ID
42686
Description
USMCI 8214/Z6091: On-Study Form Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=60004F3F-C2F6-CADB-E040-BB89AD43053A
Link
Keywords
Versions (3)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 9/17/21 9/17/21 -
Uploaded on
September 17, 2021
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Colorectal Cancer NCT01167725 On-Study - USMCI 8214/Z6091: On-Study Form - 2823136v1.0
No Instruction available.
- StudyEvent: USMCI 8214/Z6091: On-Study Form
Description
Patient Demographics
Description
PatientRegistrationDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C25646
- UMLS 2011AA Property
- C1514821
Description
Patient Weight
Data type
float
Measurement units
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Description
Patient Height
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0489786
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25347
Description
Body Surface Area
Data type
float
Measurement units
- m2
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS CUI-1
- C0005902
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property
- C25157
Description
Extenet Of Peritoneal Disease
Description
DiseaseorDisorderLaparoscopyStagingInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C16969
- UMLS 2011AA Property
- C0031150
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property-2
- C15608
- UMLS 2011AA Property-2
- C0332305
Description
PeritonealCarcinomatosisInvolvementScore
Data type
float
Alias
- NCI Thesaurus Property
- C25548
- UMLS 2011AA Property
- C1314939
- NCI Thesaurus ObjectClass
- C25313
- UMLS 2011AA ObjectClass
- C0442034
- NCI Thesaurus ObjectClass-2
- C3693
- UMLS 2011AA ObjectClass-2
- C0205699
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Description
PeritonealCarcinomatosisEpigastricInvolvementMeasurement
Data type
float
Measurement units
- cm
Alias
- NCI Thesaurus ObjectClass
- C25313
- UMLS 2011AA ObjectClass
- C0442034
- NCI Thesaurus ObjectClass-2
- C3693
- UMLS 2011AA ObjectClass-2
- C0205699
- NCI Thesaurus Property
- C25548
- UMLS 2011AA Property
- C1314939
- NCI Thesaurus Property-2
- C28026
- UMLS 2011AA Property-2
- C0521440
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
Description
SmallBowelObstructionInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C12386
- UMLS 2011AA ObjectClass
- C0021852
- NCI Thesaurus Property
- C3284
- UMLS 2011AA Property
- C0028778
Description
Pathology Information
Description
ColorectalMalignantNeoplasmDescriptionType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C13363
- UMLS 2011AA ObjectClass
- C0555952
- NCI Thesaurus ObjectClass-2
- C9305
- UMLS 2011AA ObjectClass-2
- C0006826
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
ColorectalTumorPathologicTStage
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C13363
- UMLS 2011AA ObjectClass-2
- C0555952
- NCI Thesaurus Property
- C25610
- UMLS 2011AA Property
- C1521733
- NCI Thesaurus Property-2
- C25728
- UMLS 2011AA Property-2
- C0475455
- NCI Thesaurus ValueDomain
- C16899
- UMLS 2011AA ValueDomain
- C1300072
Description
ColorectalTumorPathologicNStage
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C13363
- UMLS 2011AA ObjectClass-2
- C0555952
- NCI Thesaurus Property
- C25610
- UMLS 2011AA Property
- C1521733
- NCI Thesaurus Property-2
- C25580
- UMLS 2011AA Property-2
- C0456532
- NCI Thesaurus ValueDomain
- C16899
- UMLS 2011AA ValueDomain
- C1300072
Description
ColorectalTumorHistologicClassificationAmericanJointCommitteeonCancerGrade
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C13363
- UMLS 2011AA ObjectClass-2
- C0555952
- NCI Thesaurus Property
- C25526
- UMLS 2011AA Property
- C0205462
- NCI Thesaurus Property-2
- C25161
- UMLS 2011AA Property-2
- C0008902
- NCI Thesaurus ValueDomain
- C39315
- UMLS 2011AA ValueDomain
- C1515946
- NCI Thesaurus ValueDomain-2
- C48309
- UMLS 2011AA ValueDomain-2
- C0441800
Description
TumorLymphovascularInvasionInd
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C20625
- UMLS 2011AA Property
- C1269955
- NCI Thesaurus Property-2
- C25561
- UMLS 2011AA Property-2
- C1518090
Description
ColorectalMalignantNeoplasmMucinCellularSecretionPresentIndicator
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C13363
- UMLS 2011AA ObjectClass
- C0555952
- NCI Thesaurus ObjectClass-2
- C9305
- UMLS 2011AA ObjectClass-2
- C0006826
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property-2
- C17119
