ID

6916

Description

Recurrent Gynecologic Cancer - On-study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A974-3FA4-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A974-3FA4-E034-080020C9C0E0

Keywords

  1. 9/19/12 9/19/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
Uploaded on

January 8, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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On-Study - Recurrent Gynecologic Cancer - On-study Form - 2019342v2.31

No Instruction available.

  1. StudyEvent: Recurrent Gynecologic Cancer - On-study Form
    1. No Instruction available.
Crf Header
Description

Crf Header

Coordinating Group Protocol Number
Description

CoordinatingGroupProtocolNumber

Data type

text

Coordinating Group Code
Description

CoordinatingGroupCode

Data type

text

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

Protocol Title

Data type

text

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

PatientStudyID,CoordinatingGroup

Data type

text

Patient Study ID, Participating Group
Description

PatientStudyID,ParticipatingGroup

Data type

text

Participating Group Code
Description

ParticipatingGroupCode

Data type

text

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

InstitutionName

Data type

text

Affiliate Name
Description

AffiliateName

Data type

text

Patient Name, Last
Description

PatientName,Last

Data type

text

Patient Name, First
Description

PatientName,First

Data type

text

Patient Name, Middle
Description

PatientName,Middle

Data type

text

Gyn: Form Administration
Description

Gyn: Form Administration

Person Completing Form, Last Name
Description

PersonCompletingForm,LastName

Data type

text

Person Completing Form, First Name
Description

PersonCompletingForm,FirstName

Data type

text

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

AmendedDataInd

Data type

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Interval Report From Date
Description

IntervalReportFromDate

Data type

date

Interval Report To Date
Description

IntervalReportToDate

Data type

date

Gyn: Disease Description - Prior History
Description

Gyn: Disease Description - Prior History

Primary Tumor Diagnosis Date
Description

PrimaryTumorDiagnosisDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Stage Grouping
Description

StageGrouping

Data type

text

Histologic Grade
Description

HistologicGrade

Data type

text

Histologic Type
Description

HistologicType

Data type

text

Histologic Type, Other Name
Description

HistologicType,OtherName

Data type

text

Primary Surgery Type
Description

PrimarySurgeryType

Data type

text

Primary Surgery Other Type
Description

PrimarySurgeryOtherType

Data type

text

Primary Surgery Date
Description

PrimarySurgeryDate

Data type

date

Gyn: Disease Description - Current History
Description

Gyn: Disease Description - Current History

Residual Disease Status
Description

ResidualDiseaseStatus

Data type

text

Disease Status
Description

DiseaseStatus

Data type

text

Progression Date, First
Description

ProgressionDate,First

Data type

date

Progression Assessment Method
Description

ProgressionAssessmentMethod

Data type

text

Disease Site
Description

DiseaseSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus ObjectClass-2
C12971
UMLS 2011AA ObjectClass-2
C0006141
Disease Site, Lymph Nodes
Description

