ID

8070

Description

CALGB Non-Small Cell Lung Cancer Staging Form (AJCC V.7.0) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=85DE3B43-56B5-4D38-E040-BB89AD4369BA

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=85DE3B43-56B5-4D38-E040-BB89AD4369BA

Mots-clés

Versions (2)
  1. 20/09/2012 20/09/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le

9 janvier 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
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On-Study - CALGB Non-Small Cell Lung Cancer Staging Form (AJCC V.7.0) - 3082176v1.0

Anglais

INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy complete the form electronically. After entering all data, click the "Print and/or Submit to CALGB" button located at the bottom of the last page of the form. Retain a copy of the form for your records. Submit supporting documentation by fax (919-416-4990) or mail. If data are amended, circle amended items, check the "Yes" box, and submit by fax or mail

1 Formulaires  
Header
Description

Header

CALGB Form
Description

Form ID CALGB

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3262252
NCI Thesaurus ObjectClass
C19464
UMLS CUI-2
C1516238
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass-2
C25442
CALGB Study No.
Description

Protocol ID CALGB

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1516238
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25442
CALGB Patient ID
Description

Trial subject ID CALGB

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1516238
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25442
Date Current Staging Assessment Completed (MM DD YYYY)
Description

CurrentStageCompleteAssessmentDate

Type de données

date

Alias
NCI Thesaurus ObjectClass
C25471
UMLS 2011AA ObjectClass
C0521116
NCI Thesaurus ObjectClass-2
C16899
UMLS 2011AA ObjectClass-2
C1300072
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Are data amended
Description

Data amended

Type de données

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Unnamed2
Description

Unnamed2

Patient Initials (Last, First Middle)
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Patient Hospital No.
Description

Medical Record Number

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301894
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25261
NCI Thesaurus Property-2
C25198
Institution/Affiliate
Description

Institution Name

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Participating Group
Description

Participating Group

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2347449
NCI Thesaurus ObjectClass
C25608
NCI Thesaurus ObjectClass-2
C17005
NCI Thesaurus Property
C25364
Participating Group Study No
Description

Study Number Participating Group

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Participating Group Patient ID
Description

Trial subject ID Participating Group

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Staging
Description

Staging

Method of Evaluation (Staging Method)
Description

Evaluation method

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C2911685
NCI Thesaurus ObjectClass
C20989
NCI Thesaurus Property
C16847
TNM descriptors (Mark all that apply with an X. as determined by the Staging Method indicated above)
Description

TNMDescriptionType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25384
UMLS 2011AA ObjectClass
C1515169
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
Tumor Size (cm)
Description

TumorSizeDiameterMeasurement

Type de données

float

Unités de mesure
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25681
UMLS 2011AA Property
C0456389
cm
Clinical T Stage
Description

Clinical T Stage

T Stage (Primary tumor)
Description

LungTumorClinicalTStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
T2 tumor with any of the following (Mark all that apply with an X.)
Description

LungTumorTStageTwoPresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66833
UMLS 2011AA Property-2
C0205448
NCI Thesaurus Property-3
C25728
UMLS 2011AA Property-3
C0475455
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
T3 tumor with any of the following (Mark all that apply with an X.)
Description

LungTumorTStageThreePresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus Property-3
C66834
UMLS 2011AA Property-3
C0205449
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
T4 tumor of any size with invasion of (Mark all that apply with an X.)
Description

LungTumorTStageFourPresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66835
UMLS 2011AA Property-2
C0205450
NCI Thesaurus Property-3
C25728
UMLS 2011AA Property-3
C0475455
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Clinical N Stage
Description

Clinical N Stage

N Stage (Regional lymph nodes)
Description

LungTumorClinicalNStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
Clinical M Stage
Description

Clinical M Stage

M Stage (Metastasis)
Description

LungTumorClinicalMStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
M1a metastasis with any of the following (Mark all that apply with an X.)
Description

LungTumorMStageOnePresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66832
UMLS 2011AA Property-2
C0205447
NCI Thesaurus Property-3
C25727
UMLS 2011AA Property-3
C0456533
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Specify site
Description

NeoplasmSpecimenMetastaticAnatomicLocationSpecify

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property-2
C14174
UMLS 2011AA Property-2
C0036525
NCI Thesaurus Property-3
C25421
UMLS 2011AA Property-3
C0002808
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Clinical T Stage
Description

Clinical T Stage

T Stage
Description

LungTumorPathologicTStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
T2 tumor with any of the following (Mark all that apply with an X.)
Description

LungTumorTStageTwoPresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66833
UMLS 2011AA Property-2
C0205448
NCI Thesaurus Property-3
C25728
UMLS 2011AA Property-3
C0475455
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
T3 tumor with any of the following (Mark all that apply with an X.)
Description

LungTumorTStageThreePresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus Property-3
C66834
UMLS 2011AA Property-3
C0205449
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
T4 tumor of any size with invasion of (Mark all that apply with an X.)
Description

LungTumorTStageFourPresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66835
UMLS 2011AA Property-2
C0205450
NCI Thesaurus Property-3
C25728
UMLS 2011AA Property-3
C0475455
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Clinical N Stage
Description

Clinical N Stage

N Stage
Description

LungTumorPathologicNStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
Clinical M Stage
Description

Clinical M Stage

M Stage
Description

LungTumorPathologicMStage

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus ValueDomain-2
C39315
UMLS 2011AA ValueDomain-2
C1515946
M1a metastasis with any of the following (Mark all that apply with an X.)
Description

LungTumorMStageOnePresentType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12468
UMLS 2011AA ObjectClass-2
C0024109
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C66832
UMLS 2011AA Property-2
C0205447
NCI Thesaurus Property-3
C25727
UMLS 2011AA Property-3
C0456533
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Specify site
Description

NeoplasmSpecimenMetastaticAnatomicLocationSpecify

Type de données

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property-2
C14174
UMLS 2011AA Property-2
C0036525
NCI Thesaurus Property-3
C25421
UMLS 2011AA Property-3
C0002808
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Overall Response
Description

Overall Response

Completed by (Last name, First name)
Description

Person Completing Form

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Date Form Originally Completed (MM DD YYYY)
Description

Form Completion Date

Type de données

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS CUI-1
C1549507
NCI Thesaurus Property
C25250
NCI Thesaurus Property-2
C25604
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
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INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy complete the form electronically. After entering all data, click the "Print and/or Submit to CALGB" button located at the bottom of the last page of the form. Retain a copy of the form for your records. Submit supporting documentation by fax (919-416-4990) or mail. If data are amended, circle amended items, check the "Yes" box, and submit by fax or mail

