ID

8319

Description

RTOG-0412 S1: Post-Op Immunotherapy/RT Surgery Form Cisplatin and Docetaxel With or Without Radiation Therapy in Treating Patients Who Are Undergoing Surgery for Newly Diagnosed Stage III Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4C3CDDF-D8AA-1A4C-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4C3CDDF-D8AA-1A4C-E034-0003BA3F9857

Keywords

Versions (2)
  1. 12/18/14 12/18/14 - Martin Dugas
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

January 9, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00113386 Treatment - RTOG-0412 S1: Post-Op Immunotherapy/RT Surgery Form - 2293382v3.0

English

Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

1 forms  
Module 1
Description

Module 1

RTOG Study
Description

Protocol ID RTOG

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
Case #
Description

Case#

Data type

text

Institution
Description

Institution Name

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Institution No.
Description

Institution Number

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Participant's Initials
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Participant's I.D. No.
Description

Patient Study ID

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
AMENDED DATA (INSTRUCTIONS: This form is submitted on all surgically resected patients. Record dates as mm-dd-yyyy unless otherwise specified.)
Description

Data amended

Data type

boolean

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

Surgery Date

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C1628561
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C15329
NCI Thesaurus Property
C25275
TYPE OF PRIMARY SURGERY
Description

PrimarySurgeryType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
DURATION OF SURGERY (hour:minutes)
Description

SurgeryDuration

Data type

date

ESTIMATED BLOOD LOSS (cc)
Description

BloodLossAmount

Data type

float

Alias
NCI Thesaurus ObjectClass
C12434
UMLS 2011AA ObjectClass
C0229664
NCI Thesaurus Property
C25559
UMLS 2011AA Property
C1517945
NCI Thesaurus ValueDomain
C25417
INTRAOP AND PERIOP (TRANSFUSIONS OF WHOLE BLOOD OR PACKED CELLS) (units)
Description

WholeBloodTransfusionAdministeredUnitCount

Data type

float

Alias
NCI Metathesaurus ObjectClass
C0370231
NCI Thesaurus ObjectClass
C15408
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C44278
UMLS 2011AA ValueDomain
C0439148
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
INTRAOP AND PERIOP (TRANSFUSIONS OF OTHER BLOOD PRODUCT) (units)
Description

OtherTransfusionBloodAdministeredCount

Data type

float

Alias
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass-2
C15408
NCI Thesaurus Property
C12434
UMLS 2011AA Property
C0229664
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Surgical Pathological Results
Description

Surgical Pathological Results

R0 (all margins pathologically negative)
Description

SurgicalResectionNegativeFindingMarginPerformedInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25698
NCI Thesaurus ObjectClass-2
C15232
UMLS 2011AA ObjectClass
C0728940
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C38757
UMLS 2011AA Property-2
C1513916
NCI Thesaurus Property-3
C25563
UMLS 2011AA Property-3
C0205284
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
R1 (microscopically positive margins or microscopic residual disease)
Description

SurgicalResectionMicroscopicPositiveFindingMarginPerformedInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25698
NCI Thesaurus ObjectClass-2
C15232
UMLS 2011AA ObjectClass
C0728940
NCI Thesaurus Property
C25252
UMLS 2011AA Property
C0205288
NCI Thesaurus Property-2
C38000
UMLS 2011AA Property-2
C0884358
NCI Thesaurus Property-3
C38758
UMLS 2011AA Property-3
C1514241
NCI Thesaurus Property-4
C25563
UMLS 2011AA Property-4
C0205284
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
R2 (macroscopically positive margins or gross residual disease)
Description

SurgicalResectionGrossPositiveFindingMarginPerformedInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25698
NCI Thesaurus ObjectClass-2
C15232
UMLS 2011AA ObjectClass
C0728940
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C38758
UMLS 2011AA Property-2
C1514241
NCI Thesaurus Property-3
C25563
UMLS 2011AA Property-3
C0205284
NCI Thesaurus Property-4
C43566
UMLS 2011AA Property-4
C0439806
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
N Stage, Pathologic (N0, N1, N2, N3)
Description

N Stage pathologic

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS CUI-1
C0456532
NCI Thesaurus ObjectClass-2
C12468
UMLS CUI-2
C1521733
NCI Thesaurus Property
C25610
NCI Thesaurus Property-2
C25580
NCI Thesaurus ValueDomain
C16899
T Stage, Pathologic (T1, T2, T3, T4)
Description

