ID

43127

Description

The patient's enrollment information at the time of study entry. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACFCC8EF-1679-775F-E040-BB89AD4328A6

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACFCC8EF-1679-775F-E040-BB89AD4328A6

Mots-clés

Versions (4)
  1. 19/09/2012 19/09/2012 -
  2. 11/08/2014 11/08/2014 - Martin Dugas
  3. 09/01/2015 09/01/2015 - Martin Dugas
  4. 20/09/2021 20/09/2021 -
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20 septembre 2021

DOI

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Licence

Creative Commons BY-NC 3.0 Legacy
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Registration - Enrollment - 3276705v1.0

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: Enrollment
    1. No Instruction available.
Enrollment
Description

Enrollment

Visit Date (Enter the patient's registration date.)
Description

FormCompletionDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
Gender (Select the patient's gender:)
Description

PersonGenderTextType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C17357
UMLS 2011AA Property
C0079399
Date of Birth (Enter the patient's date of birth.)
Description

PersonBirthDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25155
UMLS 2011AA Property
C0005615
Age at Entry
Description

PatientAgeValue

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
Patient Initials (Enter the patient's initials.)
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Date from which to Start Including labs (Enter the date indicating when lab results data should be start being loaded from the centralized lab.)
Description

PrestudyLabDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C38470
NCI Metathesaurus Property
C0039593
Race (Select Yes or No for the following OMB race categories when subject is multi-racial, answer YES to all the apply and No to the other race categories:)
Description

RaceCategoryText

Type de données

text

Alias
NCI Thesaurus Property
C25372
UMLS 2011AA Property
C0683312
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ObjectClass
C17049
UMLS 2011AA ObjectClass
C0034510
Ethnicity (Select one of the following OMB ethnicity categories:)
Description

EthnicGroupCategoryText

Type de données

text

Alias
NCI Thesaurus Property
C25372
UMLS 2011AA Property
C0683312
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ObjectClass
C16564
UMLS 2011AA ObjectClass
C0015031
Registering Institution (Enter the unique CTEP institution code where the patient was originally registered on study e.g., institution where the patient signed the informed consent form.)
Description

RegisteringInstitutionIdentificationCode

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25645
NCI Metathesaurus Property
CL281747
Primary ID
Description

PatientIdentifier

Type de données

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25364
UMLS 2011AA ValueDomain
C0600091
Patient Subgroup (Select the appropriate unique code for identification of uniform groups of patients for separate analysis or treatment as defined in the Clinical Data System CDS.)
Description

PatientSubgroupAssignment

Type de données

text

Alias
NCI Metathesaurus ObjectClass
C0030705
NCI Thesaurus Property
C25693
UMLS 2011AA Property
C1515021
Registering Group (Note: This is required for Inter-Group trials only ¿ otherwise leave blank.)
Description

RegisteringGroup

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25646
UMLS 2011AA ObjectClass
C1514821
NCI Thesaurus Property
C43359
UMLS 2011AA Property
C0441833
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Country Code
Description

CountryCode

Type de données

text

Alias
NCI Thesaurus Property
C25162
UMLS 2011AA Property
C0805701
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25464
UMLS 2011AA ObjectClass
C0454664
Postal Code (For U.S. residents, enter the patient's home 5 digit zip code. Do not enter the last 4 digits of the complete zip code to assure patient confidentiality. Also do not enter the dash.)
Description

AddressPostalCodeIdentifier

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25407
UMLS 2011AA ObjectClass
C1442065
NCI Thesaurus Property
C25621
UMLS 2011AA Property
C1514254
NCI Thesaurus ValueDomain
C25364
UMLS 2011AA ValueDomain
C0600091
NCI Thesaurus ValueDomain-2
C25407
UMLS 2011AA ValueDomain-2
C1442065
NCI Thesaurus ValueDomain-3
C25621
UMLS 2011AA ValueDomain-3
C1514254
Method of Payment (Select the patient's primary method of payment using the following codes:)
Description

PaymentMethod

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C25371
UMLS 2011AA ObjectClass
C0680264
Primary Disease Site (Select the primary disease site of the malignancy from the pick list.)
Description

PrimarySiteofDiseaseAnatomicSiteName

Type de données

text

Alias
NCI Thesaurus ObjectClass
C13717
UMLS 2011AA ObjectClass
C1515974
NCI Thesaurus ObjectClass-2
C25251
UMLS 2011AA ObjectClass-2
C0205225
NCI Thesaurus Property
C2991
UMLS 2011AA Property
C0012634
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain-2
C42614
UMLS 2011AA ValueDomain-2
C0027365
Disease Term (Select a disease term. Use the list of Disease Terms "MedDRA" as listed on the CTEP Web site.)
Description

DiseaseDiagnosisTermName

Type de données

text

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Disease Stage of Entry (Select the stage of the disease at the time of study entry if appropriate. Otherwise, leave it blank.)
Description

DiseaseStageCode

Type de données

text

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C16899
UMLS 2011AA Property
C1300072
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain-2
C2991
UMLS 2011AA ValueDomain-2
C0012634
NCI Thesaurus ValueDomain-3
C16899
UMLS 2011AA ValueDomain-3
C1300072
Disease T Stage (Select the stage of disease based on the primary tumor.)
Description

DiseaseTumorStageNumber

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C3262
UMLS 2011AA Property
C0027651
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property-2
C16899
UMLS 2011AA Property-2
C1300072
Disease N Stage (Select the stage of disease based on the nodes present.)
Description

DiseaseLymphNodeStageNumber

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C12745
UMLS 2011AA Property
C0024204
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property-2
C16899
UMLS 2011AA Property-2
C1300072
Disease M Stage (Select the stage of disease based on the metastases present.)
Description

DiseaseMetastasisStageNumber

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C19151
UMLS 2011AA Property
C0027627
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property-2
C16899
UMLS 2011AA Property-2
C1300072
Histology/Cytopathology (State briefly the type of histology or cytopathology found at the time of original diagnosis.)
Description

Histology/CytopathologyDescription

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ValueDomain-2
C25704
UMLS 2011AA ValueDomain-2
C1527021
NCI Thesaurus ObjectClass
C16681
UMLS 2011AA ObjectClass
C0019638
NCI Metathesaurus Property
CL282989
Date of Confirmation of Histology (Enter the date when the patient's disease status was confirmed, at the treating institution, prior to study entry if required by the protocol.)
Description

HistologicConfirmationDate

Type de données

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25526
UMLS 2011AA ObjectClass
C0205462
NCI Metathesaurus ObjectClass
CL232278
Grade of Histology (Enter the grade of histology at study entry, if appropriate. Leave it blank otherwise.)
Description

HistopathologicDifferentiationTextGrade

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C12801
UMLS 2011AA ObjectClass
C0040300
NCI Thesaurus Property
C18000
UMLS 2011AA Property
C0919553
NCI Thesaurus ValueDomain-2
C18000
UMLS 2011AA ValueDomain-2
C0919553
Date of Diagnosis (Enter the first date of original diagnosis e.g., when a positive biopsy or surgical result was obtained. Do not give the start date of symptoms as the date of diagnosis.)
Description

Diagnosis Date

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2316983
NCI Thesaurus Property
C25626
NCI Thesaurus ObjectClass
C15220
Treatment Assignment Code (Select the appropriate code for the patient's treatment assignment as specified.)
Description

EnrollmentTreatmentStudyAssignmentCode

Type de données

text

Alias
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus ObjectClass-2
C19992
UMLS 2011AA ObjectClass
C1516607
NCI Thesaurus Property
C25162
UMLS 2011AA Property
C0805701
NCI Thesaurus Property-2
C25426
UMLS 2011AA Property-2
C1516050
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain-2
C37948
UMLS 2011AA ValueDomain-2
C1516879
NCI Thesaurus ValueDomain-3
C25426
UMLS 2011AA ValueDomain-3
C1516050
NCI Thesaurus ValueDomain-4
C49656
UMLS 2011AA ValueDomain-4
C0087111
Date Informed Consent Signed (Enter the date the patient signed the informed consent form.)
Description

InformedConsentFormSignedDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C16468
UMLS 2011AA ObjectClass
C0009797
NCI Thesaurus Property
C25679
Date of Informed Consent Version (Enter the date of the informed consent version of the IRB-approved informed consent form that was signed by the patient at the time of study entry.)
Description

ProtocolAmendmentDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Metathesaurus Property
C0680532
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1 Formulaires
  1. StudyEvent: Enrollment
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Enrollment
FormCompletionDate
Item
Visit Date (Enter the patient's registration date.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
Item
Gender (Select the patient's gender:)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
CL.1
Code List
Gender (Select the patient's gender:)
CL Item
Male Gender (Male)
C46109 (NCI Thesaurus)
C1706180 (UMLS 2011AA)
CL Item
Female Gender (Female)
C46110 (NCI Thesaurus)
C0086287 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
PersonBirthDate
Item
Date of Birth (Enter the patient's date of birth.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25155 (NCI Thesaurus Property)
C0005615 (UMLS 2011AA Property)
PatientAgeValue
Item
Age at Entry
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
Patient Initials
Item
Patient Initials (Enter the patient's initials.)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
PrestudyLabDate
Item
Date from which to Start Including labs (Enter the date indicating when lab results data should be start being loaded from the centralized lab.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C0039593 (NCI Metathesaurus Property)
Item
Race (Select Yes or No for the following OMB race categories when subject is multi-racial, answer YES to all the apply and No to the other race categories:)
text
C25372 (NCI Thesaurus Property)
C0683312 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C17049 (NCI Thesaurus ObjectClass)
C0034510 (UMLS 2011AA ObjectClass)
CL.2
Code List
Race (Select Yes or No for the following OMB race categories when subject is multi-racial, answer YES to all the apply and No to the other race categories:)
CL Item
White (White)
C41261 (NCI Thesaurus)
C0007457 (UMLS 2011AA)
CL Item
Black Or African American (Black or African American)
C16352 (NCI Thesaurus)
C0085756 (UMLS 2011AA)
CL Item
Asian (Asian)
C41260 (NCI Thesaurus)
C0078988 (UMLS 2011AA)
CL Item
American Indian Or Alaska Native (American Indian or Alaska Native)
C41259 (NCI Thesaurus)
C1515945 (UMLS 2011AA)
CL Item
Native Hawaiian Or Other Pacific Islander (Native Hawaiian or other Pacific Islander)
C41219 (NCI Thesaurus)
C1513907 (UMLS 2011AA)
CL Item
Not Reported (Not Reported)
C43234 (NCI Thesaurus)
C1706613 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Ethnicity (Select one of the following OMB ethnicity categories:)
text
C25372 (NCI Thesaurus Property)
C0683312 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C16564 (NCI Thesaurus ObjectClass)
C0015031 (UMLS 2011AA ObjectClass)
CL.3
Code List
Ethnicity (Select one of the following OMB ethnicity categories:)
CL Item
Hispanic Or Latino (Hispanic or Latino)
C17459 (NCI Thesaurus)
C0086409 (UMLS 2011AA)
CL Item
Not Hispanic Or Latino (Not Hispanic or Latino)
C41222 (NCI Thesaurus)
C1518424 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Not Reported (Not reported)
C43234 (NCI Thesaurus)
C1706613 (UMLS 2011AA)
RegisteringInstitutionIdentificationCode
Item
Registering Institution (Enter the unique CTEP institution code where the patient was originally registered on study e.g., institution where the patient signed the informed consent form.)
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25645 (NCI Thesaurus ObjectClass)
CL281747 (NCI Metathesaurus Property)
PatientIdentifier
Item
Primary ID
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
PatientSubgroupAssignment
Item
Patient Subgroup (Select the appropriate unique code for identification of uniform groups of patients for separate analysis or treatment as defined in the Clinical Data System CDS.)
text
C0030705 (NCI Metathesaurus ObjectClass)
C25693 (NCI Thesaurus Property)
C1515021 (UMLS 2011AA Property)
RegisteringGroup
Item
Registering Group (Note: This is required for Inter-Group trials only ¿ otherwise leave blank.)
text
C25646 (NCI Thesaurus ObjectClass)
C1514821 (UMLS 2011AA ObjectClass)
C43359 (NCI Thesaurus Property)
C0441833 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
Item
Country Code
text
C25162 (NCI Thesaurus Property)
C0805701 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25464 (NCI Thesaurus ObjectClass)
C0454664 (UMLS 2011AA ObjectClass)
CL.4
Code List
Country Code
CL Item
Ascension Island (AC)
CL Item
Andorra (AD)
C16289 (NCI Thesaurus)
C0002838 (UMLS 2011AA)
CL Item
United Arab Emirates (AE)
C17232 (NCI Thesaurus)
C0041698 (UMLS 2011AA)
CL Item
Afghanistan (AF)
C16267 (NCI Thesaurus)
C0001732 (UMLS 2011AA)
CL Item
Antigua And Barbuda (AG)
C16303 (NCI Thesaurus)
C0003354 (UMLS 2011AA)
CL Item
Anguilla (AI)
C20133 (NCI Thesaurus)
C0003353 (UMLS 2011AA)
CL Item
Albania (AL)
CL Item
Armenia (AM)
C16306 (NCI Thesaurus)
C0003798 (UMLS 2011AA)
CL Item
Netherland Antilles (AN)
CL Item
Angola (AO)
C16292 (NCI Thesaurus)
C0003023 (UMLS 2011AA)
CL Item
Antarctica (AQ)
C18007 (NCI Thesaurus)
C0454691 (UMLS 2011AA)
CL Item
Argentina (AR)
C16305 (NCI Thesaurus)
C0003761 (UMLS 2011AA)
CL Item
American Samoa (AS)
C17739 (NCI Thesaurus)
C0242536 (UMLS 2011AA)
CL Item
Austria (AT)
C16312 (NCI Thesaurus)
C0004348 (UMLS 2011AA)
CL Item
Australia (AU)
C16311 (NCI Thesaurus)
C0004340 (UMLS 2011AA)
CL Item
Aruba (AW)
C17884 (NCI Thesaurus)
C0282379 (UMLS 2011AA)
CL Item
Azerbaidjan (AZ)
CL Item
Bosnia-herzegovina (BA)
C16361 (NCI Thesaurus)
C0006036 (UMLS 2011AA)
CL Item
Barbados (BB)
C16324 (NCI Thesaurus)
C0004739 (UMLS 2011AA)
CL Item
Bangladesh (BD)
C16323 (NCI Thesaurus)
C0004732 (UMLS 2011AA)
CL Item
Belgium (BE)
C16329 (NCI Thesaurus)
C0004950 (UMLS 2011AA)
CL Item
Burkina Faso (BF)
C16369 (NCI Thesaurus)
C0006409 (UMLS 2011AA)
CL Item
Bulgaria (BG)
C16368 (NCI Thesaurus)
C0006368 (UMLS 2011AA)
CL Item
Bahrain (BH)
C16322 (NCI Thesaurus)
C0004684 (UMLS 2011AA)
CL Item
Burundi (BI)
C16371 (NCI Thesaurus)
C0006448 (UMLS 2011AA)
CL Item
Benin (BJ)
CL Item
Bermuda (BM)
C16334 (NCI Thesaurus)
C0005126 (UMLS 2011AA)
CL Item
Brunei Darussalam (BN)
C16367 (NCI Thesaurus)
C0006320 (UMLS 2011AA)
CL Item
Bolivia (BO)
C16359 (NCI Thesaurus)
C0005918 (UMLS 2011AA)
CL Item
Brazil (BR)
C16364 (NCI Thesaurus)
C0006137 (UMLS 2011AA)
CL Item
Bahamas (BS)
C16321 (NCI Thesaurus)
C0004683 (UMLS 2011AA)
CL Item
Bhutan (BT)
C16336 (NCI Thesaurus)
C0005341 (UMLS 2011AA)
CL Item
Bouvet Island (BV)
C20104 (NCI Thesaurus)
C1511278 (UMLS 2011AA)
CL Item
Botswana (BW)
C16363 (NCI Thesaurus)
C0006041 (UMLS 2011AA)
CL Item
Belarus (BY)
C16372 (NCI Thesaurus)
C0006539 (UMLS 2011AA)
CL Item
Belize (BZ)
C16331 (NCI Thesaurus)
C0004952 (UMLS 2011AA)
CL Item
Canada (CA)
C16380 (NCI Thesaurus)
C0006823 (UMLS 2011AA)
CL Item
Cocos Isl. (CC)
CL Item
Rep. Dem. Congo (CD)
CL Item
Central African Rep. (CF)
CL Item
Congo (CG)
C16467 (NCI Thesaurus)
C0009738 (UMLS 2011AA)
CL Item
Switzerland (CH)
C17181 (NCI Thesaurus)
C0039021 (UMLS 2011AA)
CL Item
Ivory Coast (CI)
CL Item
Cook Islands (CK)
C16469 (NCI Thesaurus)
C0009956 (UMLS 2011AA)
CL Item
Chile (CL)
CL Item
Cameroon (CM)
C16379 (NCI Thesaurus)
C0006802 (UMLS 2011AA)
CL Item
China (CN)
C16428 (NCI Thesaurus)
C0008115 (UMLS 2011AA)
CL Item
Colombia (CO)
C16449 (NCI Thesaurus)
C3245499 (UMLS 2011AA)
CL Item
Costa Rica (CR)
C16470 (NCI Thesaurus)
C0010182 (UMLS 2011AA)
CL Item
Cuba (CU)
C16477 (NCI Thesaurus)
C0010435 (UMLS 2011AA)
CL Item
Cape Verde (CV)
C16382 (NCI Thesaurus)
C0006893 (UMLS 2011AA)
CL Item
Christmas Island (CX)
C44482 (NCI Thesaurus)
C0006888 (UMLS 2011AA)
CL Item
Cyprus (CY)
C16480 (NCI Thesaurus)
C0010622 (UMLS 2011AA)
CL Item
Czech Republic (CZ)
C17668 (NCI Thesaurus)
C0206578 (UMLS 2011AA)
CL Item
Germany (DE)
CL Item
Djibouti (DJ)
CL Item
Denmark (DK)
CL Item
Dominica (DM)
CL Item
Dominican Republic (DO)
CL Item
Algeria (DZ)
CL Item
Ecuador (EC)
CL Item
Estonia (EE)
CL Item
Egypt (EG)
CL Item
Western Sahara (EH)
CL Item
Eritrea (ER)
CL Item
Spain (ES)
CL Item
Ethiopia (ET)
CL Item
Finland (FI)
CL Item
Fiji (FJ)
CL Item
Falkland Isl. (FK)
CL Item
Micronesia (FM)
CL Item
Faroe Islands (FO)
CL Item
France (FR)
CL Item
France (european Ter.) (FX)
CL Item
Gabon (GA)
CL Item
Great Britain (GB)
CL Item
Grenada (GD)
CL Item
Georgia (GE)
CL Item
Guiana (fr.) (GF)
CL Item
Guernsey (GG)
CL Item
Ghana (GH)
CL Item
Gibraltar (GI)
CL Item
Greenland (GL)
CL Item
Gambia (GM)
CL Item
Guinea (GN)
CL Item
Guadeloupe (fr.) (GP)
CL Item
Equatorial Guinea (GQ)
CL Item
Greece (GR)
CL Item
South Georgia And South Sandwich Islands (GS)
CL Item
Guatemala (GT)
CL Item
Guam (us) (GU)
CL Item
Guinea Bissau (GW)
CL Item
Guyana (GY)
CL Item
Hong Kong (HK)
CL Item
Heard & Mcdonald Isl. (HM)
CL Item
Honduras (HN)
C16694 (NCI Thesaurus)
C0019905 (UMLS 2011AA)
CL Item
Croatia (HR)
C16474 (NCI Thesaurus)
C0010343 (UMLS 2011AA)
CL Item
Haiti (HT)
C16660 (NCI Thesaurus)
C0018510 (UMLS 2011AA)
CL Item
Hungary (HU)
C16699 (NCI Thesaurus)
C0020174 (UMLS 2011AA)
CL Item
Indonesia (ID)
C16728 (NCI Thesaurus)
C0021247 (UMLS 2011AA)
CL Item
Ireland (IE)
C16757 (NCI Thesaurus)
C0022067 (UMLS 2011AA)
CL Item
Israel (IL)
C16760 (NCI Thesaurus)
C0022271 (UMLS 2011AA)
CL Item
Isle Of Man (IM)
C0022132 (NCI Metathesaurus)
CL Item
India (IN)
C16727 (NCI Thesaurus)
C0021201 (UMLS 2011AA)
CL Item
British Indian O. Ter. (IO)
CL Item
Iraq (IQ)
C16756 (NCI Thesaurus)
C0022066 (UMLS 2011AA)
CL Item
Iran (IR)
C16755 (NCI Thesaurus)
C0022065 (UMLS 2011AA)
CL Item
Iceland (IS)
C16704 (NCI Thesaurus)
C0020750 (UMLS 2011AA)
CL Item
Italy (IT)
C16761 (NCI Thesaurus)
C0022277 (UMLS 2011AA)
CL Item
Jersey (JE)
CL Item
Jamaica (JM)
C16763 (NCI Thesaurus)
C0022337 (UMLS 2011AA)
CL Item
Jordan (JO)
C16765 (NCI Thesaurus)
C0022418 (UMLS 2011AA)
CL Item
Japan (JP)
C16764 (NCI Thesaurus)
C0022341 (UMLS 2011AA)
CL Item
Kenya (KE)
C16769 (NCI Thesaurus)
C0022558 (UMLS 2011AA)
CL Item
Kyrgyz Republic (KG)
CL Item
Cambodia (KH)
C16378 (NCI Thesaurus)
C0006797 (UMLS 2011AA)
CL Item
Kiribati (KI)
C16639 (NCI Thesaurus)
C0017550 (UMLS 2011AA)
CL Item
Comoros (KM)
C16458 (NCI Thesaurus)
C0009490 (UMLS 2011AA)
CL Item
St. Kitts Nevis Anguilla (KN)
CL Item
Korea (north) (KP)
CL Item
Korea (south) (KR)
CL Item
Kuwait (KW)
C16775 (NCI Thesaurus)
C0022804 (UMLS 2011AA)
CL Item
Cayman Islands (KY)
C16391 (NCI Thesaurus)
C0007481 (UMLS 2011AA)
CL Item
Kazakstan (KZ)
CL Item
Laos (LA)
CL Item
Lebanon (LB)
C16784 (NCI Thesaurus)
C0023190 (UMLS 2011AA)
CL Item
Saint Lucia (LC)
C17113 (NCI Thesaurus)
C0036056 (UMLS 2011AA)
CL Item
Liechtenstein (LI)
C16794 (NCI Thesaurus)
C0023668 (UMLS 2011AA)
CL Item
Sri Lanka (LK)
C17163 (NCI Thesaurus)
C0038088 (UMLS 2011AA)
CL Item
Liberia (LR)
C16791 (NCI Thesaurus)
C0023617 (UMLS 2011AA)
CL Item
Lesotho (LS)
CL Item
Lithuania (LT)
C16799 (NCI Thesaurus)
C0023879 (UMLS 2011AA)
CL Item
Luxembourg (LU)
C16803 (NCI Thesaurus)
C0024176 (UMLS 2011AA)
CL Item
Latvia (LV)
C16783 (NCI Thesaurus)
C0023128 (UMLS 2011AA)
CL Item
Libya (LY)
CL Item
Morocco (MA)
C16878 (NCI Thesaurus)
C0026544 (UMLS 2011AA)
CL Item
Monaco (MC)
C16874 (NCI Thesaurus)
C0026405 (UMLS 2011AA)
CL Item
Moldova (MD)
C16871 (NCI Thesaurus)
C0026374 (UMLS 2011AA)
CL Item
Madagascar (MG)
C16808 (NCI Thesaurus)
C0024443 (UMLS 2011AA)
CL Item
Marshall Islands (MH)
C16822 (NCI Thesaurus)
C0024851 (UMLS 2011AA)
CL Item
Macedonia (MK)
C0700290 (NCI Metathesaurus)
CL Item
Mali (ML)
C16816 (NCI Thesaurus)
C0024581 (UMLS 2011AA)
CL Item
Myanmar (MM)
C16370 (NCI Thesaurus)
C0006416 (UMLS 2011AA)
CL Item
Mongolia (MN)
C16875 (NCI Thesaurus)
C0026410 (UMLS 2011AA)
CL Item
Macau (MO)
C16807 (NCI Thesaurus)
C0024403 (UMLS 2011AA)
CL Item
Northern Mariana Isl. (MP)
CL Item
Martinique (fr.) (MQ)
CL Item
Mauritania (MR)
C16826 (NCI Thesaurus)
C0024943 (UMLS 2011AA)
CL Item
Montserrat (MS)
C16876 (NCI Thesaurus)
C0026514 (UMLS 2011AA)
CL Item
Malta (MT)
C16817 (NCI Thesaurus)
C0024653 (UMLS 2011AA)
CL Item
Mauritius (MU)
C16827 (NCI Thesaurus)
C0024944 (UMLS 2011AA)
CL Item