DiseaseSite,LymphNodes

Data type

text

Disease Site, Other
Description

DiseaseSite,Other

Data type

text

Lymph Nodes Type
Description

LymphNodesType

Data type

text

Lymph Node Involvement
Description

LymphNodeInvolvement

Data type

text

Assessment Type
Description

AssessmentType

Data type

text

Lymph Nodes Other Type
Description

LymphNodesOtherType

Data type

text

Disease Assessment, Measurable Ind
Description

DiseaseAssessment,MeasurableInd

Data type

text

Gyn: Prior Treatment For Gynecologic Cancer
Description

Gyn: Prior Treatment For Gynecologic Cancer

Prior Chemotherapy Ind
Description

PriorChemotherapyInd

Data type

text

First Prior Treatment Begin Date
Description

FirstPriorTreatmentBeginDate

Data type

date

Prior Chemotherapy End Date
Description

PriorChemotherapyEndDate

Data type

date

Prior Chemotherapy Regimen
Description

PriorChemotherapyRegimen

Data type

text

Prior Chemotherapy Regimen, Agent
Description

PriorChemotherapyRegimen,Agent

Data type

text

Prior Chemotherapy Regimen, Other Agent
Description

PriorChemotherapyRegimen,OtherAgent

Data type

text

Prior Hormonal Therapy Ind
Description

PriorHormonalTherapyInd

Data type

text

Prior Hormonal Therapy Type
Description

PriorHormonalTherapyType

Data type

text

Prior Immunotherapy Ind
Description

PriorImmunotherapyInd

Data type

text

Prior Immunotherapy Type
Description

PriorImmunotherapyType

Data type

text

Prior RT Ind
Description

PriorRTInd

Data type

text

RT Recurrence Site Ind
Description

RTRecurrenceSiteInd

Data type

boolean

Prior Surgery Ind
Description

PriorSurgeryInd

Data type

text

Allows Documentation Of Any Additional Cooments
Description

Allows Documentation Of Any Additional Cooments

Comments
Description

Comments

Data type

text

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  1. StudyEvent: Recurrent Gynecologic Cancer - On-study Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
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
Gyn: 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)
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)
IntervalReportFromDate
Item
Interval Report From Date
date
IntervalReportToDate
Item
Interval Report To Date
date
Item Group
Gyn: Disease Description - Prior History
PrimaryTumorDiagnosisDate
Item
Primary Tumor Diagnosis Date
date
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
Stage Grouping
text
Code List
Stage Grouping
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (I)
CL Item
Stage Grouping Cannot Be Assessed (X)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IA1)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IA2)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IB)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IB1)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IB2)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IC)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (II)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIA)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIB)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIC)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (III)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIIA)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIIB)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IIIC)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IV)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IVA)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IVB)
CL Item
Refer To Figo Staging For Specific Gynecologic Cancer (IA)
Item
Histologic Grade
text
Code List
Histologic Grade
CL Item
Grade 1-well Differentiated (1)
CL Item
Grade 2-moderately Differentiated (2)
CL Item
Grade Unknown (Unknown)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Applicable (Not applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Grade 3-poorly Differentiated (3)
Item
Histologic Type
text
Code List
Histologic Type
CL Item
Adenocarcinoma With Squamous Differentiation (Adenocarcinoma with Squamous Differentiation)
CL Item
Undifferentiated Carcinoma (Undifferentiated carcinoma)
C3692 (NCI Thesaurus)
C0205698 (UMLS 2011AA)
CL Item
Adenofibroma (Adenofibroma)
C8984 (NCI Thesaurus)
C0001422 (UMLS 2011AA)
CL Item
Adenosarcoma (Adenosarcoma)
C9474 (NCI Thesaurus)
C0001442 (UMLS 2011AA)
CL Item
Adenosquamous (Adenosquamous)
CL Item
Brenner Tumor (benign) (Brenner tumor (benign))
CL Item
Brenner Tumor (malignant) (Brenner tumor (malignant))
CL Item
Brenner Tumor Of Low Malignant Potential (Brenner tumor of LMP)
CL Item
Cancer With Dermoid Cyst, Specify Types (Cancer with dermoid cyst)
CL Item
Carcinosarcoma/mesodermal (mullerian) Mixed Tumor (Carcinosarcoma/Mesodermal (Mullerian) mixed tumor)
