ID

9153

Beschrijving

ACOSOG-Z4051 Registration Worksheet Panitumumab, Docetaxel, Cisplatin, Radiation Therapy, and Surgery in Treating Patients With Newly Diagnosed, Locally Advanced Esophageal Cancer or Cancer of the Gastroesophageal Junction Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6F3CD617-2357-8015-E040-BB89AD43783A

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6F3CD617-2357-8015-E040-BB89AD43783A

Trefwoorden

Versies (6)
  1. 19-09-12 19-09-12 -
  2. 11-08-14 11-08-14 - Martin Dugas
  3. 11-08-14 11-08-14 - Martin Dugas
  4. 11-08-14 11-08-14 - Martin Dugas
  5. 09-01-15 09-01-15 - Martin Dugas
  6. 09-01-15 09-01-15 - Martin Dugas
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9 januari 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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Esophageal Cancer NCT00757172 Registration - ACOSOG-Z4051 Registration Worksheet - 2921081v1.0

Engels

Each eligibility criterion must be evaluated and documented in the patient's medical record. No eligibility exemptions or waivers will be permitted

1 Formulieren  
Header Module
Beschrijving

Header Module

Protocol Number
Beschrijving

Protocol ID ACOSOG

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1515944
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C19712
Patient ID
Beschrijving

Patient Study ID

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Patient Initials (L F M)
Beschrijving

Patient Initials

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution Number
Beschrijving

Institution Number

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Institution
Beschrijving

Institution Name

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Are data amended (if data are amended, please circle in red when using paper form)
Beschrijving

Data amended

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Eligibility Criteria
Beschrijving

Eligibility Criteria

Age >= 18 years
Beschrijving

PatientAgeInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
ECOG Performance Status 0-1 (Zubrod)
Beschrijving

EasternCooperativeOncologyGroupPerformanceStatusAssessmentInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C25491
UMLS 2011AA ObjectClass
C1512162
NCI Metathesaurus ObjectClass
CL092952
Biopsy-proven resectable primary (nonrecurrent) adenocarcinoma of the distal esophagus or GE junction (Siewert Type I or II) (Siewert Type definitions: Siewert Type I: adenocarcinoma of the distal esophagus Siewert Type II: adenocarcinoma of the esophago-gastric junction/real cardia)
Beschrijving

SpecimenConfirmationBiopsyInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25458
UMLS 2011AA Property
C0750484
NCI Thesaurus Property-2
C15189
UMLS 2011AA Property-2
C0005558
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Pre-registration EUS, CT of chest and upper abdomen, and PET must support a clinical stage of T3N0M0, T2-3N1M0 or T2-3N0-1M1a (celiac adenopathy must be <=2 cm by EUS) (Clinically staged T1 tumors and T2N0M0 tumors are not eligible. N1 does not require biopsy/FNA)
Beschrijving

PatientAdvancedMalignantNeoplasmPriorRegistrationEligibilityDeterminationInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25646
UMLS 2011AA Property
C1514821
NCI Thesaurus Property-2
C25411
UMLS 2011AA Property-2
C0205179
NCI Thesaurus Property-3
C9305
UMLS 2011AA Property-3
C0006826
NCI Thesaurus Property-4
C25629
UMLS 2011AA Property-4
C0332152
NCI Thesaurus Property-5
C25171
UMLS 2011AA Property-5
C0013893
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
No definitive radiological evidence of distant metastases
Beschrijving

DistantMetastasisPresentInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus ObjectClass
C25321
UMLS 2011AA ObjectClass
C0443203
NCI Thesaurus ObjectClass-2
C19151
UMLS 2011AA ObjectClass-2
C0027627
No pre-existing grade 2 or greater peripheral neuropathy of any etiology
Beschrijving

Grade2PeripheralSensoryNeuropathyHistoryInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C3501
UMLS 2011AA ObjectClass
C0151313
NCI Thesaurus ObjectClass-2
C28078
UMLS 2011AA ObjectClass-2
C1522446
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Adequate bone marrow, hepatic and renal function prior to registration (WBC >= 3000/mm^3 ANC >= 1,500/mm^3 Hemoglobin >= 9.5 g/dL Platelet count >= 100,000/mm^3 Creatinine <= 1.5 mg/dL Total bilirubin <= 3 mg/dL AST SGOT <= 2.0 times ULN ALT SGPT <= 2.0 times ULN Alkaline phosphatase <= 2.0 times ULN Albumin >= 2.0 g/dL or prealbumin >= 15 mg/dL Magnesium >= LLN)
Beschrijving

PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25646
UMLS 2011AA Property
C1514821
NCI Thesaurus Property-2
C25629
UMLS 2011AA Property-2
C0332152
NCI Thesaurus Property-3
C25294
UMLS 2011AA Property-3
C0022885
NCI Thesaurus Property-4
C25171
UMLS 2011AA Property-4
C0013893
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Patient must be evaluated before registration by medical oncologist, radiation oncologist and surgeon and deemed fit for protocol therapy and surgery
Beschrijving

Eligibility for trial

Datatype

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C1302261
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25171
No prior invasive malignancy, unless disease-free for >= 5 years (Exceptions: non-melanoma skin cancer, in-situ cancers)
Beschrijving

PreviousCancerIdentifiedInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25737
UMLS 2011AA Property
C0205396
Non-pregnant and non-breast-feeding (Female participants of childbearing potential must have a negative urine or serum pregnancy test <= 14 days prior to registration. Perimenopausal participants must be amenorrheic >= 12 months to be considered not of childbearing potential. All patients of reproductive potential must agree to use an effective method of birth-control while receiving study therapy and for six months after completion of therapy)
Beschrijving

PatientNegativePregnancyTestIndicator

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25247
UMLS 2011AA Property
C0205160
NCI Metathesaurus Property
C0032976
No history of prior EGFR targeted therapy or therapy for pancreatic cancer or active infection requiring intravenous antibiotics at the time of registration
Beschrijving

ACOSOGPatientPriorEpidermalGrowthFactorReceptorTreatmentClinicalTrialEligibilityCriteriaInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C19712
UMLS 2011AA ObjectClass-2
C1515944
NCI Thesaurus Property
C25629
UMLS 2011AA Property
C0332152
NCI Thesaurus Property-2
C15368
NCI Thesaurus Property-3
C16112
UMLS 2011AA Property-2
C1516637
NCI Thesaurus Property-4
C17068
UMLS 2011AA Property-3
C0034802
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations
Beschrijving

PatientUncontrolledConcurrentDiseaseorDisorderExclusionCriteriaInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C2991
UMLS 2011AA Property
C0012634
NCI Thesaurus Property-2
C25456
UMLS 2011AA Property-2
C0205420
NCI Thesaurus Property-3
C48932
UMLS 2011AA Property-3
C0205318
NCI Thesaurus Property-4
C25370
UMLS 2011AA Property-4
C0680251
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
No history of interstitial lung disease e.g. pneumonitis or pulmonary fibrosis or any evidence of interstitial lung disease on baseline chest CT scan
Beschrijving

PatientInterstitialDiseaseLungPersonalMedicalHistoryInd-3

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C12468
UMLS 2011AA Property
C0024109
NCI Thesaurus Property-2
C18772
UMLS 2011AA Property-2
C0262926
NCI Thesaurus Property-3
C62410
UMLS 2011AA Property-3
C1881236
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
No history of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with the study participation or investigational product(s) administration
Beschrijving

PsychiatricDiseaseHistoryInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C2893
UMLS 2011AA Property
C0004936
NCI Thesaurus Property-2
C18772
UMLS 2011AA Property-2
C0262926
Smoking Status
Beschrijving

Smoking Status

Have you smoked at least 100 cigarettes in your entire life? (check one)
Beschrijving

Smoking history

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1519384
NCI Thesaurus ObjectClass
C17934
NCI Thesaurus Property
C18772
How old were you when you first started to smoke regularly? (Age)
Beschrijving

AgeBeganSmokinginYears

Datatype

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
NCI Thesaurus Property-2
C18270
UMLS 2011AA Property-2
C0700219
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C29848
UMLS 2011AA ValueDomain-2
C0439234
NCI Thesaurus ValueDomain-3
C25150
UMLS 2011AA ValueDomain-3
C0001779
On average, how many cigarettes do/did you smoke per day
Beschrijving

CigaretteAverageDailyUseCount

Datatype

float

Alias
NCI Thesaurus ObjectClass
C1802
UMLS 2011AA ObjectClass
C0677453
NCI Thesaurus Property
C25473
UMLS 2011AA Property
C0332173
NCI Thesaurus Property-2
C37917
UMLS 2011AA Property-2
C1510992
NCI Thesaurus Property-3
C25340
UMLS 2011AA Property-3
C0457083
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Do you now smoke cigarettes? (smoked in the past 30 days check one)
Beschrijving

CurrentSmokingHistoryType

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25471
UMLS 2011AA ObjectClass
C0521116
NCI Thesaurus ObjectClass-2
C17934
UMLS 2011AA ObjectClass-2
C0453996
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Number of years smoked cigarettes (If No)
Beschrijving

CigarettesSmokingYearNumber

Datatype

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C1802
UMLS 2011AA ObjectClass
C0677453
NCI Thesaurus ValueDomain-2
C29848
UMLS 2011AA ValueDomain-2
C0439234
NCI Thesaurus Property
C17934
UMLS 2011AA Property
C0453996
Date Patient Stopped Smoking (cigarettes mm/dd/yyyy)
Beschrijving

SmokingDiscontinuedDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25484
UMLS 2011AA Property
C1444662
NCI Thesaurus ObjectClass
C17934
UMLS 2011AA ObjectClass
C0453996
Cigar (Have you used any other tobacco products at least 100 times in your lifetime)
Beschrijving

CigarSmokingUseIndicator

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C1813
UMLS 2011AA ObjectClass
C0182504
NCI Thesaurus ObjectClass-2
C17934
UMLS 2011AA ObjectClass-2
C0453996
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
Pipe (Have you used any other tobacco products at least 100 times in your lifetime)
Beschrijving

Current Smoker

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C3241966
NCI Thesaurus Property
C25471
NCI Thesaurus ObjectClass
C17934
NCI Metathesaurus Property
C0449865
Snuff (Have you used any other tobacco products at least 100 times in your lifetime)
Beschrijving

PatientSnuffTobaccoPersonalMedicalHistoryInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
NCI Thesaurus Property-2
C63733
UMLS 2011AA Property-2
C0037390
Chewing tobacco (Have you used any other tobacco products at least 100 times in your lifetime)
Beschrijving

ChewingTobaccoCurrentUseInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus ObjectClass
C361
UMLS 2011AA ObjectClass
C0008038
NCI Thesaurus Property-2
C25340
UMLS 2011AA Property-2
C0457083
Other (Have you used any other tobacco products at least 100 times in your lifetime)
Beschrijving

PatientSmokingAssessmentScale

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0037369
Other, specify
Beschrijving

TobaccoTypeDescriptiveShortText

Datatype

text

Alias
NCI Thesaurus ObjectClass
C891
UMLS 2011AA ObjectClass
C0040329
NCI Thesaurus Property
C25284
UMLS 2011AA Property
C0332307
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain-2
C25365
UMLS 2011AA ValueDomain-2
C0678257
NCI Thesaurus ValueDomain-3
C25249
UMLS 2011AA ValueDomain-3
C1806781
For how many years (If Yes, years)
Beschrijving

Smoking Duration

Datatype

float

Alias
NCI Thesaurus ValueDomain
C25463
UMLS CUI-1
C3694955
NCI Thesaurus ObjectClass
C17934
NCI Thesaurus Property
C25330
Laboratory Values
Beschrijving

Laboratory Values

WBC (cells/mm^3)
Beschrijving

LaboratoryProcedureLeukocyteResultUnspecifiedValue

Datatype

float

Alias
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus Property
C12529
UMLS 2011AA Property
C0023516
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
ANC (cells/mm^3)
Beschrijving

Neutrophil count

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS CUI-1
C0200633
NCI Thesaurus Property
C12533
NCI Thesaurus Property-2
C20200
NCI Thesaurus ValueDomain
C25304
NCI Thesaurus ValueDomain-2
C25712
Hemoglobin (g/dL)
Beschrijving

Hemoglobin

Datatype

float

Maateenheden
  • g/dL
Alias
NCI Thesaurus Property
C16676
UMLS CUI-1
C0019046
NCI Thesaurus Property-2
C20200
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus ValueDomain
C25712
g/dL
Platelet count (cells/mm^3)
Beschrijving

Platelets

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS CUI-1
C0005821
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C12520
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
Serum Creatinine (mg/dL)
Beschrijving

Creatinine, Serum

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS CUI-1
C0201976
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C399
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
Total Bilirubin (mg/dL)
Beschrijving

LaboratoryProcedureTotalBilirubinResultSpecifiedValue

Datatype

float

Maateenheden
  • 1000/uL
Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C38037
UMLS 2011AA Property-2
C0201913
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C38024
UMLS 2011AA ValueDomain-2
C0205369
1000/uL
SGOT (AST) (U/L)
Beschrijving

SGOT (AST)

Datatype

float

Maateenheden
  • U/L
Alias
NCI Thesaurus Property
C25202
UMLS CUI-1
C0201899
NCI Thesaurus Property-2
C20200
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus ValueDomain
C25712
U/L
SGOT (AST) ULN (U/L)
Beschrijving

LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25202
UMLS 2011AA Property
C0242192
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
SGPT (ALT) (U/L)
Beschrijving

SGPT (ALT)

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS CUI-1
C0201836
NCI Thesaurus Property
C20200
NCI Thesaurus Property-2
C25293
NCI Thesaurus ValueDomain
C38046
NCI Thesaurus ValueDomain-2
C25712
SGPT (ALT) ULN (U/L)
Beschrijving

LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C25293
UMLS 2011AA Property-2
C0376147
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
Alkaline Phosphatase (U/L)
Beschrijving

Alkaline Phosphatase

Datatype

float

Alias
NCI Thesaurus Property
C20200
UMLS CUI-1
C0201850
NCI Thesaurus ObjectClass
C25294
NCI Thesaurus ValueDomain
C25712
NCI Thesaurus Property-2
C16276
Alkaline Phosphatase ULN (U/L)
Beschrijving

LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue

Datatype

float

Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property-2
C16276
UMLS 2011AA Property-2
C0002059
NCI Thesaurus ValueDomain-2
C25706
UMLS 2011AA ValueDomain-2
C1519815
Albumin (g/dL or)
Beschrijving

LaboratoryProcedureAlbuminResultUnspecifiedValue

Datatype

float

Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C214
UMLS 2011AA Property-2
C0001924
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Prealbumin (mg/dL)
Beschrijving

LaboratoryProcedurePrealbuminResultSpecifiedValue

Datatype

float

Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property-2
C2280
UMLS 2011AA Property-2
C0040160
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Magnesium (mg/dL)
Beschrijving

LaboratoryProcedureMagnesiumResultUnspecifiedValue

Datatype

float

Maateenheden
  • mmol/L
Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C29239
UMLS 2011AA Property-2
C0024467
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
mmol/L
Magnesium, LLN (mg/dL)
Beschrijving

LaboratoryProcedureMagnesiumResultUnspecifiedLowerLimitofNormalValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C29239
UMLS 2011AA Property-2
C0024467
NCI Thesaurus ValueDomain
C38046
UMLS 2011AA ValueDomain
C0205370
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
NCI Thesaurus ValueDomain-3
C25555
UMLS 2011AA ValueDomain-3
C1518030
Date of collection (mm/dd/yyyy)
Beschrijving

SpecimenCollectedDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25452
NCI Thesaurus Property-2
C25275
UMLS 2011AA Property
C2745955
Pregnancy Test
Beschrijving