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Header
Form ID CALGB
Item
CALGB Form
text
C25337 (NCI Thesaurus ValueDomain)
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
Protocol ID CALGB
Item
CALGB Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
Trial subject ID CALGB
Item
CALGB Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
CurrentStageCompleteAssessmentDate
Item
Date Current Staging Assessment Completed (MM DD YYYY)
date
C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ObjectClass-2)
C1300072 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Data amended
Item
Are data amended
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Unnamed2
Patient Initials
Item
Patient Initials (Last, First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Medical Record Number
Item
Patient Hospital No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Participating Group
Item
Participating Group
text
C25191 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Study No
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Item Group
Staging
Item
Method of Evaluation (Staging Method)
text
C25284 (NCI Thesaurus ValueDomain)
C2911685 (UMLS CUI-1)
C20989 (NCI Thesaurus ObjectClass)
C16847 (NCI Thesaurus Property)
CL.2
Code List
Method of Evaluation (Staging Method)
CL Item
Chest Radiography (Chest CT)
C38103 (NCI Thesaurus)
C0039985 (UMLS 2011AA)
CL Item
Chest X-ray (Chest x-ray)
CL Item
Pet Scan (PET scan)
CL Item
Histology (Histology)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
CL Item
Cytology (Cytology)
C16491 (NCI Thesaurus)
C0010819 (UMLS 2011AA)
Item
TNM descriptors (Mark all that apply with an X. as determined by the Staging Method indicated above)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25384 (NCI Thesaurus ObjectClass)
C1515169 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
CL.3
Code List
TNM descriptors (Mark all that apply with an X. as determined by the Staging Method indicated above)
CL Item
Multiple Primary Tumors (m)
CL Item
Recurrent (r)
C14173 (NCI Thesaurus)
C2945760 (UMLS 2011AA)
CL Item
Post-treatment (y)
CL024863 (NCI Metathesaurus)
TumorSizeDiameterMeasurement
Item
Tumor Size (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25681 (NCI Thesaurus Property)
C0456389 (UMLS 2011AA Property)
Item Group
Clinical T Stage
Item
T Stage (Primary tumor)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.4
Code List
T Stage (Primary tumor)
CL Item
No Evidence Of Primary Tumor (T0)
CL Item
Tumor <=3 Cm In Greatest Dimension, Surrounded By Lung Or Visceral Pleura, Without Bronchoscopic Evidence Of Invasion More Proximal Than The Lobar Bronchus (i.e., Not In The Main Bronchus) (T1)
CL Item
Tumor > 3 Cm But <=7 Cm Involves Main Bronchus, >=2 Cm Distal To The Carina Invades Visceral Pleura (pl1 Or Pl2) Associated With Atelectasis Or Obstructive Pneumonitis That Extends To The Hilar Region But Does Not Involve The Entire Lung (T2)
CL Item
Tumor > 7 Cm Or One That Directly Invades Any Of The Following: Parietal Pleural (pl3) Chest Wall (including Superior Sulcus Tumors), Diaphragm, Phrenic Nerve, Mediastinal Pleura, Parietal Pericardium; Or Tumor In The Main Bronchus (T3)
CL Item
Tumor Of Any Size That Invades Any Of The Following: Mediastinum, Heart, Great Vessels, Trachea, Recurrent Laryngeal Nerve, Esophagus, Vertebral Body, Carina, Separate Tumor Nodule(s) In A Different Ipsilateral Lobe (T4)
CL Item
Primary Tumor Cannot Be Assessed (TX)
CL Item
Tis Carcinoma In Situ (Tis)
Item
T2 tumor with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66833 (NCI Thesaurus Property-2)
C0205448 (UMLS 2011AA Property-2)
C25728 (NCI Thesaurus Property-3)
C0475455 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.12
Code List
T2 tumor with any of the following (Mark all that apply with an X.)
CL Item
> 3 But <= 7 Cm (> 3 but <= 7 cm)
CL Item
Atelectasis/obstructive Pneumonia Extending To Hilum But Not Involving The Entire Lung (Atelectasis/obstructive pneumonia extending to hilum but not involving the entire lung)
CL Item
Invades Visceral Pleura (Invades visceral pleura)
CL Item
Involves Main Bronchus >= 2 Cm Distal To The Carina (Involves main bronchus >= 2 cm distal to the carina)
Item
T3 tumor with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C66834 (NCI Thesaurus Property-3)
C0205449 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.13
Code List
T3 tumor with any of the following (Mark all that apply with an X.)
CL Item
> 7 Cm (> 7 cm)
CL Item
Atelectasis/obstructive Pneumonia Of Entire Lung (Atelectasis/obstructive pneumonia of entire lung)
CL Item
Directly Invading Chest Wall, Diaphragm, Phrenic Nerve, Mediastinal Pleura, Or Parietal Pericardium (Directly invading chest wall, diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium)
CL Item
Separate Tumor Nodule(s) In The Same Lobe (as Primary Tumor) (Separate tumor nodule(s) in the same lobe (as primary tumor))