Maldives (MV)
C16815 (NCI Thesaurus)
C0024553 (UMLS 2011AA)
CL Item
Malawi (MW)
C16813 (NCI Thesaurus)
C0024548 (UMLS 2011AA)
CL Item
Mexico (MX)
C16850 (NCI Thesaurus)
C0025885 (UMLS 2011AA)
CL Item
Malaysia (MY)
C16814 (NCI Thesaurus)
C0024552 (UMLS 2011AA)
CL Item
Mozambique (MZ)
C16882 (NCI Thesaurus)
C0026655 (UMLS 2011AA)
CL Item
Namibia (NA)
C16891 (NCI Thesaurus)
C0027366 (UMLS 2011AA)
CL Item
New Caledonia (fr.) (NC)
CL Item
Niger (NE)
C16916 (NCI Thesaurus)
C0028074 (UMLS 2011AA)
CL Item
Norfolk Island (NF)
C16919 (NCI Thesaurus)
C0028366 (UMLS 2011AA)
CL Item
Nigeria (NG)
C16917 (NCI Thesaurus)
C0028075 (UMLS 2011AA)
CL Item
Nicaragua (NI)
C16915 (NCI Thesaurus)
C0028002 (UMLS 2011AA)
CL Item
Netherlands (NL)
C16903 (NCI Thesaurus)
C0027778 (UMLS 2011AA)
CL Item
Norway (NO)
C16920 (NCI Thesaurus)
C0028423 (UMLS 2011AA)
CL Item
Nepal (NP)
C16901 (NCI Thesaurus)
C0027689 (UMLS 2011AA)
CL Item
Nauru (NR)
C16896 (NCI Thesaurus)
C0027496 (UMLS 2011AA)
CL Item
Niue (NU)
C16918 (NCI Thesaurus)
C0028219 (UMLS 2011AA)
CL Item
New Zealand (NZ)
C16914 (NCI Thesaurus)
C0027978 (UMLS 2011AA)
CL Item
Oman (OM)
C16933 (NCI Thesaurus)
C0028971 (UMLS 2011AA)
CL Item
Other (Other)
CL Item
Panama (PA)
C16951 (NCI Thesaurus)
C0030266 (UMLS 2011AA)
CL Item
Peru (PE)
C16972 (NCI Thesaurus)
C0031238 (UMLS 2011AA)
CL Item
Polynesia (fr.) (PF)
CL Item
Papua New Guinea (PG)
C16952 (NCI Thesaurus)
C0030375 (UMLS 2011AA)
CL Item
Philippines (PH)
CL Item
Pakistan (PK)
C16949 (NCI Thesaurus)
C0030211 (UMLS 2011AA)
CL Item
Poland (PL)
C17002 (NCI Thesaurus)
C0032356 (UMLS 2011AA)
CL Item
St. Pierre & Miquelon (PM)
CL Item
Pitcairn (PN)
C16993 (NCI Thesaurus)
C0031995 (UMLS 2011AA)
CL Item
Puerto Rico (PR)
C17043 (NCI Thesaurus)
C0034044 (UMLS 2011AA)
CL Item
Portugal (PT)
C17006 (NCI Thesaurus)
C0032729 (UMLS 2011AA)
CL Item
Palau (PW)
C17733 (NCI Thesaurus)
C0242397 (UMLS 2011AA)
CL Item
Paraguay (PY)
C16953 (NCI Thesaurus)
C0030428 (UMLS 2011AA)
CL Item
Qatar (QA)
C17045 (NCI Thesaurus)
C0034366 (UMLS 2011AA)
CL Item
Reunion (fr.) (RE)
CL Item
Romania (RO)
C17108 (NCI Thesaurus)
C0035826 (UMLS 2011AA)
CL Item
Russian Federation (RU)
CL Item
Rwanda (RW)
C17112 (NCI Thesaurus)
C0035978 (UMLS 2011AA)
CL Item
Saudi Arabia (SA)
C17117 (NCI Thesaurus)
C0036243 (UMLS 2011AA)
CL Item
Solomon Islands (SB)
C17148 (NCI Thesaurus)
C0037623 (UMLS 2011AA)
CL Item
Seychelles (SC)
C17129 (NCI Thesaurus)
C0036919 (UMLS 2011AA)
CL Item
Sudan (SD)
C17170 (NCI Thesaurus)
C0038642 (UMLS 2011AA)
CL Item
Sweden (SE)
C17180 (NCI Thesaurus)
C0038995 (UMLS 2011AA)
CL Item
Singapore (SG)
C17134 (NCI Thesaurus)
C0037173 (UMLS 2011AA)
CL Item
St. Helena (SH)
CL Item
Slovenia (SI)
C17138 (NCI Thesaurus)
C0037334 (UMLS 2011AA)
CL Item
Svalbard & Jan Mayen Isl. (SJ)
CL Item
Slovakia (SK)
C17669 (NCI Thesaurus)
C0206579 (UMLS 2011AA)
CL Item
Sierra Leone (SL)
C17130 (NCI Thesaurus)
C0037063 (UMLS 2011AA)
CL Item
San Marino (SM)
C17115 (NCI Thesaurus)
C0036154 (UMLS 2011AA)
CL Item
Senegal (SN)
C17121 (NCI Thesaurus)
C0036644 (UMLS 2011AA)
CL Item
Somalia (SO)
C17149 (NCI Thesaurus)
C0037640 (UMLS 2011AA)
CL Item
Suriname (SR)
C17175 (NCI Thesaurus)
C0038944 (UMLS 2011AA)
CL Item
St. Tome And Principe (ST)
CL Item
Soviet Union (SU)
CL Item
El Salvador (SV)
C16532 (NCI Thesaurus)
C0013754 (UMLS 2011AA)
CL Item
Syria (SY)
C17182 (NCI Thesaurus)
C0039138 (UMLS 2011AA)
CL Item
Swaziland (SZ)
C17179 (NCI Thesaurus)
C0038983 (UMLS 2011AA)
CL Item
Turks & Caicos Islands (TC)
CL Item
Chad (TD)
C16412 (NCI Thesaurus)
C0007928 (UMLS 2011AA)
CL Item
French Southern Terr. (TF)
CL Item
Togo (TG)
C17202 (NCI Thesaurus)
C0040363 (UMLS 2011AA)
CL Item
Thailand (TH)
C17192 (NCI Thesaurus)
C0039725 (UMLS 2011AA)
CL Item
Tadjikistan (TJ)
CL Item
Tokelau (TK)
C17704 (NCI Thesaurus)
C0220928 (UMLS 2011AA)
CL Item
Turkmenistan (TM)
C17223 (NCI Thesaurus)
C0041403 (UMLS 2011AA)
CL Item
Tunisia (TN)
C17221 (NCI Thesaurus)
C0041388 (UMLS 2011AA)
CL Item
Tonga (TO)
CL Item
East Timor (TP)
C17200 (NCI Thesaurus)
C1452561 (UMLS 2011AA)
CL Item
Turkey (TR)
C17222 (NCI Thesaurus)
C0041400 (UMLS 2011AA)
CL Item
Trinidad & Tobago (TT)
CL Item
Tuvalu (TV)
C17225 (NCI Thesaurus)
C0041413 (UMLS 2011AA)
CL Item
Taiwan (TW)
C17184 (NCI Thesaurus)
C0039260 (UMLS 2011AA)
CL Item
Tanzania (TZ)
C17185 (NCI Thesaurus)
C0039298 (UMLS 2011AA)
CL Item
Ukraine (UA)
C17229 (NCI Thesaurus)
C0041580 (UMLS 2011AA)
CL Item
Uganda (UG)
C17228 (NCI Thesaurus)
C0041573 (UMLS 2011AA)
CL Item
United Kingdom (UK)
C17233 (NCI Thesaurus)
C0041700 (UMLS 2011AA)
CL Item
Us Minor Outlying Isl. (UM)
CL Item
Usa (US)
CL Item
Uruguay (UY)
C17244 (NCI Thesaurus)
C0042113 (UMLS 2011AA)
CL Item
Uzbekistan (UZ)
C17246 (NCI Thesaurus)
C0042177 (UMLS 2011AA)
CL Item
Vatican City State (VA)
CL Item
St. Vincent & Grenadines (VC)
CL Item
Venezuela (VE)
C17250 (NCI Thesaurus)
C0042469 (UMLS 2011AA)
CL Item
Virgin Islands (brit) (VG)
CL Item
Virgin Islands (us) (VI)
CL Item
Vietnam (VN)
C17252 (NCI Thesaurus)
C0042658 (UMLS 2011AA)
CL Item
Vanuatu (VU)
C17247 (NCI Thesaurus)
C0042321 (UMLS 2011AA)
CL Item
Wallis & Futuna Islands (WF)
CL Item
Western Samoa (WS)
CL Item
Yemen (YE)
C17264 (NCI Thesaurus)
C0043402 (UMLS 2011AA)
CL Item
Mayotte (YT)
C16828 (NCI Thesaurus)
C0024974 (UMLS 2011AA)
CL Item
Yugoslavia (YU)
CL Item
South Africa (ZA)
CL Item
Zambia (ZM)
C17267 (NCI Thesaurus)
C0043445 (UMLS 2011AA)
CL Item
Dem. Rep. Of Congo (ZR)
CL Item
Zimbabwe (ZW)
C17268 (NCI Thesaurus)
C0043476 (UMLS 2011AA)
AddressPostalCodeIdentifier
Item
Postal Code (For U.S. residents, enter the patient's home 5 digit zip code. Do not enter the last 4 digits of the complete zip code to assure patient confidentiality. Also do not enter the dash.)
text
C25407 (NCI Thesaurus ObjectClass)
C1442065 (UMLS 2011AA ObjectClass)
C25621 (NCI Thesaurus Property)
C1514254 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
C25407 (NCI Thesaurus ValueDomain-2)
C1442065 (UMLS 2011AA ValueDomain-2)
C25621 (NCI Thesaurus ValueDomain-3)