Pregnancy Test

Pregnancy test done (check one)
Beschrijving

PregnancyTestPerformedInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25742
UMLS 2011AA ObjectClass
C0032961
NCI Thesaurus ObjectClass-2
C25294
UMLS 2011AA ObjectClass-2
C0022885
Reason pregnancy test not performed (If No, check one)
Beschrijving

PregnancyLaboratoryProcedureNotPerformedReason

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25742
UMLS 2011AA ObjectClass
C0032961
NCI Thesaurus ObjectClass-2
C25294
UMLS 2011AA ObjectClass-2
C0022885
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus Property-2
C38000
UMLS 2011AA Property-2
C0884358
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
Other, specify
Beschrijving

PregnancyLaboratoryProcedureNotPerformedSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25742
UMLS 2011AA ObjectClass
C0032961
NCI Thesaurus ObjectClass-2
C25294
UMLS 2011AA ObjectClass-2
C0022885
NCI Thesaurus Property
C25594
UMLS 2011AA Property
C1518422
NCI Thesaurus Property-2
C38000
UMLS 2011AA Property-2
C0884358
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Pregnancy Test Date (If Yes, Negative mm/dd/yyyy)
Beschrijving

PatientMostRecentPregnancyTestDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Metathesaurus Property
C0032976
NCI Thesaurus Property
C25577
UMLS 2011AA Property
C1513491
Pre-treatment Staging
Beschrijving

Pre-treatment Staging

Date of endoscopy (mm/dd/yyyy)
Beschrijving

EndoscopyDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16546
UMLS 2011AA ObjectClass
C0014245
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Proximal tumor extent (cm from incisors)
Beschrijving

EsophagealMalignantNeoplasmProximalExtentMeasurement

Datatype

float

Alias
NCI Thesaurus ObjectClass
C37950
UMLS 2011AA ObjectClass
C1522619
NCI Thesaurus ObjectClass-2
C9305
UMLS 2011AA ObjectClass-2
C0006826
NCI Thesaurus Property
C25236
UMLS 2011AA Property
C0205107
NCI Thesaurus Property-2
C25332
UMLS 2011AA Property-2
C0439792
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
Distal tumor extent (cm from incisors)
Beschrijving

EsophagealMalignantNeoplasmDistalExtentMeasurement

Datatype

float

Alias
NCI Thesaurus ObjectClass
C37950
UMLS 2011AA ObjectClass
C1522619
NCI Thesaurus ObjectClass-2
C9305
UMLS 2011AA ObjectClass-2
C0006826
NCI Thesaurus Property
C25237
UMLS 2011AA Property
C0205108
NCI Thesaurus Property-2
C25332
UMLS 2011AA Property-2
C0439792
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
Siewert Type (check one)
Beschrijving

EsophagealMalignantNeoplasmPathologicExtentType

Datatype

text

Alias
NCI Thesaurus ObjectClass
C37950
UMLS 2011AA ObjectClass
C1522619
NCI Thesaurus ObjectClass-2
C9305
UMLS 2011AA ObjectClass-2
C0006826
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25332
UMLS 2011AA Property-2
C0439792
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Date of CT chest/upper abdomen (mm/dd/yyyy)
Beschrijving

MagneticResonanceImagingComputedTomographyDiagnosticImagingChestAbdominalCavityAssessmentDate

Datatype

date

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass-2
C17204
UMLS 2011AA ObjectClass-2
C0040405
NCI Thesaurus ObjectClass-3
C16809
UMLS 2011AA ObjectClass-3
C0024485
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25389
UMLS 2011AA Property-2
C0817096
NCI Thesaurus Property-3
C12664
UMLS 2011AA Property-3
C0230168
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
CT evidence of tumor invasion into adjacent structures (check one)
Beschrijving

ComputedTomographyDiagnosticImagingTumorCellInvasionPresentInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass-2
C17204
UMLS 2011AA ObjectClass-2
C0040405
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C20625
UMLS 2011AA Property-2
C1269955
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
CT suspicious for pulmonary metastases (check one)
Beschrijving

ComputedTomographyDiagnosticImagingPulmonaryMetastasisPresentInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass-2
C17204
UMLS 2011AA ObjectClass-2
C0040405
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C13304
UMLS 2011AA Property-2
C2709248
NCI Thesaurus Property-3
C19151
UMLS 2011AA Property-3
C0027627
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
CT suspicious for liver metastases (check one)
Beschrijving

ComputedTomographyDiagnosticImagingLiverMetastasisPresentInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass-2
C17204
UMLS 2011AA ObjectClass-2
C0040405
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C12392
UMLS 2011AA Property-2
C0023884
NCI Thesaurus Property-3
C19151
UMLS 2011AA Property-3
C0027627
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Biopsy done (If Yes, check one)
Beschrijving

BiopsyPerformedInd-3

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
CT nodal enlargement (check one)
Beschrijving

ComputedTomographyDiagnosticImagingNodalEnlargementPresentInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass-2
C17204
UMLS 2011AA ObjectClass-2
C0040405
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Metathesaurus Property
CL110875
NCI Thesaurus Property-2
C73432
UMLS 2011AA Property-2
C1293134
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Nodal Sites (If Yes, indicate check all that apply)
Beschrijving

HeadandNeckLymphNodeInvolvedSite

Datatype

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C12418
UMLS 2011AA ObjectClass
C0460004
NCI Thesaurus ObjectClass-2
C12745
UMLS 2011AA ObjectClass-2
C0024204
NCI Thesaurus Property
C25547
Pre-treatment Staging1
Beschrijving

