ID

43302

Beschrijving

RTOG 0724 Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy: Initial Evaluation Form (I1) NCT00980954 Chemotherapy and Pelvic Radiation Therapy With or Without Additional Chemotherapy in Treating Patients With High-Risk Early-Stage Cervical Cancer After Radical Hysterectomy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D016EA3-A43F-2E2A-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5D016EA3-A43F-2E2A-E044-0003BA3F9857

Trefwoorden

Geüploaded op

20 september 2021

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy

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RTOG 0724 Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy: Initial Evaluation Form (I1) NCT00980954

model
Details

INSTRUCTIONS: All questions must be answered per code table and/or instructions. Record dates as mm-dd-yyyy unless otherwise specified

1 Formulieren

StudyEvent: RTOG 0724 Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy: Initial Evaluation Form (I1)
1. INSTRUCTIONS: All questions must be answered per code table and/or instructions. Record dates as mm-dd-yyyy unless otherwise specified

Name

Type

Description | Question | Decode (Coded Value)

Datatype

Alias

Header Module

Item Group

Header module

Protocol ID RTOG

Item

RTOG Study No.

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Item

Case #

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)

Institution Name

Item

Institution

text

C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)

Institution Number

Item

Institution No.

text

C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)

Patient Initials

Item

Participant Initials

text

C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)

Trial subject ID RTOG

Item

RTOG Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

Data amended

Item

Amended Data (INSTRUCTIONS: All questions must be answered per code table and/or instructions. Record dates as mm-dd-yyy unless otherwise specified.)

boolean

C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)

Assessment

Item Group

Assessment

PatientAgeValue

Item

Patient Age

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)

ZubrodPerformanceStatusScore

Item

Performance Status (Zubrod)

text

C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)

CL.2

Code List

Performance Status (Zubrod)

CL Item

Normal Activity (0)

CL Item

Symptoms, But Nearly Fully Ambulatory (1)

CL Item

Some Bed Time, But Needs To Be In Bed <50% Of Normal Daytime (2)

CL Item

Needs To Be In Bed > 50% Of Normal Daytime (3)

CL Item

Unable To Get Out Of Bed (4)

GynecologicTumorGroupingGynecologicTumorGroupingStage

Item

FIGO staging (CLINICAL AJCC 6TH EDITION)

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C28016 (NCI Thesaurus ObjectClass-2)
C0205480 (UMLS 2011AA ObjectClass-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25523 (NCI Thesaurus Property)
C1522242 (UMLS 2011AA Property)

CL.3

Code List

FIGO staging (CLINICAL AJCC 6TH EDITION)

CL Item

Stage Ia2 Cervical Cancer (IA2)

C6315 (NCI Thesaurus)
C1336110 (UMLS 2011AA)
C6315 (NCI Thesaurus-3)
C1336110 (UMLS 2011AA-4)

CL Item

Stage Ib Cervical Cancer (IB)

C6316 (NCI Thesaurus)
C0278582 (UMLS 2011AA)
C6316 (NCI Thesaurus-3)
C0278582 (UMLS 2011AA-4)

CL Item

Stage Iia Cervical Cancer (IIA)

C6319 (NCI Thesaurus)
C0278588 (UMLS 2011AA)
C6319 (NCI Thesaurus-3)
C0278588 (UMLS 2011AA-4)

CervicalTumorPathologicTStage

Item

Pathologic T Stage

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12844 (NCI Thesaurus ObjectClass-2)
C0205064 (UMLS 2011AA ObjectClass-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25728 (NCI Thesaurus Property)
C0475455 (UMLS 2011AA Property)

CL.4

Code List

Pathologic T Stage

CL Item

No Evidence Of Primary Tumor (T0)

CL Item

Cervical Carcinoma Confined To Uterus (extension To Corpus Should Be Disregarded) (T1)

CL Item

Invasive Carcinoma Diagnosed Only By Microscopy (T1a)

CL Item

Measured Stromal Invasion 3 Mm Or Less In Depth And 7 Mm Or Less In Horizontal Spread (T1a1)