C1514254 (UMLS 2011AA ValueDomain-3)
Item
Method of Payment (Select the patient's primary method of payment using the following codes:)
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C25371 (NCI Thesaurus ObjectClass)
C0680264 (UMLS 2011AA ObjectClass)
CL.5
Code List
Method of Payment (Select the patient's primary method of payment using the following codes:)
CL Item
Private Insurance (1)
CL Item
Medicare (2)
C16665 (NCI Thesaurus)
C0018717 (UMLS 2011AA)
CL Item
Medicare And Private Insurance (3)
CL Item
Medicaid (4)
C0025071 (NCI Metathesaurus)
CL Item
Medicaid And Medicare (5)
CL Item
Military Or Veterans Sponsored Nos (6)
CL Item
Military Sponsored (including Champus &tricare) (6a)
CL Item
Veterans Sponsored (6b)
CL Item
Self Pay (no Insurance) (7)
CL Item
No Means Of Payment (no Insurance) (8)
CL Item
Other (98)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (99)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Primary Disease Site (Select the primary disease site of the malignancy from the pick list.)
text
C13717 (NCI Thesaurus ObjectClass)
C1515974 (UMLS 2011AA ObjectClass)
C25251 (NCI Thesaurus ObjectClass-2)
C0205225 (UMLS 2011AA ObjectClass-2)
C2991 (NCI Thesaurus Property)
C0012634 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C0027365 (UMLS 2011AA ValueDomain-2)
CL.6
Code List
Primary Disease Site (Select the primary disease site of the malignancy from the pick list.)
CL Item
Abdomen (Abdomen)
C12664 (NCI Thesaurus)
C0230168 (UMLS 2011AA)
CL Item
Abdomen/pelvis (Abdomen/Pelvis)
CL Item
Abdominal Wall (Abdominal wall)
C77608 (NCI Thesaurus)
C0836916 (UMLS 2011AA)
CL Item
Acetabulum (Acetabulum)
C32042 (NCI Thesaurus)
C0000962 (UMLS 2011AA)
CL Item
Pharyngeal Tonsil (Adenoid)
CL Item
Adipose Tissue (Adipose)
CL Item
Adrenal Gland (Adrenal gland)
C12666 (NCI Thesaurus)
C0001625 (UMLS 2011AA)
CL Item
Alveolar Ridge (Alveolar Ridge)
CL Item
Amniotic Fluid (Amniotic Fluid)
CL Item
Ampulla Of Vater (Ampulla of Vater)
CL Item
Anal Canal (Anal canal)
C12375 (NCI Thesaurus)
C0227411 (UMLS 2011AA)
CL Item
Anal Sphincter (Anal sphincter)
C32069 (NCI Thesaurus)
C1275631 (UMLS 2011AA)
C28381 (NCI Thesaurus-3)
C1409894 (UMLS 2011AA-4)
CL Item
Ankle (Ankle)
c32078 (NCI Thesaurus)
CL Item
Anorectum (Anorectum)
CL Item
Antecubital Fossa (Antecubital fossa)
CL Item
Antrum Pylori (Antrum)
CL Item
Anus (Anus)
C43362 (NCI Thesaurus)
C0003461 (UMLS 2011AA)
CL Item
Aorta (Aorta)
C12669 (NCI Thesaurus)
C0003483 (UMLS 2011AA)
CL Item
Aortic Body (Aortic Body)
CL Item
Appendix (Appendix)
C12380 (NCI Thesaurus)
C0003617 (UMLS 2011AA)
CL Item
Aqueous Fluid (Aqueous Fluid)
CL Item
Arm (Arm)
C32141 (NCI Thesaurus)
C1140618 (UMLS 2011AA)
CL Item
Artery (Artery)
C12372 (NCI Thesaurus)
C0003842 (UMLS 2011AA)
CL Item
Ascending Colon (Ascending colon)
C12265 (NCI Thesaurus)
C0227375 (UMLS 2011AA)
CL Item
Ascending Colon Hepatic Flexure (Ascending Colon Hepatic Flexure)
CL Item
Auditory Canal (Auditory canal)
CL Item
Autonomic Nervous System (Autonomic nervous system)
C12673 (NCI Thesaurus)
C0004388 (UMLS 2011AA)
CL Item
Axilla (Axilla)
C12674 (NCI Thesaurus)
C0004454 (UMLS 2011AA)
CL Item
Back (Back)
C13062 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Bile Duct (Bile duct)
C12376 (NCI Thesaurus)
C0005400 (UMLS 2011AA)
CL Item
Bladder (Bladder)
C12414 (NCI Thesaurus)
C0005682 (UMLS 2011AA)
CL Item
Blood (Blood)
C12434 (NCI Thesaurus)
C0229664 (UMLS 2011AA)
CL Item
Blood Vessel (Blood vessel)
C12679 (NCI Thesaurus)
C0005847 (UMLS 2011AA)
CL Item
Bone (Bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
CL Item
Bone Marrow (Bone marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
CL Item
Bowel (Bowel)
CL Item
Brain (Brain)
C12439 (NCI Thesaurus)
C0006104 (UMLS 2011AA)
CL Item
Brain Stem (Brain stem)
C12441 (NCI Thesaurus)
C0006121 (UMLS 2011AA)
CL Item
Breast (Breast)
C12971 (NCI Thesaurus)
C0006141 (UMLS 2011AA)
CL Item
Broad Ligament (Broad ligament)
CL Item
Bronchiole (Bronchiole)
C12684 (NCI Thesaurus)
C0006270 (UMLS 2011AA)
CL Item
Bronchus (Bronchus)
C12683 (NCI Thesaurus)
C0006255 (UMLS 2011AA)
CL Item
Bronchus And Lung (Bronchus and Lung)
CL Item
Brow (Brow)
C0015420 (NCI Metathesaurus)
CL Item
Buccal Cavity (Buccal cavity)
C12504 (NCI Thesaurus)
CL Item
Buccal Mucosa (Buccal mucosa)
C12505 (NCI Thesaurus)
C1578559 (UMLS 2011AA)
CL Item
Buttock (Buttock)
C89806 (NCI Thesaurus)
CL Item
Calf (Calf)
CL Item
Capillary (Capillary)
CL Item
Gastric Cardia (Cardia)
CL Item
Carina (Carina)
C25264 (NCI Thesaurus)
C0225594 (UMLS 2011AA)
CL Item
Carotid Artery (Carotid artery)
C12687 (NCI Thesaurus)
C0007272 (UMLS 2011AA)
CL Item
Carotid Body (Carotid body)
CL Item
Cartilage (Cartilage)
CL Item
Cecum (Cecum)
C12381 (NCI Thesaurus)
C0007531 (UMLS 2011AA)
CL Item
Central Line Catheter (Central Line Catheter)
CL Item
Central Nervous System (Central nervous system)
C12438 (NCI Thesaurus)
C3714787 (UMLS 2011AA)
CL Item
Cerebellum (Cerebellum)
C12445 (NCI Thesaurus)
C0007765 (UMLS 2011AA)
CL Item
Cerebral Cortex (Cerebral cortex)
CL Item
Cerebrospinal Fluid (Cerebrospinal fluid)
C12692 (NCI Thesaurus)
C0007806 (UMLS 2011AA)
CL Item
Cerebrum (Cerebrum)
CL Item
Cervical Spine (Cervical spine)
C69313 (NCI Thesaurus)
C0728985 (UMLS 2011AA)
CL Item
Cervical/thoracic/lumbar Spine (Cervical/Thoracic/Lumbar spine)
CL Item
Cervix (Cervix)
C12311 (NCI Thesaurus)
C0007874 (UMLS 2011AA)
CL Item
Chest (Chest)
C25389 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Chest Wall (Chest wall)
CL035093 (NCI Metathesaurus)
C62484 (NCI Thesaurus)
C0205076 (UMLS 2011AA)
CL Item
Chest/abdomen/pelvis (Chest/Abdomen/Pelvis)
CL Item
Chest/pelvis (Chest/Pelvis)
CL Item
Chin (Chin)
CL Item
Clavicle (Clavicle)
C12695 (NCI Thesaurus)
C0008913 (UMLS 2011AA)
CL Item
Clitoris (Clitoris)
CL Item
Colon (Colon)
C12382 (NCI Thesaurus)
C0009368 (UMLS 2011AA)
CL Item
Colon And Rectum (Colon and rectum)
CL Item
Colon Mucosa (Colon, mucosa only)
CL Item
Common Duct (Common duct)
CL Item
Conjunctiva (Conjunctiva)
