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6899

Description

Muscle Invasive Bladder Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95D-3FA4-E034-080020C9C0E0

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95D-3FA4-E034-080020C9C0E0

Mots-clés

Versions (2)
  1. 19/09/2012 19/09/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
Téléchargé le

8 janvier 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
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    On-Study - Muscle Invasive Bladder Cancer - On-Study Form - 2019331v2.31

    Anglais

    No Instruction available.

    1 Formulaires  
    1. StudyEvent: Muscle Invasive Bladder Cancer - On-Study Form
      1. No Instruction available.
    Crf Header
    Description

    Crf Header

    Coordinating Group Protocol Number
    Description

    CoordinatingGroupProtocolNumber

    Type de données

    text

    Coordinating Group Code
    Description

    CoordinatingGroupCode

    Type de données

    text

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

    Protocol Title

    Type de données

    text

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

    PatientStudyID,CoordinatingGroup

    Type de données

    text

    Patient Study ID, Participating Group
    Description

    PatientStudyID,ParticipatingGroup

    Type de données

    text

    Participating Group Code
    Description

    ParticipatingGroupCode

    Type de données

    text

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

    InstitutionName

    Type de données

    text

    Affiliate Name
    Description

    AffiliateName

    Type de données

    text

    Patient Name, Last
    Description

    PatientName,Last

    Type de données

    text

    Patient Name, First
    Description

    PatientName,First

    Type de données

    text

    Patient Name, Middle
    Description

    PatientName,Middle

    Type de données

    text

    Bladder: Form Administration
    Description

    Bladder: Form Administration

    Person Completing Form, Last Name
    Description

    PersonCompletingForm,LastName

    Type de données

    text

    Person Completing Form, First Name
    Description

    PersonCompletingForm,FirstName

    Type de données

    text

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

    AmendedDataInd

    Type de données

    text

    Alias
    NCI Thesaurus ObjectClass
    C25474
    UMLS 2011AA ObjectClass
    C1511726
    NCI Thesaurus Property
    C25416
    UMLS 2011AA Property
    C1691222
    Bladder: Disease Description For Muscle Invasive Bladder Cancer
    Description

    Bladder: Disease Description For Muscle Invasive Bladder Cancer

    Prior Superficial Disease Ind
    Description

    PriorSuperficialDiseaseInd

    Type de données

    text

    Prior Papillary Occurrences
    Description

    PriorPapillaryOccurrences

    Type de données

    float

    Prior CIS Occurrences
    Description

    PriorCISOccurrences

    Type de données

    float

    Initial Diagnosis Date, Pathologic
    Description

    InitialDiagnosisDate,Pathologic

    Type de données

    date

    Initial Diagnosis Date, Pathologic
    Description

    InitialDiagnosisDate,Pathologic

    Type de données

    date

    Pathologic Diagnosis Date
    Description

    PathologicDiagnosisDate

    Type de données

    date

    Prior Recent Recurrence Date
    Description

    PriorRecentRecurrenceDate

    Type de données

    date

    Alias
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25279
    UMLS 2011AA Property
    C0332162
    Histologic Type
    Description

    HistologicType

    Type de données

    text

    Alias
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    NCI Thesaurus ValueDomain-2
    C25526
    UMLS 2011AA ValueDomain-2
    C0205462
    Histologic Type, Other Name
    Description

    HistologicType,OtherName

    Type de données

    text

    Histologic Grade
    Description

    HistologicGrade

    Type de données

    text

    Alias
    NCI Thesaurus ValueDomain
    C25526
    UMLS 2011AA ValueDomain
    C0205462
    NCI Thesaurus ValueDomain-2
    C18000
    UMLS 2011AA ValueDomain-2
    C0919553
    T Stage, Pathologic
    Description

    TStage,Pathologic

    Type de données

    text

    T Stage, Clinical
    Description

    TStage,Clinical

    Type de données

    text

    N Stage, Pathologic
    Description

    NStage,Pathologic

    Type de données

    text

    Alias
    NCI Thesaurus ValueDomain
    C16899
    UMLS 2011AA ValueDomain
    C1300072
    N Stage, Clinical
    Description

    NStage,Clinical

    Type de données

    text

    Lymph Node(s) Examined Number
    Description

    LymphNode(s)ExaminedNumber

    Type de données

    float

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

    LymphNode(s)PositiveNumber

    Type de données

    float

    Alias
    NCI Thesaurus Property
    C25246
    UMLS 2011AA Property
    C1446409
    NCI Thesaurus ObjectClass
    C12745
    UMLS 2011AA ObjectClass
    C0024204
    Lymph Nodes Type
    Description

