ID

6893

Beskrivning

Advanced Melanoma-On-study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A996-3FA4-E034-080020C9C0E0

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A996-3FA4-E034-080020C9C0E0

Nyckelord

Versioner (2)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-08 2015-01-08 - Martin Dugas
Uppladdad den

8 januari 2015

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0 Legacy
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On-Study - Advanced Melanoma-On-study Form - 2020195v2.31

Engelsk

No Instruction available.

1 Formulär  
  1. StudyEvent: Advanced Melanoma-On-study Form
    1. No Instruction available.
Crf Header
Beskrivning

Crf Header

Coordinating Group Protocol Number
Beskrivning

CoordinatingGroupProtocolNumber

Datatyp

text

Coordinating Group Code
Beskrivning

CoordinatingGroupCode

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Protocol Title
Beskrivning

Protocol Title

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C25320
UMLS CUI-1
C2986303
NCI Thesaurus Property
C42774
Patient Study ID, Coordinating Group
Beskrivning

PatientStudyID,CoordinatingGroup

Datatyp

text

Patient Study ID, Participating Group
Beskrivning

PatientStudyID,ParticipatingGroup

Datatyp

text

Participating Group Code
Beskrivning

ParticipatingGroupCode

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Institution Name
Beskrivning

InstitutionName

Datatyp

text

Affiliate Name
Beskrivning

AffiliateName

Datatyp

text

Patient Name, Last
Beskrivning

PatientName,Last

Datatyp

text

Patient Name, First
Beskrivning

PatientName,First

Datatyp

text

Patient Name, Middle
Beskrivning

PatientName,Middle

Datatyp

text

Melanoma: Form Administration
Beskrivning

Melanoma: Form Administration

Person Completing Form, Last Name
Beskrivning

PersonCompletingForm,LastName

Datatyp

text

Person Completing Form, First Name
Beskrivning

PersonCompletingForm,FirstName

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Amended Data Ind
Beskrivning

AmendedDataInd

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Melanoma (advanced): Disease Description
Beskrivning

Melanoma (advanced): Disease Description

Initial Diagnosis Date, Pathologic
Beskrivning

InitialDiagnosisDate,Pathologic

Datatyp

date

Primary Surgery Type
Beskrivning

PrimarySurgeryType

Datatyp

text

Primary Surgery, Other Type
Beskrivning

PrimarySurgery,OtherType

Datatyp

text

Primary Surgery Date
Beskrivning

PrimarySurgeryDate

Datatyp

date

Advanced Disease Registration Status
Beskrivning

AdvancedDiseaseRegistrationStatus

Datatyp

text

Primary Site
Beskrivning

PrimarySite

Datatyp

text

Primary Site, Other
Beskrivning

PrimarySite,Other

Datatyp

text

Primary Tumor Resection Status
Beskrivning

PrimaryTumorResectionStatus

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C15232
UMLS 2011AA Property
C0728940
Involvement Pattern
Beskrivning

InvolvementPattern

Datatyp

text

Involvement Pattern, Other
Beskrivning

InvolvementPattern,Other

Datatyp

text

Breslow Depth
Beskrivning

BreslowDepth

Datatyp

float

Lab, Chemistry, Lactate Dehydrogenase
Beskrivning

Lab,Chemistry,LactateDehydrogenase

Datatyp

float

Clark Level
Beskrivning

ClarkLevel

Datatyp

text

Ulceration Ind
Beskrivning

UlcerationInd

Datatyp

text

Lymph Node(s) Examined Number
Beskrivning

LymphNode(s)ExaminedNumber

Datatyp

float

Alias
NCI Thesaurus Property
C25500
UMLS 2011AA Property
C0332128
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
Lymph Node(s) Positive Number
Beskrivning

LymphNode(s)PositiveNumber

Datatyp

float

Alias
NCI Thesaurus Property
C25246
UMLS 2011AA Property
C1446409
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
Lymph Node Involvement
Beskrivning