C12341 (NCI Thesaurus)
C0009758 (UMLS 2011AA)
CL Item
Connective Tissue (Connective tissue)
C12374 (NCI Thesaurus)
C0009780 (UMLS 2011AA)
CL Item
Descending Colon (Descending colon)
C12268 (NCI Thesaurus)
C0227389 (UMLS 2011AA)
CL Item
Diaphragm (Diaphragm)
C12702 (NCI Thesaurus)
C0011980 (UMLS 2011AA)
CL Item
Duodenum (Duodenum)
C12263 (NCI Thesaurus)
C0013303 (UMLS 2011AA)
CL Item
Ear (Ear)
C12394 (NCI Thesaurus)
C0013443 (UMLS 2011AA)
CL Item
Ear Canal (Ear canal)
CL Item
External Ear (Ear, Pinna (External))
CL Item
Effusion (Effusion)
CL Item
Elbow (Elbow)
CL Item
Endocrine Gland (Endocrine gland)
C12704 (NCI Thesaurus)
C0014133 (UMLS 2011AA)
CL Item
Epididymis (Epididymis)
CL Item
Epidural Spinal Canal Space (Epidural space)
CL Item
Esophagogastric Junction (Esophagogastric junction)
CL Item
Esophagus (Esophagus)
C12389 (NCI Thesaurus)
C0014876 (UMLS 2011AA)
CL Item
Esophageal Mucosa (Esophagus, Mucosa only)
CL Item
Extremities (Extremities)
CL Item
Eye (Eye)
C12401 (NCI Thesaurus)
C0015392 (UMLS 2011AA)
CL Item
Fallopian Tube (Fallopian tube)
C12403 (NCI Thesaurus)
C0015560 (UMLS 2011AA)
CL Item
Femur (Femur)
C12717 (NCI Thesaurus)
C0015811 (UMLS 2011AA)
CL Item
Fibula (Fibula)
C12718 (NCI Thesaurus)
C0016068 (UMLS 2011AA)
CL Item
Finger (Finger)
C32608 (NCI Thesaurus)
C0016129 (UMLS 2011AA)
CL Item
Floor Of Mouth (Floor of Mouth)
CL Item
Body Fluid Or Substance (Fluid)
CL Item
Foot (Foot)
C32622 (NCI Thesaurus)
C0016504 (UMLS 2011AA)
CL Item
Forearm (Forearm)
C32628 (NCI Thesaurus)
C0016536 (UMLS 2011AA)
CL Item
Forehead (Forehead)
CL Item
Foreskin (Foreskin)
CL Item
Frontal Lobe (Frontal lobe)
C12352 (NCI Thesaurus)
C0016733 (UMLS 2011AA)
CL Item
Fundus Of Stomach (Fundus of stomach)
CL Item
Gallbladder (Gallbladder)
C12377 (NCI Thesaurus)
C0016976 (UMLS 2011AA)
CL Item
Ganglion (Ganglia)
CL Item
Gastroesophageal Junction (Gastroesophageal Junction)
CL Item
Gastrointestinal Tract (Gastrointestinal tract)
C34082 (NCI Thesaurus)
C0017189 (UMLS 2011AA)
CL Item
Genitourinary (Genitourinary)
C25350 (NCI Thesaurus)
C0042066 (UMLS 2011AA)
CL Item
Groin (Groin)
C0018246 (NCI Metathesaurus)
CL Item
Gum (Gum)
CL Item
Hand (Hand)
C32712 (NCI Thesaurus)
C0018563 (UMLS 2011AA)
CL Item
Hard Palate (Hard palate)
C12230 (NCI Thesaurus)
C0226901 (UMLS 2011AA)
CL Item
Head - Face Or Neck, Nos (Head - face or neck, NOS)
CL Item
Head/neck (Head/Neck)
CL Item
Head/neck/chest/adb/pelvis (Head/Neck/Chest/Adb/Pelvis)
CL Item
Heart (Heart)
C12727 (NCI Thesaurus)
C0018787 (UMLS 2011AA)
CL Item
Hepatic Duct (Hepatic duct)
CL Item
Hip (Hip)
C64193 (NCI Thesaurus)
C0019552 (UMLS 2011AA)
CL Item
Humerus (Humerus)
C12731 (NCI Thesaurus)
C0020164 (UMLS 2011AA)
CL Item
Hypopharynx (Hypopharynx)
C12246 (NCI Thesaurus)
C0020629 (UMLS 2011AA)
CL Item
Ileum (Ileum)
CL Item
Ilium (Ilium)
C32765 (NCI Thesaurus)
C0020889 (UMLS 2011AA)
CL Item
Intestine (Intestine)
C12736 (NCI Thesaurus)
C0021853 (UMLS 2011AA)
CL Item
Ischium (Ischium)
CL Item
Jaw (Jaw)
C48821 (NCI Thesaurus)
C0022359 (UMLS 2011AA)
CL Item
Jejunum (Jejunum)
C12388 (NCI Thesaurus)
C0022378 (UMLS 2011AA)
CL Item
Joints (Joints)
CL Item
Kidney (Kidney)
C12415 (NCI Thesaurus)
C0022646 (UMLS 2011AA)
CL Item
Knee (Knee)
CL Item
Lacrimal Gland (Lacrimal Gland)
CL Item
Large Bowel (Large bowel)
CL Item
Laryngopharynx (Laryngopharynx)
CL Item
Larynx (Larynx)
C12420 (NCI Thesaurus)
C0023078 (UMLS 2011AA)
CL Item
Leg (Leg)
C32974 (NCI Thesaurus)
C1140621 (UMLS 2011AA)
CL Item
Ligament (Ligament)
CL Item
Lip (Lip)
C12220 (NCI Thesaurus)
C0023759 (UMLS 2011AA)
CL Item
Liver (Liver)
C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)
CL Item
Liver And Intrahepatic Duct (Liver and intrahepatic duct)
CL Item
Liver/spleen (Liver/Spleen)
CL Item
Lumbar Spine (Lumbar spine)
C69314 (NCI Thesaurus)
C0024091 (UMLS 2011AA)
CL Item
Lung (Lung)
C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)
CL Item
Lymph Node (Lymph node)
C12745 (NCI Thesaurus)
C0024204 (UMLS 2011AA)
CL Item
Lymph Node(s) Axilla (Lymph Node(s) Axilla)
CL Item
Lymph Node(s) Cervical (Lymph Node(s) Cervical)
CL Item
Distant Lymph Node (Lymph node(s) Distant)
CL Item
Lymph Node(s) Hilar (Lymph Node(s) Hilar)
CL Item
Lymph Node(s) Inguinal (Lymph Node(s) Inguinal)
CL Item
Lymph Node(s) Int Mammary (Lymph Node(s) Int Mammary)
CL Item
Lymph Node(s) Mammary (Lymph Node(s) Mammary)
CL Item
Paraaortic Region Lymph Node (Lymph node(s) Para aortic)
CL Item
Lymph Node(s) Pelvic (Lymph Node(s) Pelvic)
CL Item
Regional Lymph Node (Lymph node(s) Regional)
CL Item
Scalene Lymph Node (Lymph node(s) Scalene)
CL Item
Lymph Node(s) Subclavicular (Lymph Node(s) Subclavicular)
CL Item
Lymph Node(s) Supraclav (Lymph Node(s) Supraclav)
CL Item
Lymph Nodes (Lymph nodes)
CL Item
Mediastinal Lymph Node (Lymph nodes(s) Mediastinal)
CL Item
Lymphoma (Lymphoma)
C3208 (NCI Thesaurus)
C0024299 (UMLS 2011AA)
CL Item
Mammary Gland (Mammary Gland)
CL Item
Mandible (Mandible)
C12290 (NCI Thesaurus)
C0024687 (UMLS 2011AA)
CL Item
Maxilla (Maxilla)
C26470 (NCI Thesaurus)
C0024947 (UMLS 2011AA)
CL Item
Mediastinum (Mediastinum)
C12748 (NCI Thesaurus)
C0025066 (UMLS 2011AA)
CL Item
Mesentery (Mesentery)
CL Item
Mesothelium (Mesothelium)
CL Item
Mini Mantle (Mini Mantle)
CL Item
Mouth (Mouth)
C0922752 (NCI Metathesaurus)
CL Item
Muscle (Muscle)
C13056 (NCI Thesaurus)
C0026845 (UMLS 2011AA)
CL Item
Nail (Nails)
CL Item
Nasal Cavity (Nasal Cavity)
CL Item
Nasopharynx (Nasopharynx)
C12423 (NCI Thesaurus)
C0027442 (UMLS 2011AA)
CL Item
Neck (Neck)
C13063 (NCI Thesaurus)
C0027530 (UMLS 2011AA)
CL Item
Neck Chest (Neck/Chest)
CL Item
Neck/chest/abdomen/pelvis (Neck/Chest/Abdomen/Pelvis)
CL Item
Nerve (Nerve)
C12466 (NCI Thesaurus)
C0027740 (UMLS 2011AA)
CL Item
Cranial Nerve (Nerve(s) Cranial)
CL Item
Not Applicable (Not Applicable)
CL Item
Ocular Orbits (Ocular Orbits)
CL Item
Omentum (Omentum)
C33209 (NCI Thesaurus)
C0028977 (UMLS 2011AA)
CL Item
Oral Cavity (Oral cavity)
C12421 (NCI Thesaurus)
C0226896 (UMLS 2011AA)
CL Item