CL Item

Measured Stromal Invasion More Than 3 Mm And Not More Than 5 Mm With A Horizontal Spread 7 Mm Or Less (T1a2)

CL Item

Clinically Visible Lesion Confined To The Cervix Or Microscopic Lesion Greater Than T1a2 (T1b)

CL Item

Clinically Visible Lesion 4 Cm Or Less In Greatest Dimension (T1b1)

CL Item

Clinically Visible Lesion More Than 4 Cm In Greatest Dimension (T1b2)

CL Item

Cervical Carcinoma Invades Beyond Uterus But Not To Pelvic Wall Or To The Lower Third Of The Vagina (T2)

CL Item

Tumor With Parametrial Involvement (T2b)

CL Item

Tumor Extends To The Pelvic Wall And/or Involves The Lower Third Of The Vagina, And/or Causes Hydronephrosis Or Nonfunctioning Kidney (T3)

CL Item

Tumor Involves Lower Third Of The Vagina, No Extension To Pelvic Wall (T3a)

CL Item

Tumor Extends To Pelvic Wall And/or Causes Hydronephrosis Or Nonfunctioning Kidney (T3b)

CL Item

Tumor Invades Mucosa Of The Bladder Or Rectum, And/or Extends Beyond True Pelvis (T4)

CL Item

Carcinoma In Situ (Tis)

C2917 (NCI Thesaurus)
C0007099 (UMLS 2011AA)

CervicalTumorPathologicNStage

Item

Pathologic N Stage

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12844 (NCI Thesaurus ObjectClass-2)
C0205064 (UMLS 2011AA ObjectClass-2)
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)

CL.5

Code List

Pathologic N Stage

CL Item

No Regional Lymph Node Metastasis (N0)

CL Item

Regional Lymph Node Metastasis (N1)

CL Item

Regional Lymph Nodes Cannot Be Assessed (NX)

CervicalTumorPathologicMStage

Item

Pathologic M Stage

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12844 (NCI Thesaurus ObjectClass-2)
C0205064 (UMLS 2011AA ObjectClass-2)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)

CL.6

Code List

Pathologic M Stage

CL Item

No Distant Metastasis (M0)

CL Item

Distant Metastasis (M1)

C18206 (NCI Thesaurus)
C1269798 (UMLS 2011AA)

CL Item

Distant Metastasis Cannot Be Assessed (MX)

TotalHysterectomyPerformedType

Item

Type of radical hysterectomy

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15701 (NCI Thesaurus ObjectClass)
C0677962 (UMLS 2011AA ObjectClass)

CL.7

Code List

Type of radical hysterectomy

CL Item

Open (Open)

CL Item

Laparoscopic (Laparoscopic)

CL Item

Robotic (Robotic)

TotalHysterectomyPerformedDate

Item

Date of radical hysterectomy

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15701 (NCI Thesaurus ObjectClass)
C0677962 (UMLS 2011AA ObjectClass)

Histologic Category

Item Group

Histologic Category

GynecologicTumorHistologicCategory

Item

Histologic Type

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C28016 (NCI Thesaurus ObjectClass-2)
C0205480 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)

CL.8

Code List

Histologic Type

CL Item

Squamous Cell Carcinoma (Squamous cell carcinoma)

C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)

CL Item

Adenosquamous (Adenosquamous carcinoma)

CL Item

Adenocarcinoma, Unspecified (Adenocarcinoma, unspecified)

CervixUteriNeoplasmHistologicGrade

Item

Histologic Grade

text

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12311 (NCI Thesaurus ObjectClass-2)
C0007874 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C48309 (NCI Thesaurus ValueDomain)
C0441800 (UMLS 2011AA ValueDomain)

CL.9

Code List

Histologic Grade

CL Item

Well Differentiated (G1-Well Differentiated)

C14171 (NCI Thesaurus)
C0205615 (UMLS 2011AA)

CL Item

Moderately Differentiated (G2-Moderately Differentiated)

C14162 (NCI Thesaurus)
C0205616 (UMLS 2011AA)

CL Item

Poorly Differentiated (G3-Poorly Differentiated)