CL Item
Choriocarcinoma (Choriocarcinoma)
C2948 (NCI Thesaurus)
C0008497 (UMLS 2011AA)
CL Item
Clear Cell Carcinoma (Clear cell carcinoma)
CL Item
Clear Cell Cystadenofibroma (benign) (Clear cell cystadenofibroma (benign))
CL Item
Clear Cell Cystadenoma (benign) (Clear cell cystadenoma (benign))
CL Item
Clear Cell Tumor Of Low Malignant Potential (Clear cell tumor of LMP)
CL Item
Dysgerminoma (Dysgerminoma)
C2996 (NCI Thesaurus)
C0013377 (UMLS 2011AA)
CL Item
Embryonal Carcinoma (Embryonal carcinoma)
C3752 (NCI Thesaurus)
C0026705 (UMLS 2011AA)
CL Item
Endodermal Sinus Tumor (yolk Sac Tumor) (Endodermal sinus tumor)
CL Item
Endometrial Stromal Sarcoma (Endometrial stromal sarcoma)
C8973 (NCI Thesaurus)
C0206630 (UMLS 2011AA)
CL Item
Endometrioid Adenocarcinoma (Endometrioid adenocarcinoma)
C3769 (NCI Thesaurus)
C0206687 (UMLS 2011AA)
CL Item
Endometrioid Cystadenofibroma (benign) (Endometrioid cystadenofibroma (benign))
CL Item
Endometrioid Cystadenoma (benign) (Endometrioid cystadenoma (benign))
CL Item
Endometrioid Tumor Of Low Malignant Potential (Endometrioid tumor of LMP)
CL Item
Fibroma (Fibroma)
C3041 (NCI Thesaurus)
C0016045 (UMLS 2011AA)
CL Item
Germ Cell Tumor, Mixed (Germ cell tumor, mixed)
CL Item
Gestational Trophoblastic Disease (Gestational trophoblastic disease)
CL Item
Granulosa Cell Tumor (Granulosa cell tumor)
C3070 (NCI Thesaurus)
C0018206 (UMLS 2011AA)
CL Item
Gynandroblastoma (Gynandroblastoma)
C0018413 (NCI Metathesaurus)
CL Item
Mixed Epithelial Carcinoma, Specify Components (Mixed epithelial carcinoma)
CL Item
Mixed Malignant Germ Cell Tumor, Specify Components (Mixed malignant germ cell tumor)
CL Item
Mucinous Adenocarcinoma (Mucinous adenocarcinoma)
C26712 (NCI Thesaurus)
C0007130 (UMLS 2011AA)
CL Item
Mucinous Cystadenofibroma (benign) (Mucinous cystadenofibroma (benign))
CL Item
Mucinous Cystadenoma (benign) (Mucinous cystadenoma (benign))
CL Item
Mucinous Tumor Of Low Malignant Potential (Mucinous tumor of LMP)
CL Item
Other, Specify (Other, specify)
CL Item
Ovarian Endometriosis (Ovarian endometriosis)
C27628 (NCI Thesaurus)
C0156344 (UMLS 2011AA)
CL Item
Physiologic Cyst (corpus Luteum) (Physiologic cyst (corpus luteum))
CL Item
Physiologic Cyst (follicle) (Physiologic cyst (follicle))
CL Item
Polyembryoma (Polyembryoma)
C0334518 (NCI Metathesaurus)
CL Item
Serous Adenocarcinoma (Serous adenocarcinoma)
C40101 (NCI Thesaurus)
C0206701 (UMLS 2011AA)
CL Item
Serous Cystadenofibroma (benign) (Serous cystadenofibroma (benign))
CL Item
Serous Cystadenoma (benign) (Serous cystadenoma (benign))
CL Item
Serous Tumor Of Low Malignant Potential (Serous tumor of LMP)
CL Item
Sertoli-leydig Cell (androblastoma) (Sertoli-Leydig cell (Androblastoma))
CL Item
Sex-cord/stromal, Unclassified (Sex-cord/stromal, unclassified)
CL Item
Simple Cyst (Simple cyst)
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Steroid/lipid Cell Tumor (Steroid/Lipid cell tumor)
CL Item
Teratoma, Immature, Specify Components (Teratoma, immature)
CL Item
Teratoma, Mature (Teratoma, mature)
CL Item
Transitional Cell Carcinoma, Including Brenner Tumor (Transitional cell carcinoma (including Brenner))
CL Item
Adenocarcinoma, Unspecified (Adenocarcinoma, unspecified)
HistologicType,OtherName
Item
Histologic Type, Other Name
text
Item
Primary Surgery Type
text
Code List
Primary Surgery Type
CL Item
Omentectal Biopsy (Omentectal biopsy)
CL Item
Peritoneal Sampling (Peritoneal sampling)
CL Item
Bilateral Salpingo-oophorectomy (bilateral salpingo-oophorectomy)
CL Item
Cervical Conization (cervical conization)
CL Item
Omentectomy (omentectomy)
C0198614 (NCI Metathesaurus)
CL Item
Other, Specify (other, specify)
CL Item
Unilateral Salpingo-oophorectomy (unilateral salpingo-oophorectomy)
C28012 (NCI Thesaurus)
C0205092 (UMLS 2011AA)
C15323 (NCI Thesaurus-3)
C0036132 (UMLS 2011AA-4)
CL Item
Partial Hysterectomy (partial hysterectomy)
C40961 (NCI Thesaurus)
C1270947 (UMLS 2011AA)
CL Item
Pelvic Lymphadenectomy (pelvic lymphadenectomy)
CL Item
Pelvic Node Sampling/dissection (pelvic node sampling/dissection)
CL Item
Radical Hysterectomy (radical hysterectomy)
CL Item
Radical Trachelectomy (radical trachelectomy)
CL Item
Total Hysterectomy (total hysterectomy)
C15701 (NCI Thesaurus)
C0677962 (UMLS 2011AA)
CL Item
Para-aortic Node Sampling/dissection (para-aortic node sampling/dissection)
PrimarySurgeryOtherType
Item
Primary Surgery Other Type
text
PrimarySurgeryDate
Item
Primary Surgery Date
date
Item Group
Gyn: Disease Description - Current History
Item
Residual Disease Status
text
Code List
Residual Disease Status
CL Item
Gross Disease (gross disease)
CL Item
Unknown/not Documented (unknown/not documented)
CL Item
No Evidence Of Disease (no evidence of disease)
C40413 (NCI Thesaurus)