Oral Cavity Mucosa (Oral Cavity, Mucosa only)
CL Item
Oropharynx (Oropharynx)
CL Item
Other (Other)
CL Item
Ovary (Ovary)
C12404 (NCI Thesaurus)
C0029939 (UMLS 2011AA)
CL Item
Posterior Anterior/lateral (PA/Lat)
CL Item
Palate (Palate)
C12229 (NCI Thesaurus)
C0700374 (UMLS 2011AA)
CL Item
Pancreas (Pancreas)
C12393 (NCI Thesaurus)
C0030274 (UMLS 2011AA)
CL Item
Paraspinal Ganglion (Paraspinal Ganglion)
CL Item
Parathyroid Gland (Parathyroid)
CL Item
Parotid Gland (Parotid gland)
C12427 (NCI Thesaurus)
C0030580 (UMLS 2011AA)
CL Item
Patella (Patella)
C0030647 (NCI Metathesaurus)
CL Item
Pelvis (Pelvis)
C12767 (NCI Thesaurus)
C0030797 (UMLS 2011AA)
CL Item
Penis (Penis)
C12409 (NCI Thesaurus)
C0030851 (UMLS 2011AA)
CL Item
Perianus (Perianus)
CL Item
Pericardium (Pericardium)
C13005 (NCI Thesaurus)
C0031050 (UMLS 2011AA)
CL Item
Peritoneal Cavity (Peritoneal cavity)
C12769 (NCI Thesaurus)
C1704247 (UMLS 2011AA)
CL Item
Peritoneum (Peritoneum)
CL Item
Pharynx (Pharynx)
C12425 (NCI Thesaurus)
C0031354 (UMLS 2011AA)
CL Item
Pineal Gland (Pineal Gland)
CL Item
Pituitary Gland (Pituitary gland)
C12399 (NCI Thesaurus)
C0032005 (UMLS 2011AA)
CL Item
Placenta (Placenta)
CL Item
Pleura (Pleura)
C12469 (NCI Thesaurus)
C0032225 (UMLS 2011AA)
CL Item
Popliteal Fossa (Popliteal fossa)
CL Item
Prostate (Prostate)
C12410 (NCI Thesaurus)
C0033572 (UMLS 2011AA)
CL Item
Pylorus (Pylorus)
CL Item
Rectosigmoid Junction (Rectosigmoid Junction)
CL Item
Rectum (Rectum)
C12390 (NCI Thesaurus)
C0034896 (UMLS 2011AA)
CL Item
Retina (Retina)
C12343 (NCI Thesaurus)
C0035298 (UMLS 2011AA)
CL Item
Retro-orbital Area (Retro-orbital Area)
CL Item
Retroperitoneum (Retroperitoneum)
C12298 (NCI Thesaurus)
C0035359 (UMLS 2011AA)
CL Item
Ribs (Ribs)
C12782 (NCI Thesaurus)
C0035561 (UMLS 2011AA)
CL Item
Round Ligament (Round ligament)
CL Item
Sacrum (Sacrum)
C33508 (NCI Thesaurus)
C0036037 (UMLS 2011AA)
CL Item
Salivary Gland (Salivary gland)
C12426 (NCI Thesaurus)
C0036098 (UMLS 2011AA)
CL Item
Scalp (Scalp)
C89807 (NCI Thesaurus)
CL Item
Scapula (Scapula)
C12783 (NCI Thesaurus)
C0036277 (UMLS 2011AA)
CL Item
Scrotum (Scrotum)
C12785 (NCI Thesaurus)
C0036471 (UMLS 2011AA)
CL Item
Shoulder Joint (Shoulder)
C25203 (NCI Thesaurus)
C0037004 (UMLS 2011AA)
CL Item
Sigmoid Colon (Sigmoid colon)
C12384 (NCI Thesaurus)
C0227391 (UMLS 2011AA)
CL Item
Sinus(es) (Sinus(es))
CL Item
Sinus(es), Maxillary (Sinus(es), Maxillary)
CL Item
Skeletal Muscle Tissue (Skeletal Muscle)
CL Item
Skin (Skin)
C12470 (NCI Thesaurus)
C1123023 (UMLS 2011AA)
CL Item
Skull (Skull)
C12789 (NCI Thesaurus)
C0037303 (UMLS 2011AA)
CL Item
Small Bowel Mucosa (Small Bowel, Mucosa only)
CL Item
Small Intestine (Small intestine)
C12386 (NCI Thesaurus)
C0021852 (UMLS 2011AA)
CL Item
Soft Tissue (Soft Tissue)
CL Item
Spinal Cord (Spinal Cord)
CL Item
Spine (Spine)
CL Item
Spine/femur (Spine/Femur)
CL Item
Spine/femur/radius (Spine/Femur/Radius)
CL Item
Spleen (Spleen)
C12432 (NCI Thesaurus)
C0037993 (UMLS 2011AA)
CL Item
Splenic Flexure (Splenic Flexure)
CL Item
Sternum (Sternum)
C12793 (NCI Thesaurus)
C0038293 (UMLS 2011AA)
CL Item
Stomach (Stomach)
C12391 (NCI Thesaurus)
C0038351 (UMLS 2011AA)
CL Item
Stomach Mucosa (Stomach, Mucosa only)
CL Item
Subcutaneous Tissue (Subcutaneous tissue)
CL Item
Synovial Membrane (Synovium)
CL Item
Tendon (Tendon)
CL Item
Testis (Testicle)
C12412 (NCI Thesaurus)
C0039597 (UMLS 2011AA)
CL Item
Testicle (Testicle)
C12412 (NCI Thesaurus)
C0039597 (UMLS 2011AA)
CL Item
Thigh (Thigh)
CL Item
Thoracic Spine (Thoracic spine)
C69315 (NCI Thesaurus)
C0581269 (UMLS 2011AA)
CL Item
Thoracic/lumbar Spine (Thoracic/Lumbar spine)
CL Item
Thorax (Thorax)
C12799 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Throat (Throat)
CL Item
Thymus (Thymus)
C12433 (NCI Thesaurus)
C0040113 (UMLS 2011AA)
CL Item
Thyroid Gland (Thyroid gland)
C12400 (NCI Thesaurus)
C0040132 (UMLS 2011AA)
CL Item
Tibia (Tibia)
CL Item
Tongue (Tongue)
C12422 (NCI Thesaurus)
C0040408 (UMLS 2011AA)
CL Item
Tongue, Base Of Tongue (Tongue, Base of tongue)
CL Item
Tonsil (Tonsil)
C12802 (NCI Thesaurus)
C0836921 (UMLS 2011AA)
CL Item
Pharyngeal Tonsil (Tonsil, Pharyngeal)
CL Item
Trachea (Trachea)
C12428 (NCI Thesaurus)
C0040578 (UMLS 2011AA)
CL Item
Trachea Main Bronchus (Trachea/Major Bronchi)
CL Item
Transverse Colon (Transverse Colon)
CL Item
Trunk (Trunk)
C33816 (NCI Thesaurus)
C0460005 (UMLS 2011AA)
CL Item
Superficial Trunk (Trunk, Superficial)
CL Item
Umbilical Cord (Umbilical Cord)
CL Item
Upper Extremity (Upper extremity)
CL Item
Ureter (Ureter)
C12416 (NCI Thesaurus)
C0041951 (UMLS 2011AA)
CL Item
Urethra (Urethra)
CL Item
Urinary Tract (Urinary tract)
CL Item
Uterus (Uterus)
C12405 (NCI Thesaurus)
C0042149 (UMLS 2011AA)
CL Item
Uvula (Uvula)
C12232 (NCI Thesaurus)
C0042173 (UMLS 2011AA)
CL Item
Vagina (Vagina)
C12407 (NCI Thesaurus)
C0042232 (UMLS 2011AA)
CL Item
Vas Deferens (Vas Deferens)
CL Item
Vein (Vein)
CL Item
Vena Cava (Vena Cava, Inferior/Superior)
CL Item
Vertebra (Vertebra)
C12933 (NCI Thesaurus)
C0549207 (UMLS 2011AA)
CL Item
Vertebral Column (Vertebral column)
C0037949 (NCI Metathesaurus)
CL Item
Vulva (Vulva)
C12408 (NCI Thesaurus)
C0042993 (UMLS 2011AA)
CL Item
Whole Body (Whole body)
C0444584 (NCI Metathesaurus)
CL Item
Wrist (Wrist)
C33894 (NCI Thesaurus)
C1322271 (UMLS 2011AA)
DiseaseDiagnosisTermName
Item
Disease Term (Select a disease term. Use the list of Disease Terms "MedDRA" as listed on the CTEP Web site.)
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
Item
Disease Stage of Entry (Select the stage of the disease at the time of study entry if appropriate. Otherwise, leave it blank.)
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus Property)
C1300072 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ValueDomain-2)
C0012634 (UMLS 2011AA ValueDomain-2)
C16899 (NCI Thesaurus ValueDomain-3)
C1300072 (UMLS 2011AA ValueDomain-3)
CL.7
Code List
Disease Stage of Entry (Select the stage of the disease at the time of study entry if appropriate. Otherwise, leave it blank.)