C14167 (NCI Thesaurus)
C0205617 (UMLS 2011AA)

CL Item

Undifferentiated (G4-Undifferentiated)

C14176 (NCI Thesaurus)
C0205618 (UMLS 2011AA)

CL Item

Grade Cannot Be Assessed (Gx-Grade cannot be assessed)

HIGH RISK FEATURES

Item Group

HIGH RISK FEATURES

GynecologicMalignantNeoplasmParametriumInvolvementInd-2

Item

Positive parametrium

boolean

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C28016 (NCI Thesaurus ObjectClass-2)
C0205480 (UMLS 2011AA ObjectClass-2)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C12320 (NCI Thesaurus Property-2)
C0227822 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

GynecologicMalignantNeoplasmParametriumRightInvolvementInd-4

Item

Right parametrium

text

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C28016 (NCI Thesaurus ObjectClass-2)
C0205480 (UMLS 2011AA ObjectClass-2)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)
C12320 (NCI Thesaurus Property-3)
C0227822 (UMLS 2011AA Property-3)
C49486 (NCI Thesaurus ValueDomain)
C1704854 (UMLS 2011AA ValueDomain)

CL.11

Code List

Right parametrium

CL Item

Not Applicable (N/A)

C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

GynecologicMalignantNeoplasmParametriumLeftInvolvementInd-4

Item

Left parametrium

text

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C28016 (NCI Thesaurus ObjectClass-2)
C0205480 (UMLS 2011AA ObjectClass-2)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)
C12320 (NCI Thesaurus Property-3)
C0227822 (UMLS 2011AA Property-3)
C49486 (NCI Thesaurus ValueDomain)
C1704854 (UMLS 2011AA ValueDomain)

CL.12

Code List

Left parametrium

CL Item

Not Applicable (N/A)

C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Unknown (Unknown)

C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)

PelvicLymphNodeInvolvedInd-2

Item

Positive pelvic nodes

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25547 (NCI Thesaurus Property)
C25399 (NCI Thesaurus ObjectClass-2)
C0030797 (UMLS 2011AA ObjectClass-2)

PelvicLymphNodeExaminedCount

Item

Number of pelvic nodes sampled

float

C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25399 (NCI Thesaurus ObjectClass-2)
C0030797 (UMLS 2011AA ObjectClass-2)

PelvicLymphNodePositiveFindingCount

Item

Number of pelvic nodes positive

float

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C38758 (NCI Thesaurus Property)
C1514241 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25399 (NCI Thesaurus ObjectClass-2)
C0030797 (UMLS 2011AA ObjectClass-2)

PelvicLymphNodeMalignantNeoplasmExtracapsularExtensionIndicator

Item

Extracapsular extension

text

C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C12363 (NCI Thesaurus ObjectClass-2)
C0729595 (UMLS 2011AA ObjectClass-2)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C25502 (NCI Thesaurus Property-2)
C1517049 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)

CL.14

Code List

Extracapsular extension

CL Item

Not Available (N/A)

CL Item

No (NO)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (YES)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

ParaaorticRegionLymphNodeInvolvedIndicator

Item

Positive para-aortic nodes (PA)

text

C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25547 (NCI Thesaurus Property)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)

CL.15

Code List

Positive para-aortic nodes (PA)

CL Item

No (NO)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (YES)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

CL Item

Not Sampled/dissected (Not sampled/dissected)

ParaaorticRegionLymphNodeCompleteExcisionIndicator

Item

PA nodes completely resected

text

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C15232 (NCI Thesaurus Property-2)
C0728940 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)

CL.16

Code List

PA nodes completely resected

CL Item

Not Available (N/A)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

ParaaorticRegionLymphNodeNegativeFindingPostoperativeTomographyInvolvedInd-2

Item

If positive PA (para-aortic) nodes, PET/CT negative post-op

boolean

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)
C28006 (NCI Thesaurus Property)
C0032790 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C38757 (NCI Thesaurus Property-3)
C1513916 (UMLS 2011AA Property-2)
C38093 (NCI Thesaurus Property-4)
C0040395 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