LymphNodeInvolvement

Datatyp

text

Intransit metastases/satellite lesions Ind
Beskrivning

Intransitmetastases/satellitelesionsInd

Datatyp

text

Lymph Nodes, Matted Ind
Beskrivning

LymphNodes,MattedInd

Datatyp

text

Metastatic Site
Beskrivning

MetastaticSite

Datatyp

text

Metastatic Site, Other Visceral
Beskrivning

MetastaticSite,OtherVisceral

Datatyp

text

Metastatic Site, Other Non-visceral
Beskrivning

MetastaticSite,OtherNon-visceral

Datatyp

text

T Stage, Pathologic
Beskrivning

TStage,Pathologic

Datatyp

text

N Stage, Pathologic
Beskrivning

NStage,Pathologic

Datatyp

text

M Stage, Pathologic
Beskrivning

MStage,Pathologic

Datatyp

text

Melanoma (advanced): Sentinel Node Biopsy
Beskrivning

Melanoma (advanced): Sentinel Node Biopsy

Sentinel Node Biopsy Ind
Beskrivning

SentinelNodeBiopsyInd

Datatyp

text

Sentinel Node Biopsy Date
Beskrivning

SentinelNodeBiopsyDate

Datatyp

date

Sentinel Node(s) Examined Number
Beskrivning

SentinelNode(s)ExaminedNumber

Datatyp

float

Sentinel Node(s) Positive Number
Beskrivning

SentinelNode(s)PositiveNumber

Datatyp

float

Sentinel Node Size
Beskrivning

SentinelNodeSize

Datatyp

float

Sentinel Node Biopsy Results
Beskrivning

SentinelNodeBiopsyResults

Datatyp

text

Alias
NCI Thesaurus Property
C15189
UMLS 2011AA Property
C0005558
NCI Thesaurus Property-2
C13363
UMLS 2011AA Property-2
C0555952
NCI Thesaurus ObjectClass
C12947
UMLS 2011AA ObjectClass
C1522495
Melanoma (advanced): Prior Treatment
Beskrivning

Melanoma (advanced): Prior Treatment

Prior Surgery Ind
Beskrivning

PriorSurgeryInd

Datatyp

text

Prior Surgery Type
Beskrivning

PriorSurgeryType

Datatyp

text

Prior Surgery Type, Other
Beskrivning

PriorSurgeryType,Other

Datatyp

text

Primary Surgery Date
Beskrivning

PrimarySurgeryDate

Datatyp

date

Prior RT Ind
Beskrivning

PriorRTInd

Datatyp

text

RT Site
Beskrivning

RTSite

Datatyp

text

Prior RT End Date
Beskrivning

PriorRTEndDate

Datatyp

date

RT Site, Other
Beskrivning

RTSite,Other

Datatyp

text

Prior Vaccine Ind
Beskrivning

PriorVaccineInd

Datatyp

text

Prior Vaccine Type
Beskrivning

PriorVaccineType

Datatyp

text

Prior Vaccination Date
Beskrivning

PriorVaccinationDate

Datatyp

date

Alias
NCI Thesaurus ObjectClass
C25629
UMLS 2011AA ObjectClass
C0332152
NCI Thesaurus ObjectClass-2
C923
UMLS 2011AA ObjectClass-2
C0042210
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Prior ILP Ind
Beskrivning

PriorILPInd

Datatyp

text

Prior ILP, specify
Beskrivning

PriorILP,specify

Datatyp

text

Prior ILP Date
Beskrivning

PriorILPDate

Datatyp

date

Prior Hormonal Therapy Ind
Beskrivning

PriorHormonalTherapyInd

Datatyp

text

Prior Chemotherapy Ind
Beskrivning

PriorChemotherapyInd

Datatyp

text

Prior Immunotherapy Ind
Beskrivning

PriorImmunotherapyInd

Datatyp

text

Melanoma: Prior Treatment-systemic Regimens
Beskrivning

Melanoma: Prior Treatment-systemic Regimens

Prior Treatment Regimen Name(s)
Beskrivning

PriorTreatmentRegimenName(s)

Datatyp

text

Prior Treatment Regimen Begin Date
Beskrivning

PriorTreatmentRegimenBeginDate

Datatyp

date

Prior Treatment Regimen End Date
Beskrivning

PriorTreatmentRegimenEndDate

Datatyp

date

Prior Treatment Regimen Type
Beskrivning

PriorTreatmentRegimenType

Datatyp

text

Allows Documentation Of Any Additional Cooments
Beskrivning

Allows Documentation Of Any Additional Cooments

Comments
Beskrivning

Comments

Datatyp

text

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Similar models

No Instruction available.