C1518340 (UMLS 2011AA)
CL Item
Microscopic Disease (microscopic disease)
Item
Disease Status
text
Code List
Disease Status
CL Item
Primary Gyn Disease Continues To Be Present Following Initial Treatment (Persistent)
CL Item
Recurrence Of Same Gyn Disease Previously Treated Successfully (Recurrence)
CL Item
Progression Of Gyn Disease Per Recist Criteria (Progression)
ProgressionDate,First
Item
Progression Date, First
date
Item
Progression Assessment Method
text
Code List
Progression Assessment Method
CL Item
Clinical Examination (clinical)
CL Item
Radiographic (radiographic)
CL Item
Histology (histologic)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
Item
Disease Site
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12971 (NCI Thesaurus ObjectClass-2)
C0006141 (UMLS 2011AA ObjectClass-2)
Code List
Disease Site
CL Item
Cns/brain (CNS/brain)
CL Item
Uterus (uterus)
C12405 (NCI Thesaurus)
C0042149 (UMLS 2011AA)
CL Item
Bladder (bladder)
C12414 (NCI Thesaurus)
C0005682 (UMLS 2011AA)
CL Item
Bone (bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
CL Item
Cervix (cervix)
C12311 (NCI Thesaurus)
C0007874 (UMLS 2011AA)
CL Item
Colon (colon)
C12382 (NCI Thesaurus)
C0009368 (UMLS 2011AA)
CL Item
Endometrium (endometrium)
C12313 (NCI Thesaurus)
C0014180 (UMLS 2011AA)
CL Item
Liver (liver)
C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)
CL Item
Lung (lung)
C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)
CL Item
Lymph Nodes, Specify (lymph nodes, specify)
CL Item
Other, Specify (other, specify)
CL Item
Ovary (ovary)
C12404 (NCI Thesaurus)
C0029939 (UMLS 2011AA)
CL Item
Parametrial Involvement (parametrial involvement)
CL Item
Peritoneum (peritoneum)
C12770 (NCI Thesaurus)
C0031153 (UMLS 2011AA)
CL Item
Pleura (pleura)
C12469 (NCI Thesaurus)
C0032225 (UMLS 2011AA)
CL Item
Pleural Effusion (pleural effusion)
C3331 (NCI Thesaurus)
C0021071 (UMLS 2011AA)
CL Item
Skin (skin)
C12470 (NCI Thesaurus)
C1123023 (UMLS 2011AA)
CL Item
Ascites (ascites)
C2885 (NCI Thesaurus)
C0003962 (UMLS 2011AA)
DiseaseSite,LymphNodes
Item
Disease Site, Lymph Nodes
text
DiseaseSite,Other
Item
Disease Site, Other
text
Item
Lymph Nodes Type
text
Code List
Lymph Nodes Type
CL Item
Inguinal (inguinal)
CL Item
Other, Specify (other, specify)
CL Item
Scalene (scalene)
CL Item
Pelvic (pelvic)
C25399 (NCI Thesaurus)
C0030797 (UMLS 2011AA)
CL Item
Para-aortic (para-aortic)
Item
Lymph Node Involvement
text
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
Equivocal (equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Negative (negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Unknown (unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
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
Positive (positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Not Evaluated (not evaluated)
Item
Assessment Type
text
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
Bone Scan (Bone scan)
C17646 (NCI Thesaurus)
C0203668 (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)
C16491 (NCI Thesaurus)
C0010819 (UMLS 2011AA)
CL Item
Histology (Histology)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
CL Item
Laparoscopy (Laparoscopy)
C16969 (NCI Thesaurus)
C0031150 (UMLS 2011AA)
CL Item
Laparotomy (Laparotomy)
C15266 (NCI Thesaurus)
C0023038 (UMLS 2011AA)
CL Item
Biopsy, Not Otherwise Specified (Biopsy, other)
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))
LymphNodesOtherType
Item
Lymph Nodes Other Type
text
Item
Disease Assessment, Measurable Ind
text
Code List
Disease Assessment, Measurable 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 Group
Gyn: Prior Treatment For Gynecologic Cancer
Item
Prior Chemotherapy Ind
text
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)
FirstPriorTreatmentBeginDate
Item
First Prior Treatment Begin Date
date
PriorChemotherapyEndDate
Item
Prior Chemotherapy End Date
date
PriorChemotherapyRegimen
Item
Prior Chemotherapy Regimen
text
PriorChemotherapyRegimen,Agent
Item
Prior Chemotherapy Regimen, Agent
text
PriorChemotherapyRegimen,OtherAgent
Item
Prior Chemotherapy Regimen, Other Agent
text
Item
Prior Hormonal Therapy Ind
text
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)
PriorHormonalTherapyType
Item
Prior Hormonal Therapy Type
text
Item
Prior Immunotherapy Ind
text
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)
PriorImmunotherapyType
Item
Prior Immunotherapy Type
text
Item
Prior RT Ind
text
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)
RTRecurrenceSiteInd
Item
RT Recurrence Site Ind
boolean
Item
Prior Surgery Ind
text
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 Group
Allows Documentation Of Any Additional Cooments
Comments
Item
Comments
text

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