CL Item
Stage 0 (0)
C28051 (NCI Thesaurus)
C0441763 (UMLS 2011AA)
CL Item
Stage A (A)
C28056 (NCI Thesaurus)
C0441778 (UMLS 2011AA)
CL Item
Stage B (B)
C28057 (NCI Thesaurus)
C0441781 (UMLS 2011AA)
CL Item
Stage C (C)
C28060 (NCI Thesaurus)
C0441785 (UMLS 2011AA)
CL Item
Stage D (D)
C28061 (NCI Thesaurus)
C0441789 (UMLS 2011AA)
CL Item
Stage D0 (D0)
CL Item
Stage D1 (D1)
C28062 (NCI Thesaurus)
C0441790 (UMLS 2011AA)
CL Item
Stage D2 (D2)
C28063 (NCI Thesaurus)
C0441791 (UMLS 2011AA)
CL Item
Stage D3 (D3)
CL Item
Stage I (I)
C27966 (NCI Thesaurus)
C0441766 (UMLS 2011AA)
CL Item
Stage Ia (IA)
C27975 (NCI Thesaurus)
C0456595 (UMLS 2011AA)
CL Item
Stage Ib (IB)
C27976 (NCI Thesaurus)
C0456597 (UMLS 2011AA)
CL Item
Stage Ic (IC)
C27981 (NCI Thesaurus)
C0456607 (UMLS 2011AA)
CL Item
Stage Ie (extranodal) (IE)
CL Item
Stage Ii (II)
C28054 (NCI Thesaurus)
C0441767 (UMLS 2011AA)
CL Item
Stage Iia (IIA)
C27967 (NCI Thesaurus)
C0441768 (UMLS 2011AA)
CL Item
Stage Iib (IIB)
C27968 (NCI Thesaurus)
C0441769 (UMLS 2011AA)
CL Item
Stage Iic (IIC)
C27969 (NCI Thesaurus)
C0441770 (UMLS 2011AA)
CL Item
Stage Iie (extranodal) (IIE)
CL Item
Stage Iii (III)
C27970 (NCI Thesaurus)
C0441771 (UMLS 2011AA)
CL Item
Stage Iiia (IIIA)
C27977 (NCI Thesaurus)
C0456598 (UMLS 2011AA)
CL Item
Stage Iiib (IIIB)
C27978 (NCI Thesaurus)
C0456599 (UMLS 2011AA)
CL Item
Iiic (IIIC)
C27982 (NCI Thesaurus)
C0456608 (UMLS 2011AA)
CL Item
Stage Iv (IV)
C27971 (NCI Thesaurus)
C0441772 (UMLS 2011AA)
CL Item
Stage Iva (IVA)
C27979 (NCI Thesaurus)
C0456600 (UMLS 2011AA)
CL Item
Stage Ivb (IVB)
C27980 (NCI Thesaurus)
C0456601 (UMLS 2011AA)
DiseaseTumorStageNumber
Item
Disease T Stage (Select the stage of disease based on the primary tumor.)
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus Property)
C0027651 (UMLS 2011AA Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus Property-2)
C1300072 (UMLS 2011AA Property-2)
DiseaseLymphNodeStageNumber
Item
Disease N Stage (Select the stage of disease based on the nodes present.)
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus Property)
C0024204 (UMLS 2011AA Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus Property-2)
C1300072 (UMLS 2011AA Property-2)
DiseaseMetastasisStageNumber
Item
Disease M Stage (Select the stage of disease based on the metastases present.)
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C19151 (NCI Thesaurus Property)
C0027627 (UMLS 2011AA Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus Property-2)
C1300072 (UMLS 2011AA Property-2)
Histology/CytopathologyDescription
Item
Histology/Cytopathology (State briefly the type of histology or cytopathology found at the time of original diagnosis.)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25704 (NCI Thesaurus ValueDomain-2)
C1527021 (UMLS 2011AA ValueDomain-2)
C16681 (NCI Thesaurus ObjectClass)
C0019638 (UMLS 2011AA ObjectClass)
CL282989 (NCI Metathesaurus Property)
HistologicConfirmationDate
Item
Date of Confirmation of Histology (Enter the date when the patient's disease status was confirmed, at the treating institution, prior to study entry if required by the protocol.)
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ObjectClass)
C0205462 (UMLS 2011AA ObjectClass)
CL232278 (NCI Metathesaurus ObjectClass)
Item
Grade of Histology (Enter the grade of histology at study entry, if appropriate. Leave it blank otherwise.)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus Property)
C0919553 (UMLS 2011AA Property)
C18000 (NCI Thesaurus ValueDomain-2)
C0919553 (UMLS 2011AA ValueDomain-2)
CL.8
Code List
Grade of Histology (Enter the grade of histology at study entry, if appropriate. Leave it blank otherwise.)
CL Item
High Grade (High Grade)
C14158 (NCI Thesaurus)
C0205082 (UMLS 2011AA)
CL Item
Low Grade (Low Grade)
C14161 (NCI Thesaurus)
C1282907 (UMLS 2011AA)
CL Item
Moderately Differentiated (Moderately)
C14162 (NCI Thesaurus)
C0205616 (UMLS 2011AA)
CL Item
Not Applicable (N/A)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Not Otherwise Specified (NOS)
CL006269 (NCI Metathesaurus)
CL Item
Not Done (Not Done)
C49484 (NCI Thesaurus)
C1272696 (UMLS 2011AA)
CL Item
Poorly Differentiated (Poorly)
C14167 (NCI Thesaurus)
C0205617 (UMLS 2011AA)
CL Item
Undifferentiated (Undifferentiated)
C14176 (NCI Thesaurus)
C0205618 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Well Differentiated (Well)
C14171 (NCI Thesaurus)
C0205615 (UMLS 2011AA)
Diagnosis Date
Item
Date of Diagnosis (Enter the first date of original diagnosis e.g., when a positive biopsy or surgical result was obtained. Do not give the start date of symptoms as the date of diagnosis.)
date
C25164 (NCI Thesaurus ValueDomain)
C2316983 (UMLS CUI-1)
C25626 (NCI Thesaurus Property)
C15220 (NCI Thesaurus ObjectClass)
EnrollmentTreatmentStudyAssignmentCode
Item
Treatment Assignment Code (Select the appropriate code for the patient's treatment assignment as specified.)
text
C15368 (NCI Thesaurus ObjectClass)
C19992 (NCI Thesaurus ObjectClass-2)
C1516607 (UMLS 2011AA ObjectClass)
C25162 (NCI Thesaurus Property)
C0805701 (UMLS 2011AA Property)
C25426 (NCI Thesaurus Property-2)
C1516050 (UMLS 2011AA Property-2)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C37948 (NCI Thesaurus ValueDomain-2)
C1516879 (UMLS 2011AA ValueDomain-2)
C25426 (NCI Thesaurus ValueDomain-3)
C1516050 (UMLS 2011AA ValueDomain-3)
C49656 (NCI Thesaurus ValueDomain-4)
C0087111 (UMLS 2011AA ValueDomain-4)
InformedConsentFormSignedDate
Item
Date Informed Consent Signed (Enter the date the patient signed the informed consent form.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
ProtocolAmendmentDate
Item
Date of Informed Consent Version (Enter the date of the informed consent version of the IRB-approved informed consent form that was signed by the patient at the time of study entry.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C0680532 (NCI Metathesaurus Property)
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