T Stage pathologic

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS CUI-1
C0475455
NCI Thesaurus ValueDomain
C16899
UMLS CUI-2
C1521733
NCI Thesaurus Property
C25365
Lymph Node Type
Description

LungLymphNodeInvolvedSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C12468
UMLS 2011AA ObjectClass
C0024109
NCI Thesaurus ObjectClass-2
C12745
UMLS 2011AA ObjectClass-2
C0024204
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property-2
C25547
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
Lymph Node Involvement
Description

LymphNodeInvolvementType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus Property
C25547
NUMBER OF DAYS ON VENTILATOR
Description

PatientVentilatorTreatmentDayCount

Data type

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C15368
NCI Thesaurus Property-2
C38388
UMLS 2011AA Property
C0087153
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
INPATIENT DISCHARGE DATE
Description

InpatientDischargeDate

Data type

date

NUMBER OF POST-OPERATIVE DAYS TO TIME OF DISCHARGE
Description

PatientPost-OperativeHospitalizationDayCount

Data type

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25623
NCI Thesaurus Property-2
C25179
UMLS 2011AA Property
C0019993
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
SEVERITY GRADE
Description

CTC Adverse Event Grade

Data type

float

Alias
NCI Thesaurus ObjectClass
C49704
UMLS CUI-1
C2985911
NCI Thesaurus ValueDomain
C18000
NCI Thesaurus Property
C25365
AE
Description

CTC Adverse Event Term

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C1516728
NCI Thesaurus ObjectClass
C49704
UMLS CUI-2
C2826934
NCI Thesaurus Property
C45559
Adverse Event Assessment Date
Description

AdverseEventAssessmentDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
COMMENTS
Description

Research Comments

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Signature of surgeon
Description

SurgeonSignatureText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
NCI Thesaurus ObjectClass
C18071
UMLS 2011AA ObjectClass
C0582175
Name of person completing form
Description

Person Completing Form

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Form completion date, original
Description

Form Completion Date

Data type

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
CHECK ATTACHMENTS
Description

CHECKATTACHMENTS

Data type

text

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Radiation Therapy Oncology Group Phase III Lung Pre-Op Chemotherapy vs. Pre-Op Concurrent Chemoradiation for NSCLC