Pre-treatment Staging1

Date of FDG-PET (mm/dd/yyyy)
Beschrijving

FluorodeoxyglucosePositronEmissionTomographyAssessmentDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25367
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass-2
C964
UMLS 2011AA ObjectClass-2
C0046056
Maximum SUV
Beschrijving

StandardUptakeValuePositronEmissionTomographyAssessmentMaximumMeasurement

Datatype

float

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass-2
C44275
UMLS 2011AA ObjectClass-2
C1442989
NCI Metathesaurus ObjectClass
C0243144
NCI Thesaurus ObjectClass-3
C25712
UMLS 2011AA ObjectClass-3
C1522609
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ValueDomain-2
C25564
UMLS 2011AA ValueDomain-2
C0806909
Uptake in LN or other sites (check one)
Beschrijving

FluorodeoxyglucosePositronEmissionTomographyLymphNodeInvolvementAssessmentInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass-2
C964
UMLS 2011AA ObjectClass-2
C0046056
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C12745
UMLS 2011AA Property
C0024204
NCI Thesaurus Property-3
C25548
UMLS 2011AA Property-2
C1314939
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Date of EUS (mm/dd/yyyy)
Beschrijving

DiagnosticImagingEndoscopicUltrasoundPerformedDate

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C46078
UMLS 2011AA Property-2
C0376443
Maximum depth of tumor invasion (check one)
Beschrijving

DiagnosticImagingEndoscopicUltrasoundTumorCellInvasionExtentType

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus Property
C25332
UMLS 2011AA Property
C0439792
NCI Thesaurus Property-2
C20625
UMLS 2011AA Property-2
C1269955
NCI Thesaurus Property-3
C46078
UMLS 2011AA Property-3
C0376443
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
EUS T stage
Beschrijving

DiagnosticImagingEndoscopicUltrasoundTStagePerformedText

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus Property-3
C46078
UMLS 2011AA Property-3
C0376443
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
EUS N stage
Beschrijving

DiagnosticImagingEndoscopicUltrasoundNStagePerformedText

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
NCI Thesaurus Property-3
C46078
UMLS 2011AA Property-3
C0376443
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Biopsy done (If Yes, check one)
Beschrijving

BiopsyPerformedInd-3

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
EUS M stage
Beschrijving

DiagnosticImagingEndoscopicUltrasoundMStagePerformedText

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
NCI Thesaurus Property-3
C46078
UMLS 2011AA Property-3
C0376443
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Nodes biopsied (check one)
Beschrijving

LymphNodeBiopsySamplingInd-2

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C51900
UMLS 2011AA ObjectClass
C0193842
NCI Thesaurus Property
C25662
UMLS 2011AA Property
C0441621
Biopsy Result (If Yes, indicate)
Beschrijving

BiopsyResultType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
LN Site
Beschrijving

NeoplasmSpecimenLymphNodeAnatomicLocationSpecify

Datatype

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
C12745
UMLS 2011AA Property-2
C0024204
NCI Thesaurus Property-3
C25421
UMLS 2011AA Property-3
C0002808
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Pre-treatment Staging2
Beschrijving

Pre-treatment Staging2

Clinical T Stage
Beschrijving

EsophagealTumorClinicalTStage

Datatype

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C37950
UMLS 2011AA ObjectClass-2
C1522619
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
Clinical N Stage
Beschrijving

EsophagealTumorClinicalNStage

Datatype

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C37950
UMLS 2011AA ObjectClass-2
C1522619
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
Clinical M Stage
Beschrijving

EsophagealTumorClinicalMStage

Datatype

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C37950
UMLS 2011AA ObjectClass-2
C1522619
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
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Similar models

Each eligibility criterion must be evaluated and documented in the patient's medical record. No eligibility exemptions or waivers will be permitted