- UMLS 2011AA Property-2
- C1327616
- NCI Thesaurus Property-3
- C16883
- UMLS 2011AA Property-3
- C0026682
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
ColorectalMalignantNeoplasmOncogeneK-RasPresentStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C13363
- UMLS 2011AA ObjectClass
- C0555952
- NCI Thesaurus ObjectClass-2
- C9305
- UMLS 2011AA ObjectClass-2
- C0006826
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property-2
- C16766
- UMLS 2011AA Property-2
- C1537502
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
ColorectalMalignantNeoplasmThymidylateSynthasePresentStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C13363
- UMLS 2011AA ObjectClass
- C0555952
- NCI Thesaurus ObjectClass-2
- C9305
- UMLS 2011AA ObjectClass-2
- C0006826
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property-2
- C17199
- UMLS 2011AA Property-2
- C0040085
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
ColorectalMalignantNeoplasmMicrosatelliteInstabilityPresentStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C13363
- UMLS 2011AA ObjectClass
- C0555952
- NCI Thesaurus ObjectClass-2
- C9305
- UMLS 2011AA ObjectClass-2
- C0006826
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property-2
- C36318
- UMLS 2011AA Property-2
- C0920269
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
Prior Treatment
Description
PriorAdjuvantChemotherapyColonCarcinomaAdministeredInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus ObjectClass-3
- C2140
- UMLS 2011AA ObjectClass-3
- C0001552
- NCI Thesaurus Property
- C4910
- UMLS 2011AA Property
- C0699790
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
PriorChemotherapyRegimenText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C15697
- UMLS 2011AA Property
- C0040808
Description
PriorAdjuvantChemotherapyAdministeredYearDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus ObjectClass-3
- C2140
- UMLS 2011AA ObjectClass-3
- C0001552
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C29848
- UMLS 2011AA ValueDomain-2
- C0439234
Description
PriorColonCarcinomaSurgicalProcedureInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C15329
- UMLS 2011AA Property
- C0543467
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus ObjectClass-2
- C4910
- UMLS 2011AA ObjectClass-2
- C0699790
Description
PriorSurgeryPerformedText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C15329
- UMLS 2011AA ObjectClass
- C0543467
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
Description
PriorSurgeryDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C15329
- UMLS 2011AA ObjectClass
- C0543467
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Similar models
No Instruction available.
- StudyEvent: USMCI 8214/Z6091: On-Study Form
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass-2)
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C3693 (NCI Thesaurus ObjectClass-2)
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C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
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C0678257 (UMLS 2011AA Property)
C0031149 (UMLS 2011AA)
C0205225 (UMLS 2011AA)
C2953 (NCI Thesaurus-3)
C0009375 (UMLS 2011AA-4)
C0027651 (UMLS 2011AA ObjectClass)
C13363 (NCI Thesaurus ObjectClass-2)
C0555952 (UMLS 2011AA ObjectClass-2)
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C0027651 (UMLS 2011AA ObjectClass)
C13363 (NCI Thesaurus ObjectClass-2)
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C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C0027651 (UMLS 2011AA ObjectClass)
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C0555952 (UMLS 2011AA ObjectClass-2)
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C0008902 (UMLS 2011AA Property-2)
C39315 (NCI Thesaurus ValueDomain)
C1515946 (UMLS 2011AA ValueDomain)
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C0441800 (UMLS 2011AA ValueDomain-2)
C0205615 (UMLS 2011AA)
C0205616 (UMLS 2011AA)
C0205617 (UMLS 2011AA)
C0205618 (UMLS 2011AA)
C1522602 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C20625 (NCI Thesaurus Property)
C1269955 (UMLS 2011AA Property)
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C0150312 (UMLS 2011AA)
C0555952 (UMLS 2011AA ObjectClass)
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C0006826 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C17199 (NCI Thesaurus Property-2)
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