [1,1])
C0596130 (UMLS CUI [1,2])
C0920425 (UMLS CUI [1,3])
Residual invasive cancer
Code List
Indicate whether the complication is attributable to colorectal cancer treatment:
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Please indicate the type of complication:
integer
C3258281 (UMLS CUI [1])
Complication type
Code List
Please indicate the type of complication:
CL Item
Leakage (0)
C0919691 (UMLS CUI-1)
(Comment:en)
CL Item
Breakdown of anastomosis (1)
C0332853 (UMLS CUI-1)
C3203359 (UMLS CUI-2)
(Comment:en)
CL Item
Wound Infection (2)
C0043241 (UMLS CUI-1)
(Comment:en)
CL Item
Thromboembolic (3)
C0040038 (UMLS CUI-1)
(Comment:en)
CL Item
Hematoma (4)
C0018944 (UMLS CUI-1)
(Comment:en)
CL Item
Stoma related complications (5)
C0009566 (UMLS CUI-1)
C1955856 (UMLS CUI-2)
(Comment:en)
CL Item
Skin desquamation (6)
C0237849 (UMLS CUI-1)
(Comment:en)
CL Item
Dysuria (7)
C0013428 (UMLS CUI-1)
(Comment:en)
CL Item
Dehydration (8)
C0011175 (UMLS CUI-1)
(Comment:en)
CL Item
Weight loss (9)
C1262477 (UMLS CUI-1)
(Comment:en)
CL Item
Febrile neuropathy (10)
C0442874 (UMLS CUI-1)
C0015967 (UMLS CUI-2)
(Comment:en)
CL Item
Neutropenic sepsis (11)
C0853697 (UMLS CUI-1)
C0243026 (UMLS CUI-2)
(Comment:en)
CL Item
Mucositis (12)
C0333355 (UMLS CUI-1)
(Comment:en)
CL Item
skin toxicity (13)
C1167791 (UMLS CUI-1)
(Comment:en)
CL Item
Neurotoxicity (14)
C0235032 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
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