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Header Module
Protocol ID ACOSOG
Item
Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1515944 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C19712 (NCI Thesaurus Property-2)
Patient Study ID
Item
Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Patient Initials
Item
Patient Initials (L F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Number
Item
Institution Number
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
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)
Data amended
Item
Are data amended (if data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Eligibility Criteria
PatientAgeInd-2
Item
Age >= 18 years
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
EasternCooperativeOncologyGroupPerformanceStatusAssessmentInd-2
Item
ECOG Performance Status 0-1 (Zubrod)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25491 (NCI Thesaurus ObjectClass)
C1512162 (UMLS 2011AA ObjectClass)
CL092952 (NCI Metathesaurus ObjectClass)
SpecimenConfirmationBiopsyInd-2
Item
Biopsy-proven resectable primary (nonrecurrent) adenocarcinoma of the distal esophagus or GE junction (Siewert Type I or II) (Siewert Type definitions: Siewert Type I: adenocarcinoma of the distal esophagus Siewert Type II: adenocarcinoma of the esophago-gastric junction/real cardia)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C15189 (NCI Thesaurus Property-2)
C0005558 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
PatientAdvancedMalignantNeoplasmPriorRegistrationEligibilityDeterminationInd-2
Item
Pre-registration EUS, CT of chest and upper abdomen, and PET must support a clinical stage of T3N0M0, T2-3N1M0 or T2-3N0-1M1a (celiac adenopathy must be <=2 cm by EUS) (Clinically staged T1 tumors and T2N0M0 tumors are not eligible. N1 does not require biopsy/FNA)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25411 (NCI Thesaurus Property-2)
C0205179 (UMLS 2011AA Property-2)
C9305 (NCI Thesaurus Property-3)
C0006826 (UMLS 2011AA Property-3)
C25629 (NCI Thesaurus Property-4)
C0332152 (UMLS 2011AA Property-4)
C25171 (NCI Thesaurus Property-5)
C0013893 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
DistantMetastasisPresentInd-2
Item
No definitive radiological evidence of distant metastases
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25321 (NCI Thesaurus ObjectClass)
C0443203 (UMLS 2011AA ObjectClass)
C19151 (NCI Thesaurus ObjectClass-2)
C0027627 (UMLS 2011AA ObjectClass-2)
Grade2PeripheralSensoryNeuropathyHistoryInd-2
Item
No pre-existing grade 2 or greater peripheral neuropathy of any etiology
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C3501 (NCI Thesaurus ObjectClass)
C0151313 (UMLS 2011AA ObjectClass)
C28078 (NCI Thesaurus ObjectClass-2)
C1522446 (UMLS 2011AA ObjectClass-2)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationInd-2
Item
Adequate bone marrow, hepatic and renal function prior to registration (WBC >= 3000/mm^3 ANC >= 1,500/mm^3 Hemoglobin >= 9.5 g/dL Platelet count >= 100,000/mm^3 Creatinine <= 1.5 mg/dL Total bilirubin <= 3 mg/dL AST SGOT <= 2.0 times ULN ALT SGPT <= 2.0 times ULN Alkaline phosphatase <= 2.0 times ULN Albumin >= 2.0 g/dL or prealbumin >= 15 mg/dL Magnesium >= LLN)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus Property-3)
C0022885 (UMLS 2011AA Property-3)
C25171 (NCI Thesaurus Property-4)
C0013893 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Patient must be evaluated before registration by medical oncologist, radiation oncologist and surgeon and deemed fit for protocol therapy and surgery
text
C38148 (NCI Thesaurus ValueDomain)
C1302261 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25171 (NCI Thesaurus Property)
CL.9
Code List
Patient must be evaluated before registration by medical oncologist, radiation oncologist and surgeon and deemed fit for protocol therapy and surgery
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PreviousCancerIdentifiedInd-2
Item
No prior invasive malignancy, unless disease-free for >= 5 years (Exceptions: non-melanoma skin cancer, in-situ cancers)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25737 (NCI Thesaurus Property)
C0205396 (UMLS 2011AA Property)
PatientNegativePregnancyTestIndicator
Item
Non-pregnant and non-breast-feeding (Female participants of childbearing potential must have a negative urine or serum pregnancy test <= 14 days prior to registration. Perimenopausal participants must be amenorrheic >= 12 months to be considered not of childbearing potential. All patients of reproductive potential must agree to use an effective method of birth-control while receiving study therapy and for six months after completion of therapy)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25247 (NCI Thesaurus Property)
C0205160 (UMLS 2011AA Property)
C0032976 (NCI Metathesaurus Property)
ACOSOGPatientPriorEpidermalGrowthFactorReceptorTreatmentClinicalTrialEligibilityCriteriaInd-2
Item
No history of prior EGFR targeted therapy or therapy for pancreatic cancer or active infection requiring intravenous antibiotics at the time of registration
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19712 (NCI Thesaurus ObjectClass-2)
C1515944 (UMLS 2011AA ObjectClass-2)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C15368 (NCI Thesaurus Property-2)
C16112 (NCI Thesaurus Property-3)
C1516637 (UMLS 2011AA Property-2)
C17068 (NCI Thesaurus Property-4)
C0034802 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientUncontrolledConcurrentDiseaseorDisorderExclusionCriteriaInd-2
Item
No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus Property)
C0012634 (UMLS 2011AA Property)
C25456 (NCI Thesaurus Property-2)
C0205420 (UMLS 2011AA Property-2)
C48932 (NCI Thesaurus Property-3)
C0205318 (UMLS 2011AA Property-3)
C25370 (NCI Thesaurus Property-4)
C0680251 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientInterstitialDiseaseLungPersonalMedicalHistoryInd-3
Item
No history of interstitial lung disease e.g. pneumonitis or pulmonary fibrosis or any evidence of interstitial lung disease on baseline chest CT scan
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus Property)
C0024109 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C62410 (NCI Thesaurus Property-3)
C1881236 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
PsychiatricDiseaseHistoryInd-2
Item
