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 8/26/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on:

January 9, 2015

DOI:
To request one please log 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

English
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

1 forms  
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

Similar models

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial