Description:

RTOG 1010 Surgery Form (S1) Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=87FDA2A8-3F52-6C0D-E040-BB89AD433137

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=87FDA2A8-3F52-6C0D-E040-BB89AD433137

Keywords:
Versions (2) ▾
  1. 8/26/12
  2. 1/9/15
Uploaded on:

January 9, 2015

DOI:
No DOI assigned. To request one pleaselog in.
License:
Creative Commons BY-NC 3.0 Legacy
Model comments:

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for:

Item comments for:

In order to download data models you must be logged in. Please log in or register for free.

Adenocarcinoma of the Gastroesophageal Junction NCT01196390 Treatment - RTOG 1010 Surgery Form (S1) - 3104579v1.0

Details

INSTRUCTIONS: Submit for all patients within 2 weeks of study entry. Submit with copies of the operative report (S2) and surgical pathology report (S5). Dates are mm-dd-yyyy unless otherwise specified

Unnamed Module 1
Amended Data
Endoscopy/biopsy/surgery
Endoscopic biopsy of esophageal tumor
Reason biopsy not done (ENDOSCOPY WITH)
Biopsy Result
Surgical Resection
Was resection attempted?
Reason surgery not performed
Protocol Surgery Type
Was patient nodal status determined (STAGING INCLUDE LEVELS 7,8,9,15,16,17 AND 20)
Resection Classification
Footer Module
Back to the top of the page