ParaaorticRegionLymphNodeExaminedCount

Item

Number of PA (para-aortic) nodes sampled

float

C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)

ParaaorticRegionLymphNodeInvolvedCount

Item

Number of PA (para-aortic) nodes positive

float

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25547 (NCI Thesaurus Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)

ParaaorticRegionLymphNodeMalignantNeoplasmExtracapsularExtensionIndicator

Item

Extracapsular extension

text

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C25316 (NCI Thesaurus ObjectClass-3)
C0456269 (UMLS 2011AA ObjectClass-3)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C25502 (NCI Thesaurus Property-2)
C1517049 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)

CL.18

Code List

Extracapsular extension

CL Item

Not Available (N/A)

CL Item

No (NO)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (YES)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

IliumLymphNodeDissectionType

Item

Common Iliac Node Dissection

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C32765 (NCI Thesaurus ObjectClass-2)
C0020889 (UMLS 2011AA ObjectClass-2)
C15227 (NCI Thesaurus Property)
C0012737 (UMLS 2011AA Property)

CL.19

Code List

Common Iliac Node Dissection

CL Item

Not Dissected (Not dissected)

CL Item

Positive (positive)

C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)

CL Item

Negative (negative)

C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)

Examinations

Item Group

Examinations

PersonalMedicalHistoryPhysicalExaminationPerformedDate

Item

Date of History and Physical Exam

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C18772 (NCI Thesaurus ObjectClass-2)
C0262926 (UMLS 2011AA ObjectClass-2)

AbdominalCavityPelvisComputedTomographyDiagnosticImagingPerformedDate

Item

Date of contrast-enhanced CT/MRI of abdomen-pelvis

date

C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C12664 (NCI Thesaurus ObjectClass-3)
C0230168 (UMLS 2011AA ObjectClass-3)
C12767 (NCI Thesaurus ObjectClass-4)
C0030797 (UMLS 2011AA ObjectClass-4)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

PatientChestRadiographyComputedTomographyAssessmentDate

Item

Date of Chest X-Ray or CT scan

date

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C38103 (NCI Thesaurus Property-2)
C0039985 (UMLS 2011AA Property-2)
C17204 (NCI Thesaurus Property-3)
C0040405 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

WholeBodyDiagnosticImagingComputedTomographyPositronEmissionTomographyPerformedDate

Item

Date of whole body PET/CT

date

C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C13041 (NCI Thesaurus ObjectClass-2)
C1268086 (UMLS 2011AA ObjectClass-2)
C25326 (NCI Thesaurus ObjectClass-3)
C0439751 (UMLS 2011AA ObjectClass-3)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C17204 (NCI Thesaurus Property-2)
C0040405 (UMLS 2011AA Property-2)
C38000 (NCI Thesaurus Property-3)
C0884358 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

ParaaorticRegionLymphNodeTomographyPositronEmissionTomographyInvolvedType

Item

PET / PET CT of Para-Aortic Nodes

text

C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25316 (NCI Thesaurus ObjectClass-2)
C0456269 (UMLS 2011AA ObjectClass-2)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C38093 (NCI Thesaurus Property-3)
C0040395 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.20

Code List

PET / PET CT of Para-Aortic Nodes

CL Item

N/a (N/A)

CL Item

Positive (positive)

C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)

CL Item

Negative (negative)

C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)

Baseline Lab Values

Item Group

Baseline Lab Values (hematologic)

Leukocytes (WBC)

Item

WBC (mm^3)

float

C25294 (NCI Thesaurus ObjectClass)
C0023508 (UMLS CUI-1)
C12529 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)

Laboratory Procedure Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)

Laboratory Procedure Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)

Laboratory Procedure Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)

Neutrophil count

Item

ANC (mm^3)

float

C25294 (NCI Thesaurus ObjectClass)
C0200633 (UMLS CUI-1)
C12533 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)

LaboratoryProcedureNeutrophilResultDate

Item

Date (MM DD YYYY)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C12533 (NCI Thesaurus Property)
C0027950 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)

Platelets

Item

Platelets (PLT) (BONE MARROW FUNCTION)

float

C20200 (NCI Thesaurus Property)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)