1 Formulär
  1. StudyEvent: Advanced Melanoma-On-study Form
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Crf Header
CoordinatingGroupProtocolNumber
Item
Coordinating Group Protocol Number
text
CoordinatingGroupCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
Protocol Title
Item
Protocol Title
text
C25320 (NCI Thesaurus ObjectClass)
C2986303 (UMLS CUI-1)
C42774 (NCI Thesaurus Property)
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
PatientName,Last
Item
Patient Name, Last
text
PatientName,First
Item
Patient Name, First
text
PatientName,Middle
Item
Patient Name, Middle
text
Item Group
Melanoma: Form Administration
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, First Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Amended Data Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Melanoma (advanced): Disease Description
InitialDiagnosisDate,Pathologic
Item
Initial Diagnosis Date, Pathologic
date
Item
Primary Surgery Type
text
CL.2
Code List
Primary Surgery Type
CL Item
Biopsy (Biopsy)
C15189 (NCI Thesaurus)
C0005558 (UMLS 2011AA)
CL Item
Excision Of Local Recurrence (Excision of local recurrence)
CL Item
Other, Specify (Other, specify)
CL Item
Excision/wide Excision Of Primary (Excision/wide excision of primary)
CL Item
Lymph Node Dissection (Lymph node dissection)
C15427 (NCI Thesaurus)
CL Item
Excision Of Satellite Or In-transit Metastases (Excision of satellite or in-transit metastases)
PrimarySurgery,OtherType
Item
Primary Surgery, Other Type
text
PrimarySurgeryDate
Item
Primary Surgery Date
date
Item
Advanced Disease Registration Status
text
CL.3
Code List
Advanced Disease Registration Status
CL Item
Recurrence (Recurrence)
CL Item
Initial Diagnosis (Initial Diagnosis)
Item
Primary Site
text
CL.4
Code List
Primary Site
CL Item
Anogenital (non-mucosal) (Anogenital (non-mucosal))
CL Item
Head (Head)
C12419 (NCI Thesaurus)
C0018670 (UMLS 2011AA)
CL Item
Lower Extremity (Lower extremity)
C12742 (NCI Thesaurus)
C0023216 (UMLS 2011AA)
CL Item
Mucosal (Mucosal)
CL Item
Neck (Neck)
C13063 (NCI Thesaurus)
C0027530 (UMLS 2011AA)
CL Item
Upper Extremity (Upper extremity)
C12671 (NCI Thesaurus)
C1140618 (UMLS 2011AA)
CL Item
Other, Specify (Other, specify)
CL Item
Subungual (Subungual)
CL Item
Trunk (Trunk)
C33816 (NCI Thesaurus)
C0460005 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Ocular (Ocular)
C0521414 (NCI Metathesaurus)
PrimarySite,Other
Item
Primary Site, Other
text
Item
Primary Tumor Resection Status
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
CL.5
Code List
Primary Tumor Resection Status
CL Item
Not Recurrent, Resected, No Residual Tumor (Not recurrent, resected, no residual tumor)
CL Item
Unresected (Unresected)
CL Item
Recurrent (Recurrent)
C14173 (NCI Thesaurus)
C2945760 (UMLS 2011AA)
CL Item
Not Recurrent, Resected, Residual Tumor (Not recurrent, resected, residual tumor)
Item
Involvement Pattern
text
CL.6
Code List
Involvement Pattern
CL Item
Acral Lentiginous (acral lentiginous)
CL Item
Lentigo Maligna Melanoma (lentigo maligna melanoma)
C9151 (NCI Thesaurus)
C2739810 (UMLS 2011AA)
CL Item
Superficial Spreading (superficial spreading)
CL Item
Other, Specify (other, specify)
CL Item
Nodular (nodular)
InvolvementPattern,Other
Item
Involvement Pattern, Other
text
BreslowDepth
Item
Breslow Depth
float
Lab,Chemistry,LactateDehydrogenase
Item
Lab, Chemistry, Lactate Dehydrogenase
float
Item
Clark Level
text
CL.7
Code List
Clark Level
CL Item
I-above Basal Lamina (in Situ) (I-above basal lamina (in situ))