No history of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with the study participation or investigational product(s) administration
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C2893 (NCI Thesaurus Property)
C0004936 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
Item Group
Smoking Status
Item
Have you smoked at least 100 cigarettes in your entire life? (check one)
text
C25180 (NCI Thesaurus ValueDomain)
C1519384 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C18772 (NCI Thesaurus Property)
CL.16
Code List
Have you smoked at least 100 cigarettes in your entire life? (check one)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
AgeBeganSmokinginYears
Item
How old were you when you first started to smoke regularly? (Age)
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C18270 (NCI Thesaurus Property-2)
C0700219 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C29848 (NCI Thesaurus ValueDomain-2)
C0439234 (UMLS 2011AA ValueDomain-2)
C25150 (NCI Thesaurus ValueDomain-3)
C0001779 (UMLS 2011AA ValueDomain-3)
CigaretteAverageDailyUseCount
Item
On average, how many cigarettes do/did you smoke per day
float
C1802 (NCI Thesaurus ObjectClass)
C0677453 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property-2)
C1510992 (UMLS 2011AA Property-2)
C25340 (NCI Thesaurus Property-3)
C0457083 (UMLS 2011AA Property-3)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
CurrentSmokingHistoryType
Item
Do you now smoke cigarettes? (smoked in the past 30 days check one)
boolean
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C17934 (NCI Thesaurus ObjectClass-2)
C0453996 (UMLS 2011AA ObjectClass-2)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
CigarettesSmokingYearNumber
Item
Number of years smoked cigarettes (If No)
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C1802 (NCI Thesaurus ObjectClass)
C0677453 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus ValueDomain-2)
C0439234 (UMLS 2011AA ValueDomain-2)
C17934 (NCI Thesaurus Property)
C0453996 (UMLS 2011AA Property)
SmokingDiscontinuedDate
Item
Date Patient Stopped Smoking (cigarettes mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25484 (NCI Thesaurus Property)
C1444662 (UMLS 2011AA Property)
C17934 (NCI Thesaurus ObjectClass)
C0453996 (UMLS 2011AA ObjectClass)
CigarSmokingUseIndicator
Item
Cigar (Have you used any other tobacco products at least 100 times in your lifetime)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1813 (NCI Thesaurus ObjectClass)
C0182504 (UMLS 2011AA ObjectClass)
C17934 (NCI Thesaurus ObjectClass-2)
C0453996 (UMLS 2011AA ObjectClass-2)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Current Smoker
Item
Pipe (Have you used any other tobacco products at least 100 times in your lifetime)
boolean
C38148 (NCI Thesaurus ValueDomain)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
PatientSnuffTobaccoPersonalMedicalHistoryInd-2
Item
Snuff (Have you used any other tobacco products at least 100 times in your lifetime)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C63733 (NCI Thesaurus Property-2)
C0037390 (UMLS 2011AA Property-2)
ChewingTobaccoCurrentUseInd-2
Item
Chewing tobacco (Have you used any other tobacco products at least 100 times in your lifetime)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C361 (NCI Thesaurus ObjectClass)
C0008038 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property-2)
C0457083 (UMLS 2011AA Property-2)
PatientSmokingAssessmentScale
Item
Other (Have you used any other tobacco products at least 100 times in your lifetime)
boolean
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0037369 (NCI Metathesaurus Property)
TobaccoTypeDescriptiveShortText
Item
Other, specify
text
C891 (NCI Thesaurus ObjectClass)
C0040329 (UMLS 2011AA ObjectClass)
C25284 (NCI Thesaurus Property)
C0332307 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25365 (NCI Thesaurus ValueDomain-2)
C0678257 (UMLS 2011AA ValueDomain-2)
C25249 (NCI Thesaurus ValueDomain-3)
C1806781 (UMLS 2011AA ValueDomain-3)
Smoking Duration
Item
For how many years (If Yes, years)
float
C25463 (NCI Thesaurus ValueDomain)
C3694955 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus Property)
Item Group
Laboratory Values
LaboratoryProcedureLeukocyteResultUnspecifiedValue
Item
WBC (cells/mm^3)
float
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
Neutrophil count
Item
ANC (cells/mm^3)
float
C25294 (NCI Thesaurus ObjectClass)
C0200633 (UMLS CUI-1)
C12533 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
Hemoglobin
Item
Hemoglobin (g/dL)
float
C16676 (NCI Thesaurus Property)
C0019046 (UMLS CUI-1)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
Platelets
Item
Platelet count (cells/mm^3)
float
C25294 (NCI Thesaurus ObjectClass)
C0005821 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C12520 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
Creatinine, Serum
Item
Serum Creatinine (mg/dL)
float
C25294 (NCI Thesaurus ObjectClass)
C0201976 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C399 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
LaboratoryProcedureTotalBilirubinResultSpecifiedValue
Item
Total Bilirubin (mg/dL)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38037 (NCI Thesaurus Property-2)
C0201913 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0205369 (UMLS 2011AA ValueDomain-2)
SGOT (AST)
Item
SGOT (AST) (U/L)
float
C25202 (NCI Thesaurus Property)
C0201899 (UMLS CUI-1)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue
Item
SGOT (AST) ULN (U/L)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
SGPT (ALT)
Item
SGPT (ALT) (U/L)
float
C25294 (NCI Thesaurus ObjectClass)
C0201836 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C25293 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue
Item
SGPT (ALT) ULN (U/L)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25293 (NCI Thesaurus Property-2)
C0376147 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
Alkaline Phosphatase
Item
Alkaline Phosphatase (U/L)
float
C20200 (NCI Thesaurus Property)
C0201850 (UMLS CUI-1)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C16276 (NCI Thesaurus Property-2)
LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue
Item
Alkaline Phosphatase ULN (U/L)
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C16276 (NCI Thesaurus Property-2)