Platelets date

Item

Date (MM DD YYYY)

date

C25164 (NCI Thesaurus ValueDomain)
C0005821 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)

LaboratoryProcedureHemoglobinResultSpecifiedValue

Item

Hemoglobin (g/dL)

float

C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)

LaboratoryProcedureHemoglobinResultDate

Item

Date (MM DD YYYY)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)

Creatinine, Serum

Item

Serum creatinine (mg/dl)

float

C20200 (NCI Thesaurus Property)
C0201976 (UMLS CUI-1)
C399 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)

Bilirubin, Total

Item

Total Bilirubin (mg/dl)

float

C25294 (NCI Thesaurus ObjectClass)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C38037 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)

LaboratoryProcedureBilirubinOutcomeDate

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)

Bilirubin, Total ULN

Item

Bilirubin ULN (mg/dl)

float

C25294 (NCI Thesaurus ObjectClass)
C0201913 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)

SGOT (AST)

Item

SGOT (AST)

float

C25202 (NCI Thesaurus Property)
C0201899 (UMLS CUI-1)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)

LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultDate

Item

Date (MM DD YYYY)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)

LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue

Item

SGOT (AST) ULN (U/L)

float

C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)

Alkaline Phosphatase

Item

Alkaline Phosphatase

float

C20200 (NCI Thesaurus Property)
C0201850 (UMLS CUI-1)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C16276 (NCI Thesaurus Property-2)

LaboratoryProcedureAlkalinePhosphataseResultDate

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C16276 (NCI Thesaurus Property-2)
C0002059 (UMLS 2011AA Property-2)

Alkaline Phosphatase ULN

Item

Alkaline Phosphatase ULN

float

C25294 (NCI Thesaurus ObjectClass)
C0151420 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C16276 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)

SGPT (ALT)

Item

SGPT (ALT)

float

C25294 (NCI Thesaurus ObjectClass)
C0201836 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C25293 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)

LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultDate

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25293 (NCI Thesaurus Property-2)
C0376147 (UMLS 2011AA Property-2)

LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue

Item

SGPT (ALT) ULN

float

C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25293 (NCI Thesaurus Property-2)
C0376147 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)

LaboratoryProcedureMagnesiumResultSpecifiedValue

Item

Magnesium

float

C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C29239 (NCI Thesaurus Property-2)
C0024467 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0205369 (UMLS 2011AA ValueDomain-2)

LaboratoryProcedureCalciumElectrolytesOutcomeUnspecifiedValue

Item

Calcium

text

C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C464 (NCI Thesaurus Property-3)
C0013832 (UMLS 2011AA Property-3)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)

LaboratoryProcedureSerumCalciumOutcomeDate

Item

Date

date

C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C13325 (NCI Thesaurus Property-2)
C0229671 (UMLS 2011AA Property-2)
C20200 (NCI Thesaurus Property-3)
C1274040 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

General Conditions

Item Group

Severe Active Comorbidity

GrossTumorResidualRemainingInd-2

Item

Residual gross tumor

boolean

C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C43566 (NCI Thesaurus ObjectClass-2)
C0439806 (UMLS 2011AA ObjectClass-2)
C37895 (NCI Thesaurus Property)
C1609982 (UMLS 2011AA Property)
C25649 (NCI Thesaurus Property-2)
C1527428 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

CarcinoidTumorHistologicClassificationInd-2

Item

Neuroendocrine histology

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2915 (NCI Thesaurus ObjectClass)
C0007095 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)

MetastaticNeoplasmConfirmedDiagnosisInd-2

Item

Does the patient have clinical or radiologic evidence of metastatic disease? (excluding completely resected PA nodes)

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C3261 (NCI Thesaurus ObjectClass)
C2939420 (UMLS 2011AA ObjectClass)

PriorCancerDiagnosisInd-3

Item

History of Prior Malignancy

boolean

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)

CancerAblationDate

Item

Date eradicated (If yes,)

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)