CL Item
Ii- Extension Into Papillary Dermis (II- extension into papillary dermis)
CL Item
V-subcutaneous Fat (V-subcutaneous fat)
CL Item
Iv-reticular Dermis (IV-reticular dermis)
CL Item
Iii-interface Papillary-reticular Dermis (III-interface papillary-reticular dermis)
Item
Ulceration Ind
text
CL.8
Code List
Ulceration Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
LymphNode(s)ExaminedNumber
Item
Lymph Node(s) Examined Number
float
C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
LymphNode(s)PositiveNumber
Item
Lymph Node(s) Positive Number
float
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
Item
Lymph Node Involvement
text
CL.9
Code List
Lymph Node Involvement
CL Item
Lymph Node(s) With Any Macroscopic/gross Metastases (Lymph node(s) with any macroscopic/gross metastases)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No Lymph Node Involvement (No lymph node involvement)
CL Item
Lymph Node(s) With Only Microscopic Metastases (Lymph node(s) with only microscopic metastases)
Item
Intransit metastases/satellite lesions Ind
text
CL.10
Code List
Intransit metastases/satellite lesions Ind
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)
Item
Lymph Nodes, Matted Ind
text
CL.11
Code List
Lymph Nodes, Matted Ind
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)
Item
Metastatic Site
text
CL.12
Code List
Metastatic Site
CL Item
Bone (Bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
CL Item
Brain (Brain)
C12439 (NCI Thesaurus)
C0006104 (UMLS 2011AA)
CL Item
Distant Lymph Nodes (Distant lymph nodes)
CL Item
Distant Skin/subcutaneous Tissue (Distant skin/subcutaneous tissue)
CL Item
Distant Soft Tissue Metastasis (Distant soft tissue metastasis)
CL Item
Other Visceral, Specify (Other visceral, specify)
CL Item
Lung (Lung)
C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Other Cns (Other CNS)
CL Item
Other Non-visceral, Specify (Other non-visceral, specify)
CL Item
Liver (Liver)
C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)
MetastaticSite,OtherVisceral
Item
Metastatic Site, Other Visceral
text
MetastaticSite,OtherNon-visceral
Item
Metastatic Site, Other Non-visceral
text
Item
T Stage, Pathologic
text
CL.13
Code List
T Stage, Pathologic
CL Item
T1a, According To Ajcc Guidelines (T1a)
CL Item
T1b, According To Ajcc Guidelines (T1b)
CL Item
T2a, According To Ajcc Guidelines (T2a)
CL Item
T2b, According To Ajcc Guidelines (T2b)
CL Item
Tx, According To Ajcc Guidelines (TX)
CL Item
T3b, According To Ajcc Guidelines (T3b)
CL Item
T4a, According To Ajcc Guidelines (T4a)
CL Item
T4b, According To Ajcc Guidelines (T4b)
CL Item
T3a, According To Ajcc Guidelines (T3a)
Item
N Stage, Pathologic
text
CL.14
Code List
N Stage, Pathologic
CL Item
N0, According To Ajcc Guidelines (N0)
CL Item
N1a, According To Ajcc Guidelines (N1a)
CL Item
N1b, According To Ajcc Guidelines (N1b)
CL Item
Nx, According To Ajcc Guidelines (NX)
CL Item
N2b, According To Ajcc Guidelines (N2b)
CL Item
N2c, According To Ajcc Guidelines (N2c)
CL Item
N3, According To Ajcc Guidelines (N3)
CL Item
N2a, According To Ajcc Guidelines (N2a)
Item
M Stage, Pathologic
text
CL.15
Code List
M Stage, Pathologic
CL Item
M0, According To Ajcc Guidelines (M0)
CL Item
M1a, According To Ajcc Guidelines (M1a)
CL Item
Mx, According To Ajcc Guidelines (MX)
CL Item
M1c, According To Ajcc Guidelines (M1c)
CL Item
M1b, According To Ajcc Guidelines (M1b)
Item Group
Melanoma (advanced): Sentinel Node Biopsy
Item
Sentinel Node Biopsy Ind
text
CL.16
Code List