CL Item
Tumor In The Main Bronchus < 2 Cm Distal To The Carina (Tumor in the main bronchus < 2 cm distal to the carina)
Item
T4 tumor of any size with invasion of (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66835 (NCI Thesaurus Property-2)
C0205450 (UMLS 2011AA Property-2)
C25728 (NCI Thesaurus Property-3)
C0475455 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.14
Code List
T4 tumor of any size with invasion of (Mark all that apply with an X.)
CL Item
Carina (Carina)
C25264 (NCI Thesaurus)
C0225594 (UMLS 2011AA)
CL Item
Esophagus (Esophagus)
C12389 (NCI Thesaurus)
C0014876 (UMLS 2011AA)
CL Item
Great Vessels (Great vessels)
CL Item
Heart (Heart)
C12727 (NCI Thesaurus)
C0018787 (UMLS 2011AA)
CL Item
Mediastinum (Mediastinum)
C12748 (NCI Thesaurus)
C0025066 (UMLS 2011AA)
CL Item
Recurrent Laryngeal Nerve (Recurrent laryngeal nerve)
CL Item
Separate Tumor Nodules In A Different Ipsilateral Lobe (Separate tumor nodules in a different ipsilateral lobe)
CL Item
Trachea (Trachea)
C12428 (NCI Thesaurus)
C0040578 (UMLS 2011AA)
CL Item
Vertebra (Vertebra)
C12933 (NCI Thesaurus)
C0549207 (UMLS 2011AA)
Item Group
Clinical N Stage
Item
N Stage (Regional lymph nodes)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.8
Code List
N Stage (Regional lymph nodes)
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Metastasis In Ipsilateral Peribronchial And/or Ipsilateral Hilar Lymph Nodes And Intrapulmonary Nodes, Including Involvement By Direct Extension (N1)
CL Item
Metastasis In Ipsilateral Mediastinal And/or Subcarinal Lymph Node(s) (N2)
CL Item
Metastasis In Contralateral Mediastinal, Contralateral Hilar, Ipsilateral Or Contralateral Scalene, Or Supraclavicular Lymph Node(s) (N3)
CL Item
Regional Lymph Nodes Cannot Be Assessed (NX)
Item Group
Clinical M Stage
Item
M Stage (Metastasis)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.9
Code List
M Stage (Metastasis)
CL Item
No Distant Metastasis (no Pathologic M0; Use Clinical M To Complete Stage Group) (M0)
CL Item
Separate Tumor Nodule(s) In A Contralateral Lobe; Tumor With Pleural Nodules Or Malignant Pleural (or Pericardial) Effusion (M1a)
CL Item
Distant Metastasis (M1b)
C18206 (NCI Thesaurus)
C1269798 (UMLS 2011AA)
C18206 (NCI Thesaurus-3)
C1269798 (UMLS 2011AA-4)
Item
M1a metastasis with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66832 (NCI Thesaurus Property-2)
C0205447 (UMLS 2011AA Property-2)
C25727 (NCI Thesaurus Property-3)
C0456533 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.17
Code List
M1a metastasis with any of the following (Mark all that apply with an X.)
CL Item
Separate Tumor Nodules In A Contralateral Lobe (Separate tumor nodules in a contralateral lobe)
CL Item
Tumor With Pleural Nodules Or Malignant Pleural (or Pericardial) Effusion (Tumor with pleural nodules or malignant pleural (or pericardial) effusion)
NeoplasmSpecimenMetastaticAnatomicLocationSpecify
Item
Specify site
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C14174 (NCI Thesaurus Property-2)
C0036525 (UMLS 2011AA Property-2)
C25421 (NCI Thesaurus Property-3)
C0002808 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item Group
Clinical T Stage
Item
T Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.11
Code List
T Stage
CL Item
No Evidence Of Primary Tumor (T0)
CL Item
Tumor <=3 Cm In Greatest Dimension, Surrounded By Lung Or Visceral Pleura, Without Bronchoscopic Evidence Of Invasion More Proximal Than The Lobar Bronchus (i.e., Not In The Main Bronchus) (T1)
CL Item
Tumor <=2 Cm In Greatest Dimension (T1a)
CL Item
Tumor > 2 Cm But <=3 Cm In Greatest Dimension (T1b)
CL Item
Tumor > 3 Cm But <=7 Cm Involves Main Bronchus, >=2 Cm Distal To The Carina Invades Visceral Pleura (pl1 Or Pl2) Associated With Atelectasis Or Obstructive Pneumonitis That Extends To The Hilar Region But Does Not Involve The Entire Lung (T2)
CL Item
Tumor > 3 Cm But <=5 Cm In Greatest Dimension (T2a)
CL Item
Tumor > 5 Cm But <=7 Cm In Greatest Dimension (T2b)
CL Item
Tumor > 7 Cm Or One That Directly Invades Any Of The Following: Parietal Pleural (pl3) Chest Wall (including Superior Sulcus Tumors), Diaphragm, Phrenic Nerve, Mediastinal Pleura, Parietal Pericardium; Or Tumor In The Main Bronchus (T3)
CL Item
Tumor Of Any Size That Invades Any Of The Following: Mediastinum, Heart, Great Vessels, Trachea, Recurrent Laryngeal Nerve, Esophagus, Vertebral Body, Carina, Separate Tumor Nodule(s) In A Different Ipsilateral Lobe (T4)
CL Item
Tis Carcinoma In Situ (Tis)
CL Item
Primary Tumor Cannot Be Assessed (TX)
Item
T2 tumor with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66833 (NCI Thesaurus Property-2)
C0205448 (UMLS 2011AA Property-2)
C25728 (NCI Thesaurus Property-3)
C0475455 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.12
Code List
T2 tumor with any of the following (Mark all that apply with an X.)
CL Item