PriorRTPelvicAdministeredInd-3

Item

Prior radiation therapy to the pelvis resulting in overlapping of radiation therapy fields per this protocol

boolean

C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C25399 (NCI Thesaurus Property)
C0030797 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)

UnstableAnginaHospitalizationInd-2

Item

Hospitalized for unstable angina and/or CHF in last 6 months

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C0002965 (NCI Metathesaurus ObjectClass)

TransmuralMyocardialInfarctionConfirmedInd-2

Item

Transmural MI in last 6 months

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C27996 (NCI Thesaurus ObjectClass)
C0027051 (UMLS 2011AA ObjectClass)
CL233186 (NCI Metathesaurus ObjectClass)

Pre-existingConditionAcuteBacterialInfectionFungalInfectionRegistrationIntravenousRouteofAdministrationAntibioticPresentInd-2

Item

Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration

boolean

C54056 (NCI Thesaurus ObjectClass)
C0521987 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25646 (NCI Thesaurus Property-2)
C1514821 (UMLS 2011AA Property-2)
C3245 (NCI Thesaurus Property-3)
C0026946 (UMLS 2011AA Property-3)
C258 (NCI Thesaurus Property-4)
C0003232 (UMLS 2011AA Property-4)
C38276 (NCI Thesaurus Property-5)
C1522726 (UMLS 2011AA Property-5)
C2890 (NCI Thesaurus Property-6)
C0004623 (UMLS 2011AA Property-6)
C14140 (NCI Thesaurus Property-7)
C0205178 (UMLS 2011AA Property-7)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2

Item

COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration

boolean

C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C3199 (NCI Thesaurus ObjectClass)
C0024117 (UMLS 2011AA ObjectClass)
CL316903 (NCI Metathesaurus ObjectClass)

HumanImmunodeficiencyVirusDiagnosisInd-3

Item

Patient known to be HIV positive

boolean

C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C14219 (NCI Thesaurus ObjectClass)
C0019682 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)

LaboratoryProcedureCD4-PositiveT-LymphocyteOutcomeIndicator

Item

Is CD4 count => 350 cells/mm

text

C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12537 (NCI Thesaurus Property-2)
C0039215 (UMLS 2011AA Property-2)

CL.31

Code List

Is CD4 count => 350 cells/mm

CL Item

Not Available (NA)

CL Item

No (No)

C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)

CL Item

Yes (Yes)

C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)

LaboratoryProcedureCD4-PositiveT-LymphocyteOutcomeDate

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12537 (NCI Thesaurus Property-2)
C0039215 (UMLS 2011AA Property-2)

ChemotherapyPriorSystemicClinicalStudyMalignantNeoplasmAdministrationInd-2

Item

Prior systemic chemotherapy for current study cancer

boolean

C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C13310 (NCI Thesaurus Property)
C0205373 (UMLS 2011AA Property)
C9305 (NCI Thesaurus Property-2)
C0006826 (UMLS 2011AA Property-2)
C25629 (NCI Thesaurus Property-3)
C0332152 (UMLS 2011AA Property-3)
C15206 (NCI Thesaurus Property-4)
C0008972 (UMLS 2011AA Property-4)
C48905 (NCI Thesaurus Property-5)
C0001554 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

PatientChemotherapyPersonalMedicalHistoryPlatinum-BasedTaxaneCompoundTherapeuticProcedureInd-2

Item

Prior allergic reaction to carboplatin, cisplatin or paclitaxel

boolean

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C49236 (NCI Thesaurus Property)
C0087111 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C25620 (NCI Thesaurus Property-3)
C1514162 (UMLS 2011AA Property-3)
C1490 (NCI Thesaurus Property-4)
C0796419 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)

Footer Module

Item Group

Footer Module

Investigator Signature

Item

Investigator Signature

text

C25704 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)

Investigator Signature Date

Item

Date

date

C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)

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RTOG 0724 Phase III Cervix Chemo RT (+)/(-) Adjuvant Chemotherapy: Initial Evaluation Form (I1) NCT00980954

INSTRUCTIONS: All questions must be answered per code table and/or instructions. Record dates as mm-dd-yyyy unless otherwise specified

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