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Module 1
Protocol ID RTOG
Item
RTOG Study
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Case#
Item
Case #
text
Institution Name
Item
Institution
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Participant's Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Patient Study ID
Item
Participant's I.D. No.
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
AMENDED DATA (INSTRUCTIONS: This form is submitted on all surgically resected patients. Record dates as mm-dd-yyyy unless otherwise specified.)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Surgery Date
Item
SURGERY DATE
date
C25164 (NCI Thesaurus ValueDomain)
C1628561 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C15329 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Item
TYPE OF PRIMARY SURGERY
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.2
Code List
TYPE OF PRIMARY SURGERY
CL Item
Lobectomy (Lobectomy)
C15272 (NCI Thesaurus)
C0023928 (UMLS 2011AA)
CL Item
Bilobectomy (Bilobectomy)
CL Item
Sleeve Resection (Sleeve Resection)
CL Item
Pneumonectomy (Pneumonectomy)
C15305 (NCI Thesaurus)
C0032284 (UMLS 2011AA)
SurgeryDuration
Item
DURATION OF SURGERY (hour:minutes)
date
BloodLossAmount
Item
ESTIMATED BLOOD LOSS (cc)
float
C12434 (NCI Thesaurus ObjectClass)
C0229664 (UMLS 2011AA ObjectClass)
C25559 (NCI Thesaurus Property)
C1517945 (UMLS 2011AA Property)
C25417 (NCI Thesaurus ValueDomain)
WholeBloodTransfusionAdministeredUnitCount
Item
INTRAOP AND PERIOP (TRANSFUSIONS OF WHOLE BLOOD OR PACKED CELLS) (units)
float
C0370231 (NCI Metathesaurus ObjectClass)
C15408 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C44278 (NCI Thesaurus ValueDomain)
C0439148 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
OtherTransfusionBloodAdministeredCount
Item
INTRAOP AND PERIOP (TRANSFUSIONS OF OTHER BLOOD PRODUCT) (units)
float
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C15408 (NCI Thesaurus ObjectClass-2)
C12434 (NCI Thesaurus Property)
C0229664 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Surgical Pathological Results
SurgicalResectionNegativeFindingMarginPerformedInd-2
Item
R0 (all margins pathologically negative)
boolean
C25698 (NCI Thesaurus ObjectClass)
C15232 (NCI Thesaurus ObjectClass-2)
C0728940 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38757 (NCI Thesaurus Property-2)
C1513916 (UMLS 2011AA Property-2)
C25563 (NCI Thesaurus Property-3)
C0205284 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
SurgicalResectionMicroscopicPositiveFindingMarginPerformedInd-2
Item
R1 (microscopically positive margins or microscopic residual disease)
boolean
C25698 (NCI Thesaurus ObjectClass)
C15232 (NCI Thesaurus ObjectClass-2)
C0728940 (UMLS 2011AA ObjectClass)
C25252 (NCI Thesaurus Property)
C0205288 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
C38758 (NCI Thesaurus Property-3)
C1514241 (UMLS 2011AA Property-3)
C25563 (NCI Thesaurus Property-4)
C0205284 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
SurgicalResectionGrossPositiveFindingMarginPerformedInd-2
Item
R2 (macroscopically positive margins or gross residual disease)
boolean
C25698 (NCI Thesaurus ObjectClass)
C15232 (NCI Thesaurus ObjectClass-2)
C0728940 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38758 (NCI Thesaurus Property-2)
C1514241 (UMLS 2011AA Property-2)
C25563 (NCI Thesaurus Property-3)
C0205284 (UMLS 2011AA Property-3)
C43566 (NCI Thesaurus Property-4)
C0439806 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
N Stage, Pathologic (N0, N1, N2, N3)
text
C3262 (NCI Thesaurus ObjectClass)
C0456532 (UMLS CUI-1)
C12468 (NCI Thesaurus ObjectClass-2)
C1521733 (UMLS CUI-2)
C25610 (NCI Thesaurus Property)
C25580 (NCI Thesaurus Property-2)
C16899 (NCI Thesaurus ValueDomain)
CL.6
Code List
N Stage, Pathologic (N0, N1, N2, N3)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Metastasis To Ipsilateral Peribronchial And/or Ipsilateral Hilar Lymph Nodes, And Intrapulmonary Nodes Including Involvement By Direct Extension Of The Primary Tumor (N1)
CL Item
Metastasis To Ipsilateral Mediastinal And/or Subcarinal Lymph Node(s) (N2)
CL Item
Metastasis To Contralateral Mediastinal, Contralateral Hilar, Ipsilateral Or Contralateral Scalene, Or Supraclavicular Lymph Node(s) (N3)
CL Item
Regional Lymph Nodes Cannot Be Assessed (NX)
Item
T Stage, Pathologic (T1, T2, T3, T4)
text
C3262 (NCI Thesaurus ObjectClass)
C0475455 (UMLS CUI-1)
C16899 (NCI Thesaurus ValueDomain)
C1521733 (UMLS CUI-2)
C25365 (NCI Thesaurus Property)
CL.7
Code List
T Stage, Pathologic (T1, T2, T3, T4)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Tumor 3 Cm Or Less In Greatest Dimension, Surrounded By Lung Or Visceral Pleura, Invasion More Proximal Than The Lobar Bronchus, (i.e., Not In The Main Bronchus) (T1)
CL Item