Sentinel Node Biopsy Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
SentinelNodeBiopsyDate
Item
Sentinel Node Biopsy Date
date
SentinelNode(s)ExaminedNumber
Item
Sentinel Node(s) Examined Number
float
SentinelNode(s)PositiveNumber
Item
Sentinel Node(s) Positive Number
float
SentinelNodeSize
Item
Sentinel Node Size
float
Item
Sentinel Node Biopsy Results
text
C15189 (NCI Thesaurus Property)
C0005558 (UMLS 2011AA Property)
C13363 (NCI Thesaurus Property-2)
C0555952 (UMLS 2011AA Property-2)
C12947 (NCI Thesaurus ObjectClass)
C1522495 (UMLS 2011AA ObjectClass)
CL.17
Code List
Sentinel Node Biopsy Results
CL Item
Positive (Positive)
CL Item
Negative (Negative)
Item Group
Melanoma (advanced): Prior Treatment
Item
Prior Surgery Ind
text
CL.18
Code List
Prior Surgery Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Prior Surgery Type
text
CL.19
Code List
Prior Surgery Type
CL Item
Biopsy (Biopsy)
C15189 (NCI Thesaurus)
C0005558 (UMLS 2011AA)
CL Item
Excision Of Distant Metastases (Excision of distant metastases)
CL Item
Excision Of Local Recurrence (Excision of local recurrence)
CL Item
Sentinel Lymph Node Biopsy (Sentinel lymph node biopsy)
C15667 (NCI Thesaurus)
C0796693 (UMLS 2011AA)
CL Item
Excision/wide Excision Of Primary (Excision/wide excision of primary)
CL Item
Lymph Node Dissection (Lymph node dissection)
C15427 (NCI Thesaurus)
CL Item
Other, Specify (Other, specify)
CL Item
Excision Of Satellite Or In-transit Metastases (Excision of satellite or in-transit metastases)
PriorSurgeryType,Other
Item
Prior Surgery Type, Other
text
PrimarySurgeryDate
Item
Primary Surgery Date
date
Item
Prior RT Ind
text
CL.20
Code List
Prior RT Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
RT Site
text
CL.21
Code List
RT Site
CL Item
Bone (Bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
CL Item
Brain (Brain)
C12439 (NCI Thesaurus)
C0006104 (UMLS 2011AA)
CL Item
Other, Specify (Other, specify)
CL Item
Lymph Nodes (soft Tissue) (Lymph nodes (soft tissue))
CL Item
Head And Neck (Head and Neck)
C12418 (NCI Thesaurus)
C0460004 (UMLS 2011AA)
PriorRTEndDate
Item
Prior RT End Date
date
RTSite,Other
Item
RT Site, Other
text
Item
Prior Vaccine Ind
text
CL.22
Code List
Prior Vaccine Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PriorVaccineType
Item
Prior Vaccine Type
text
PriorVaccinationDate
Item
Prior Vaccination Date
date
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C923 (NCI Thesaurus ObjectClass-2)
C0042210 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Item
Prior ILP Ind
text
CL.23
Code List
Prior ILP Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PriorILP,specify
Item
Prior ILP, specify
text
PriorILPDate
Item
Prior ILP Date
date
Item
Prior Hormonal Therapy Ind
text
CL.24
Code List
Prior Hormonal Therapy Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Prior Chemotherapy Ind
text
CL.25
Code List
Prior Chemotherapy Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Prior Immunotherapy Ind
text
CL.26
Code List
Prior Immunotherapy Ind
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Melanoma: Prior Treatment-systemic Regimens
PriorTreatmentRegimenName(s)
Item
Prior Treatment Regimen Name(s)
text
PriorTreatmentRegimenBeginDate
Item
Prior Treatment Regimen Begin Date
date
PriorTreatmentRegimenEndDate
Item
Prior Treatment Regimen End Date
date
PriorTreatmentRegimenType
Item
Prior Treatment Regimen Type
text
Item Group
Allows Documentation Of Any Additional Cooments
Comments
Item
Comments
text
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