    LymphNodesType

    Type de données

    text

    Lymph Node Involvement
    Description

    LymphNodeInvolvement

    Type de données

    text

    Assessment Type
    Description

    AssessmentType

    Type de données

    text

    Lymph Node Type, Other
    Description

    LymphNodeType,Other

    Type de données

    text

    Tumor Margin Ind
    Description

    TumorMarginInd

    Type de données

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus Property
    C25563
    UMLS 2011AA Property
    C0205284
    Tumor Adherence Ind
    Description

    TumorAdherenceInd

    Type de données

    text

    Muscle Invasive Bladder Disease: Prior Treatment Affecting The Bladder
    Description

    Muscle Invasive Bladder Disease: Prior Treatment Affecting The Bladder

    Prior Intravesical Therapy Ind
    Description

    PriorIntravesicalTherapyInd

    Type de données

    text

    Prior Immunotherapy Type
    Description

    PriorImmunotherapyType

    Type de données

    text

    Prior Immunotherapy Count
    Description

    PriorImmunotherapyCount

    Type de données

    float

    Prior Immunotherapy Other Agent
    Description

    PriorImmunotherapyOtherAgent

    Type de données

    text

    Prior Intravesical Chemotherapy Type
    Description

    PriorIntravesicalChemotherapyType

    Type de données

    text

    Prior Intravesical Chemotherapy Count
    Description

    PriorIntravesicalChemotherapyCount

    Type de données

    float

    Prior Intravesical Chemotherapy Other Agent
    Description

    PriorIntravesicalChemotherapyOtherAgent

    Type de données

    text

    Prior Chemotherapy Ind
    Description

    PriorChemotherapyInd

    Type de données

    text

    Prior Neoadjuvant Chemotherapy Ind
    Description

    PriorNeoadjuvantChemotherapyInd

    Type de données

    text

    Prior Neoadjuvant Chemotherapy Type
    Description

    PriorNeoadjuvantChemotherapyType

    Type de données

    text

    Prior Neoadjuvant Chemotherapy Count
    Description

    PriorNeoadjuvantChemotherapyCount

    Type de données

    float

    Prior Neoadjuvant Chemotherapy Other Type
    Description

    PriorNeoadjuvantChemotherapyOtherType

    Type de données

    text

    Prior Adjuvant Chemotherapy Ind
    Description

    PriorAdjuvantChemotherapyInd

    Type de données

    text

    Prior Adjuvant Chemotherapy Type
    Description

    PriorAdjuvantChemotherapyType

    Type de données

    text

    Prior Adjuvant Chemotherapy Count
    Description

    PriorAdjuvantChemotherapyCount

    Type de données

    float

    Prior Adjuvant Chemotherapy Other Agent
    Description

    PriorAdjuvantChemotherapyOtherAgent

    Type de données

    text

    Prior Pelvic RT Ind
    Description

    PriorPelvicRTInd

    Type de données

    text

    Prior Surgery Ind
    Description

    PriorSurgeryInd

    Type de données

    text

    Prior Surgery Type
    Description

    PriorSurgeryType

    Type de données

    text

    Prior Surgery, TURBT Count
    Description

    PriorSurgery,TURBTCount

    Type de données

    float

    Prior Surgery, Other Type
    Description

    PriorSurgery,OtherType

    Type de données

    text

    Prior Other Therapy Ind
    Description

    PriorOtherTherapyInd

    Type de données

    text

    Prior Other Therapy Name
    Description

    PriorOtherTherapyName

    Type de données

    text

    Allows Documentation Of Any Additional Cooments
    Description

    Allows Documentation Of Any Additional Cooments

    Comments
    Description

    Comments

    Type de données

    text

    Retour au début de la page

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    1 Formulaires
    1. StudyEvent: Muscle Invasive Bladder Cancer - On-Study Form
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Type de données
    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
    Bladder: 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
    Bladder: Disease Description For Muscle Invasive Bladder Cancer
    Item
    Prior Superficial Disease Ind