Tumor Of Any Size That Directly Invades Any Of The Following: Chest Wall (including Superior Sulcus Tumors), Diaphragm, Mediastinal Pleura, Parietal Pericardium; Or Tumor In The Main Bronchus Less Than 2 Cm Distal To The Carina, But Without Involvement O* (T3)
CL Item
Tumor Of Any Size That Invades Any Of The Following: Mediastinum, Heart, Great Vessels, Trachea, Esophagus, Vertebral Body, Carina; Or Separate Tumor Nodules In The Same Lobe; Or Tumor With A Malignant Pleural Effusion (T4)
CL Item
Tumor With Any Of The Following Features Of Size Or Extent: More Than 3cm In Greatest Dimension; Invades The Visceral Pleura; Associated With Atelectasis Or Obstructive Pneumonitis That Extends To The Hilar Region But Does Not Involve The Entire Lung (T2)
Item
Lymph Node Type
text
C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass-2)
C0024204 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.8
Code List
Lymph Node Type
CL Item
Highest Mediastinal (Highest Mediastinal)
CL Item
Right Upper Paratracheal Node (Right upper paratracheal)
CL Item
Left Upper Paratracheal Node (Left upper paratracheal)
CL Item
Pre And Retro Paratracheal Node (Pre and retro paratracheal)
CL Item
Right Lower Paratracheal Node (Right lower paratracheal)
CL Item
Left Lower Paratracheal Node (Left lower paratracheal)
CL Item
Subaortic Node (Subaortic)
CL Item
Para-aortic Node (Para-aortic)
CL Item
Subcarinal Node (Subcarinal)
CL Item
Paraesophageal Node (Paraesophageal)
CL Item
Pulmonary Ligament (Pulmonary ligament)
C0225794 (NCI Metathesaurus)
CL Item
Right Hilar Node (Right hilar)
CL Item
Left Hilar Node (Left hilar)
CL Item
Interlobar Node (Interlobar)
CL Item
Right Lobar Node (Right lobar)
CL Item
Left Lobar Node (Left lobar)
CL Item
Right Segmental Node (Right segmental)
CL Item
Left Segmental Node (Left segmental)
CL Item
Right Subsegmental Node (Right subsegmental)
CL Item
Left Subsegmental Node (Left subsegmental)
Item
Lymph Node Involvement
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25547 (NCI Thesaurus Property)
CL.9
Code List
Lymph Node Involvement
CL Item
Not Evaluated (not evaluated)
CL Item
Positive (positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Unknown (unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
PatientVentilatorTreatmentDayCount
Item
NUMBER OF DAYS ON VENTILATOR
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C38388 (NCI Thesaurus Property-2)
C0087153 (UMLS 2011AA Property)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
InpatientDischargeDate
Item
INPATIENT DISCHARGE DATE
date
PatientPost-OperativeHospitalizationDayCount
Item
NUMBER OF POST-OPERATIVE DAYS TO TIME OF DISCHARGE
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25623 (NCI Thesaurus Property)
C25179 (NCI Thesaurus Property-2)
C0019993 (UMLS 2011AA Property)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
CTC Adverse Event Grade
Item
SEVERITY GRADE
float
C49704 (NCI Thesaurus ObjectClass)
C2985911 (UMLS CUI-1)
C18000 (NCI Thesaurus ValueDomain)
C25365 (NCI Thesaurus Property)
Item
AE
text
C25284 (NCI Thesaurus ValueDomain)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)
CL.10
Code List
AE
CL Item
Prolonged Chest Tube Drainage Or Air Leak After Pulmonary Resection (Prolonged chest tube drainage or air leak after pulmonary resection)
CL Item
Pneumonitis Nos (PNEUMONITIS/PULMONARY INFILTRATES)
CL Item
Culture Wound Positive (INFECTION (WOUND))
C0476436 (NCI Metathesaurus)
CL Item
Atelectasis (ATELECTASIS)
C2888 (NCI Thesaurus)
C0004144 (UMLS 2011AA)
CL Item
Pneumothorax Nos (PNEUMOTHORAX)
C0032326 (NCI Metathesaurus)
CL Item
Chylothorax (CHYLOTHORAX)
C0008733 (NCI Metathesaurus)
CL Item
Myocardial Ischaemia (CARDIAC ISCHEMIA/INFARCTION)
C0151744 (NCI Metathesaurus)
CL Item
Thrombosis Nos (THROMBOSIS/EMBOLISM (PULMONARY))
CL Item
Supraventricular Arrhythmia Nos (SUPRAVENTRICULAR ARRHYTHMIA (ATRIAL))
CL Item
Post-operative Haemorrhage (HEMORRHAGE (POST-OPERATIVE))
CL Item
Fistula, Pulmonary/upper Respiratory (FISTULA PULMONARY/UPPER RESPIRATORY)
CL Item
Pleural Effusion (PLEURAL EFFUSION)
C3331 (NCI Thesaurus)
C0021071 (UMLS 2011AA)
CL Item
Death Not Associated With Ctcae Term (DEATH)
AdverseEventAssessmentDate
Item
Adverse Event Assessment Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain-2)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
Research Comments
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
SurgeonSignatureText
Item
Signature of surgeon
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C18071 (NCI Thesaurus ObjectClass)
C0582175 (UMLS 2011AA ObjectClass)
Person Completing Form
Item
Name of person completing form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Form Completion Date
Item
Form completion date, original
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)
Item
CHECK ATTACHMENTS
text
CL.11
Code List
CHECK ATTACHMENTS
CL Item
SURGICAL REPORT(S2) (SURGICAL REPORT(S2))
CL Item
RESECTION PATHOLOGY REPORT(S5) (RESECTION PATHOLOGY REPORT(S5))
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