> 3 But <= 7 Cm (> 3 but <= 7 cm)
CL Item
Atelectasis/obstructive Pneumonia Extending To Hilum But Not Involving The Entire Lung (Atelectasis/obstructive pneumonia extending to hilum but not involving the entire lung)
CL Item
Invades Visceral Pleura (Invades visceral pleura)
CL Item
Involves Main Bronchus >= 2 Cm Distal To The Carina (Involves main bronchus >= 2 cm distal to the carina)
Item
T3 tumor with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C66834 (NCI Thesaurus Property-3)
C0205449 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.13
Code List
T3 tumor with any of the following (Mark all that apply with an X.)
CL Item
> 7 Cm (> 7 cm)
CL Item
Atelectasis/obstructive Pneumonia Of Entire Lung (Atelectasis/obstructive pneumonia of entire lung)
CL Item
Directly Invading Chest Wall, Diaphragm, Phrenic Nerve, Mediastinal Pleura, Or Parietal Pericardium (Directly invading chest wall, diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium)
CL Item
Separate Tumor Nodule(s) In The Same Lobe (as Primary Tumor) (Separate tumor nodule(s) in the same lobe (as primary tumor))
CL Item
Tumor In The Main Bronchus < 2 Cm Distal To The Carina (Tumor in the main bronchus < 2 cm distal to the carina)
Item
T4 tumor of any size with invasion of (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66835 (NCI Thesaurus Property-2)
C0205450 (UMLS 2011AA Property-2)
C25728 (NCI Thesaurus Property-3)
C0475455 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.14
Code List
T4 tumor of any size with invasion of (Mark all that apply with an X.)
CL Item
Carina (Carina)
C25264 (NCI Thesaurus)
C0225594 (UMLS 2011AA)
CL Item
Esophagus (Esophagus)
C12389 (NCI Thesaurus)
C0014876 (UMLS 2011AA)
CL Item
Great Vessels (Great vessels)
CL Item
Heart (Heart)
C12727 (NCI Thesaurus)
C0018787 (UMLS 2011AA)
CL Item
Mediastinum (Mediastinum)
C12748 (NCI Thesaurus)
C0025066 (UMLS 2011AA)
CL Item
Recurrent Laryngeal Nerve (Recurrent laryngeal nerve)
CL Item
Separate Tumor Nodules In A Different Ipsilateral Lobe (Separate tumor nodules in a different ipsilateral lobe)
CL Item
Trachea (Trachea)
C12428 (NCI Thesaurus)
C0040578 (UMLS 2011AA)
CL Item
Vertebra (Vertebra)
C12933 (NCI Thesaurus)
C0549207 (UMLS 2011AA)
Item Group
Clinical N Stage
Item
N Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (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)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.15
Code List
N Stage
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Metastasis In Ipsilateral Peribronchial And/or Ipsilateral Hilar Lymph Nodes And Intrapulmonary Nodes, Including Involvement By Direct Extension (N1)
CL Item
Metastasis In Ipsilateral Mediastinal And/or Subcarinal Lymph Node(s) (N2)
CL Item
Metastasis In Contralateral Mediastinal, Contralateral Hilar, Ipsilateral Or Contralateral Scalene, Or Supraclavicular Lymph Node(s) (N3)
CL Item
Regional Lymph Nodes Cannot Be Assessed (NX)
Item Group
Clinical M Stage
Item
M Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (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)
C39315 (NCI Thesaurus ValueDomain-2)
C1515946 (UMLS 2011AA ValueDomain-2)
CL.16
Code List
M Stage
CL Item
Distant Metastasis (M1)
C18206 (NCI Thesaurus)
C1269798 (UMLS 2011AA)
C18206 (NCI Thesaurus-3)
C1269798 (UMLS 2011AA-4)
CL Item
Separate Tumor Nodule(s) In A Contralateral Lobe; Tumor With Pleural Nodules Or Malignant Pleural (or Pericardial) Effusion (M1a)
CL Item
Distant Metastasis (M1b)
C18206 (NCI Thesaurus)
C1269798 (UMLS 2011AA)
C18206 (NCI Thesaurus-3)
C1269798 (UMLS 2011AA-4)
Item
M1a metastasis with any of the following (Mark all that apply with an X.)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass-2)
C0024109 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66832 (NCI Thesaurus Property-2)
C0205447 (UMLS 2011AA Property-2)
C25727 (NCI Thesaurus Property-3)
C0456533 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.17
Code List
M1a metastasis with any of the following (Mark all that apply with an X.)
CL Item
Separate Tumor Nodules In A Contralateral Lobe (Separate tumor nodules in a contralateral lobe)
CL Item
Tumor With Pleural Nodules Or Malignant Pleural (or Pericardial) Effusion (Tumor with pleural nodules or malignant pleural (or pericardial) effusion)
NeoplasmSpecimenMetastaticAnatomicLocationSpecify
Item
Specify site
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C14174 (NCI Thesaurus Property-2)
C0036525 (UMLS 2011AA Property-2)
C25421 (NCI Thesaurus Property-3)
C0002808 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item Group
Overall Response
Person Completing Form
Item
Completed by (Last name, First name)
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Form Completion Date
Item
Date Form Originally Completed (MM DD YYYY)
date
C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
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