    text
    CL.2
    Code List
    Prior Superficial Disease 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)
    PriorPapillaryOccurrences
    Item
    Prior Papillary Occurrences
    float
    PriorCISOccurrences
    Item
    Prior CIS Occurrences
    float
    InitialDiagnosisDate,Pathologic
    Item
    Initial Diagnosis Date, Pathologic
    date
    InitialDiagnosisDate,Pathologic
    Item
    Initial Diagnosis Date, Pathologic
    date
    PathologicDiagnosisDate
    Item
    Pathologic Diagnosis Date
    date
    PriorRecentRecurrenceDate
    Item
    Prior Recent Recurrence Date
    date
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25279 (NCI Thesaurus Property)
    C0332162 (UMLS 2011AA Property)
    Item
    Histologic Type
    text
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C25526 (NCI Thesaurus ValueDomain-2)
    C0205462 (UMLS 2011AA ValueDomain-2)
    CL.3
    Code List
    Histologic Type
    CL Item
    Cis Only (CIS only)
    CL Item
    Adenocarcinoma (adenocarcinoma)
    C2852 (NCI Thesaurus)
    C0001418 (UMLS 2011AA)
    CL Item
    Other Specify (other, specify)
    CL Item
    Transitional Cell Carcinoma (transitional cell carcinoma)
    C2930 (NCI Thesaurus)
    C0007138 (UMLS 2011AA)
    CL Item
    Papillary And Cis (papillary and CIS)
    CL Item
    Small Cell Carcinoma (small cell carcinoma)
    C3915 (NCI Thesaurus)
    C0262584 (UMLS 2011AA)
    CL Item
    Squamous Cell Carcinoma (squamous cell carcinoma)
    C2929 (NCI Thesaurus)
    C0007137 (UMLS 2011AA)
    CL Item
    Papillary (papillary)
    C14166 (NCI Thesaurus)
    C0205312 (UMLS 2011AA)
    HistologicType,OtherName
    Item
    Histologic Type, Other Name
    text
    Item
    Histologic Grade
    text
    C25526 (NCI Thesaurus ValueDomain)
    C0205462 (UMLS 2011AA ValueDomain)
    C18000 (NCI Thesaurus ValueDomain-2)
    C0919553 (UMLS 2011AA ValueDomain-2)
    CL.4
    Code List
    Histologic Grade
    CL Item
    Tumor Grade Cannot Be Assessed (grade cannot be assessed (GX))
    CL Item
    Well Differentiated (well differentiated (G1))
    C14171 (NCI Thesaurus)
    C0205615 (UMLS 2011AA)
    CL Item
    Poorly Differentiated (poorly differentiated (G3))
    C14167 (NCI Thesaurus)
    C0205617 (UMLS 2011AA)
    CL Item
    Moderately Differentiated (moderately differentiated (G2))
    C14162 (NCI Thesaurus)
    C0205616 (UMLS 2011AA)
    Item
    T Stage, Pathologic
    text
    CL.5
    Code List
    T Stage, Pathologic
    CL Item
    No Evidence Of Primary Tumor (T0)
    CL Item
    Tumor Invades Subepithelial Connective Tissue (T1)
    CL Item
    Tumor Invades Superficial Muscles (inner Half) (T2a)
    CL Item
    Tumor Invades Deep Muscles (outer Half) (T2b)
    CL Item
    Primary Tumor Cannot Be Assessed (Tx)
    CL Item
    Tumor Invades Perivesical Tissue Macroscopically (extravesical Mass) (T3b)
    CL Item
    Inflammatory Carcinoma (T4)
    C0334385 (NCI Metathesaurus)
    CL Item
    Noninvasive Papillary Carcinoma (Ta)
    CL Item
    Carcinoma In Situ: "flat Tumor" (Tis)
    CL Item
    Tumor Invades Perivesical Tissue Microscopically (T3a)
    Item
    T Stage, Clinical
    text
    CL.6
    Code List
    T Stage, Clinical
    CL Item
    No Evidence Of Primary Tumor (T0)
    CL Item
    Carcinoma In Situ: Intraductal Carcinoma, Lobular Carcinoma In Situ, Or Paget's Disease Of The Nipple With No Tumor (Tis)
    CL Item
    Tumor More Than 0.1 Cm But Not More Than 0.5 Cm In Greatest Dimension (T1a)
    CL Item
    Tumor More Than 0.5 Cm But Not More Than 1 Cm In Greatest Dimension (T1b)
    CL Item
    Tumor More Than 1 Cm But Not More Than 2 Cm In Greatest Dimension (T1c)
    CL Item
    Microinvasion 0.1 Cm Or Less In Greatest Dimension (T1mic)
    CL Item
    Tumor More Than 2 Cm But Not More Than 5 Cm In Greatest Dimension (T2)
    CL Item
    Tumor More Than 5 Cm In Greatest Dimension (T3)
    CL Item
    Tumor Of Any Size With Direct Extension To (a) Chest Wall Or (b) Skin, Only As Described Below (T4)
    CL Item
    Extension To Chest Wall (T4a)
    CL Item
