Description:

NCI Cooperative Group Follow-Up Form (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C23658-5AE0-303F-E034-0003BA12F5E7

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C23658-5AE0-303F-E034-0003BA12F5E7

Keywords:
Versions (2) ▾
  1. 8/26/12
  2. 1/8/15
Uploaded on:

January 8, 2015

DOI:
No DOI assigned. To request one pleaselog in.
License:
Creative Commons BY-NC 3.0 Legacy
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Bladder Cancer NCT00014534 Follow-Up - NCI Cooperative Group Follow-Up Form (CALGB-90104) - 2056490v3.0

No Instruction available.

  1. StudyEvent: NCI Cooperative Group Follow-Up Form (CALGB-90104)
    1. No Instruction available.
Mskcc 00-138; Calgb-90104; Ecog
Form Administration
Are data amended?
Vital Status
Patient's Vital Status
Primary Cause of Death (check one)
Disease Follow-up Status
Has the patient had a documented clinical assessment for this cancer?
Notice Of Progression
Has the patient been diagnosed with a local recurrence that has not been previously reported?
Site(s) of First Local Progression (mark all that apply)
Has the patient been diagnosed with a local-regional lymph node recurrence?
Site(s) of First Local-Regional Lymph Node Progression (mark all that apply)
Has the patient been diagnosed with a distant metastatic progression that has not been previously reported?
Site(s) of First Distant Progression (mark all that apply)
Notice Of New Primary
Has a new primary cancer or myelodysplastic syndrome (MDS) been diagnosed that has not been previously reported?
Notice Of Long Term Toxicity
Has the patient experienced any severe (Grade >=3), long term toxicity that has not been previously reported?
Comments
Ccrr Module For Nci Cooperative Group Follow-up Form (calgb-90104)