    Edema (including Peau D'orange) Or Ulceration Of The Skin Of The Breast Or Satellite Skin Nodules Confined To The Same Breast (T4b)
    CL Item
    Both T4a And T4b (T4c)
    CL Item
    Inflammatory Carcinoma (T4d)
    C0334385 (NCI Metathesaurus)
    CL Item
    Primary Tumor Cannot Be Assessed (TX)
    CL Item
    Tumor 2 Cm Or Less In Greatest Dimension (T1)
    Item
    N Stage, Pathologic
    text
    C16899 (NCI Thesaurus ValueDomain)
    C1300072 (UMLS 2011AA ValueDomain)
    CL.7
    Code List
    N Stage, Pathologic
    CL Item
    Metastasis In A Single Lymph Node, 2 Cm Or Less In Greatest Dimension (N1)
    CL Item
    Metastasis In A Single Lymph Node, More Than 2 Cm But Not More Than 5 Cm In Greatest Dimension; Or Multiple Lymph Nodes, None More Than 5 Cm In Greatest Dimension (N2)
    CL Item
    Regional Lymph Nodes Cannot Be Assessed (Nx)
    CL Item
    Metastasis In A Lymph Node More Than 5 Cm In Greatest Dimension (N3)
    CL Item
    No Regional Lymph Node Metastasis (NO)
    Item
    N Stage, Clinical
    text
    CL.8
    Code List
    N Stage, Clinical
    CL Item
    No Regional Lymph Node Metastasis (N0)
    CL Item
    Metastasis In A Single Lymph Node, 2 Cm Or Less In Greatest Dimension (N1)
    CL Item
    Regional Lymph Nodes Cannot Be Assessed (NX)
    CL Item
    Metastasis In A Lymph Node More Than 5 Cm In Greatest Dimension (N3)
    CL Item
    Metastasis In A Single Lymph Node, More Than 2 Cm But Not More Than 5 Cm In Greatest Dimension; Or Multiple Lymph Nodes, None More Than 5 Cm In Greatest Dimension (N2)
    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 Nodes Type
    text
    CL.9
    Code List
    Lymph Nodes Type
    CL Item
    Common Iliac (common iliac)
    CL Item
    External Iliac (external iliac)
    CL Item
    Para-aortic (para-aortic)
    CL Item
    Internal Iliac (internal iliac)
    CL Item
    Other, Specify (other, specify)
    CL Item
    Hypogastric (hypogastric)
    Item
    Lymph Node Involvement
    text
    CL.10
    Code List
    Lymph Node Involvement
    CL Item
    The Node Is Considered To Be Negative But Not Based Upon Histological Evaluation. (clinically negative)
    CL Item
    The Node Is Considered To Be Positive But Not Based Upon Histological Evaluation. (clinically positive)
    CL Item
    Lymph Nodes Were Evaluated For Involvement, And They Were Equivocal (equivocal)
    CL Item
    Lymph Nodes Were Evaluated For Involvement, And They Were Negative (negative)
    CL Item
    Unknown Whether The Lymph Nodes Were Evaluated For Involvement (unknown)
    CL Item
    The Node Is Considered To Be Negative Based Upon Histological Evaluation. (pathologically negative)
    CL Item
    The Node Is Considered To Be Positive Based Upon Histological Evaluation. (pathologically positive)
    CL Item
    Lymph Nodes Were Evaluated For Involvement, And They Were Positive (positive)
    CL Item
    Lymph Nodes Were Not Evaluated For Involvement (not evaluated)
    Item
    Assessment Type
    text
    CL.11
    Code List
    Assessment Type
    CL Item
    Biopsy (Biopsy)
    C15189 (NCI Thesaurus)
    C0005558 (UMLS 2011AA)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Chest X-ray (Chest X-Ray)
    CL Item
    Clinical Examination (Clinical examination)
    CL Item
    Cytology (Cytology)
    CL Item
    Histology (Histology)
    CL Item
    Bone Scan (Bone scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Not Applicable (Not applicable)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    CL Item
    Not Evaluated (Not evaluated)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Pathologic (Pathologic)
    C25610 (NCI Thesaurus)
    C1521733 (UMLS 2011AA)
    CL Item
    Physical Exam (Physical exam)
    CL Item
    Radiograph (Radiograph)
    CL Item
    Spiral Ct Scan (Spiral CT Scan)
    CL Item
    Tumor Markers (Tumor Markers)
    CL Item
    Mri (MRI (NMR))
    LymphNodeType,Other
    Item
    Lymph Node Type, Other
    text
    Item
    Tumor Margin Ind
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C25563 (NCI Thesaurus Property)
    C0205284 (UMLS 2011AA Property)
    CL.12
    Code List
    Tumor Margin 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)
    Item
    Tumor Adherence Ind
    text
    CL.13
    Code List
    Tumor Adherence 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)
    Item Group
    Muscle Invasive Bladder Disease: Prior Treatment Affecting The Bladder
    Item
    Prior Intravesical Therapy Ind
    text
    CL.14
    Code List
    Prior Intravesical Therapy 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)
    Item
    Prior Immunotherapy Type
    text
    CL.15
    Code List
    Prior Immunotherapy Type
    CL Item
    Interferon (Interferon)
    C20493 (NCI Thesaurus)
    C0733470 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Bcg (BCG)
    C1328 (NCI Thesaurus)
    PriorImmunotherapyCount
    Item
    Prior Immunotherapy Count
    float
    PriorImmunotherapyOtherAgent
    Item
    Prior Immunotherapy Other Agent
    text
    Item
    Prior Intravesical Chemotherapy Type
    text
    CL.16
    Code List
    Prior Intravesical Chemotherapy Type
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Thiotepa (Thiotepa)
    C875 (NCI Thesaurus)
    C0039871 (UMLS 2011AA)
    CL Item
    Mmc (MMC)
    PriorIntravesicalChemotherapyCount
    Item
    Prior Intravesical Chemotherapy Count
    float
    PriorIntravesicalChemotherapyOtherAgent
    Item
    Prior Intravesical Chemotherapy Other Agent
    text
    Item
    Prior Chemotherapy Ind
    text
    CL.17
    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 Neoadjuvant Chemotherapy Ind
    text
    CL.18
    Code List
    Prior Neoadjuvant Chemotherapy 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)
    Item
    Prior Neoadjuvant Chemotherapy Type
    text
    CL.19
    Code List
    Prior Neoadjuvant Chemotherapy Type
    CL Item
    Carboplatin/paclitaxel (Carboplatin/Paclitaxel)
    C10662 (NCI Thesaurus)
    C0281297 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Cisplatin/gemcitabine (Cisplatin/Gemcitabine)
    C11117 (NCI Thesaurus)
    C0338265 (UMLS 2011AA)
    CL Item
    M-vac (M-VAC)
    PriorNeoadjuvantChemotherapyCount
    Item
    Prior Neoadjuvant Chemotherapy Count
    float
    PriorNeoadjuvantChemotherapyOtherType
    Item
    Prior Neoadjuvant Chemotherapy Other Type
    text
    Item
    Prior Adjuvant Chemotherapy Ind
    text
    CL.20
    Code List
    Prior Adjuvant 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 Adjuvant Chemotherapy Type
    text
    CL.21
    Code List
    Prior Adjuvant Chemotherapy Type
    CL Item
    Carboplatin/paclitaxel (Carboplatin/Paclitaxel)
    C10662 (NCI Thesaurus)
    C0281297 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Cisplatin/gemcitabine (Cisplatin/Gemcitabine)
    C11117 (NCI Thesaurus)
    C0338265 (UMLS 2011AA)
    CL Item
    M-vac (M-VAC)
    PriorAdjuvantChemotherapyCount
    Item
    Prior Adjuvant Chemotherapy Count
    float
    PriorAdjuvantChemotherapyOtherAgent
    Item
    Prior Adjuvant Chemotherapy Other Agent
    text
    Item
    Prior Pelvic RT Ind
    text
    CL.22
    Code List
    Prior Pelvic RT 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)
    Item
    Prior Surgery Ind
    text
    CL.23
    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.24
    Code List
    Prior Surgery Type
    CL Item
    Patient Previosly Had A Turbt (TURBT)
    CL Item
    Patient Previosly Had A Radical Cystectomy (radical cystectomy)
    CL Item
    Patient Previosly Had A Partial Cystectomy (partial cystectomy)
    CL Item
    Patient Previously Had Other Surgery, Specify (other, specify)
    PriorSurgery,TURBTCount
    Item
    Prior Surgery, TURBT Count
    float
    PriorSurgery,OtherType
    Item
    Prior Surgery, Other Type
    text
    Item
    Prior Other Therapy Ind
    text
    CL.25
    Code List
    Prior Other 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)
    PriorOtherTherapyName
    Item
    Prior Other Therapy Name
    text
    Item Group
    Allows Documentation Of Any Additional Cooments
    Comments
    Item
    Comments
    text
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