C0002059 (UMLS 2011AA Property-2)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureAlbuminResultUnspecifiedValue
Item
Albumin (g/dL or)
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C214 (NCI Thesaurus Property-2)
C0001924 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePrealbuminResultSpecifiedValue
Item
Prealbumin (mg/dL)
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C2280 (NCI Thesaurus Property-2)
C0040160 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureMagnesiumResultUnspecifiedValue
Item
Magnesium (mg/dL)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C29239 (NCI Thesaurus Property-2)
C0024467 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureMagnesiumResultUnspecifiedLowerLimitofNormalValue
Item
Magnesium, LLN (mg/dL)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C29239 (NCI Thesaurus Property-2)
C0024467 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
C25555 (NCI Thesaurus ValueDomain-3)
C1518030 (UMLS 2011AA ValueDomain-3)
SpecimenCollectedDate
Item
Date of collection (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
Item Group
Pregnancy Test
PregnancyTestPerformedInd-2
Item
Pregnancy test done (check one)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass-2)
C0022885 (UMLS 2011AA ObjectClass-2)
Item
Reason pregnancy test not performed (If No, check one)
text
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass-2)
C0022885 (UMLS 2011AA ObjectClass-2)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
CL.24
Code List
Reason pregnancy test not performed (If No, check one)
CL Item
Patient Is Female But Is Not Of Childbearing Potential (Patient is female but is not of childbearing potential)
CL Item
Patient Is Male (Patient is male)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
PregnancyLaboratoryProcedureNotPerformedSpecify
Item
Other, specify
text
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass-2)
C0022885 (UMLS 2011AA ObjectClass-2)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PatientMostRecentPregnancyTestDate
Item
Pregnancy Test Date (If Yes, Negative mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0032976 (NCI Metathesaurus Property)
C25577 (NCI Thesaurus Property)
C1513491 (UMLS 2011AA Property)
Item Group
Pre-treatment Staging
EndoscopyDate
Item
Date of endoscopy (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16546 (NCI Thesaurus ObjectClass)
C0014245 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
EsophagealMalignantNeoplasmProximalExtentMeasurement
Item
Proximal tumor extent (cm from incisors)
float
C37950 (NCI Thesaurus ObjectClass)
C1522619 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C25236 (NCI Thesaurus Property)
C0205107 (UMLS 2011AA Property)
C25332 (NCI Thesaurus Property-2)
C0439792 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
EsophagealMalignantNeoplasmDistalExtentMeasurement
Item
Distal tumor extent (cm from incisors)
float
C37950 (NCI Thesaurus ObjectClass)
C1522619 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C25237 (NCI Thesaurus Property)
C0205108 (UMLS 2011AA Property)
C25332 (NCI Thesaurus Property-2)
C0439792 (UMLS 2011AA Property-2)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
Item
Siewert Type (check one)
text
C37950 (NCI Thesaurus ObjectClass)
C1522619 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25332 (NCI Thesaurus Property-2)
C0439792 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.25
Code List
Siewert Type (check one)
CL Item
Type I (Type I)
CL Item
Type Ii (Type II)
MagneticResonanceImagingComputedTomographyDiagnosticImagingChestAbdominalCavityAssessmentDate
Item
Date of CT chest/upper abdomen (mm/dd/yyyy)
date
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C16809 (NCI Thesaurus ObjectClass-3)
C0024485 (UMLS 2011AA ObjectClass-3)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25389 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C12664 (NCI Thesaurus Property-3)
C0230168 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
ComputedTomographyDiagnosticImagingTumorCellInvasionPresentInd-2
Item
CT evidence of tumor invasion into adjacent structures (check one)
boolean
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C20625 (NCI Thesaurus Property-2)
C1269955 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ComputedTomographyDiagnosticImagingPulmonaryMetastasisPresentInd-2
Item
CT suspicious for pulmonary metastases (check one)
boolean
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C13304 (NCI Thesaurus Property-2)
C2709248 (UMLS 2011AA Property-2)
C19151 (NCI Thesaurus Property-3)
C0027627 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ComputedTomographyDiagnosticImagingLiverMetastasisPresentInd-2
Item
CT suspicious for liver metastases (check one)
boolean
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C12392 (NCI Thesaurus Property-2)
C0023884 (UMLS 2011AA Property-2)
C19151 (NCI Thesaurus Property-3)
C0027627 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BiopsyPerformedInd-3
Item
Biopsy done (If Yes, check one)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
ComputedTomographyDiagnosticImagingNodalEnlargementPresentInd-2
Item
CT nodal enlargement (check one)
boolean
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
CL110875 (NCI Metathesaurus Property)
C73432 (NCI Thesaurus Property-2)
C1293134 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Nodal Sites (If Yes, indicate check all that apply)
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C12418 (NCI Thesaurus ObjectClass)
C0460004 (UMLS 2011AA ObjectClass)
C12745 (NCI Thesaurus ObjectClass-2)
C0024204 (UMLS 2011AA ObjectClass-2)
C25547 (NCI Thesaurus Property)
CL.31
Code List
Nodal Sites (If Yes, indicate check all that apply)
CL Item
Celiac (Celiac)
CL Item
Peritumoral (Peritumoral)
CL Item
Perigastric (Perigastric)
Item Group
Pre-treatment Staging1
FluorodeoxyglucosePositronEmissionTomographyAssessmentDate
Item
Date of FDG-PET (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C964 (NCI Thesaurus ObjectClass-2)
C0046056 (UMLS 2011AA ObjectClass-2)
StandardUptakeValuePositronEmissionTomographyAssessmentMaximumMeasurement
Item
Maximum SUV
float
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C44275 (NCI Thesaurus ObjectClass-2)
C1442989 (UMLS 2011AA ObjectClass-2)
C0243144 (NCI Metathesaurus ObjectClass)
C25712 (NCI Thesaurus ObjectClass-3)
C1522609 (UMLS 2011AA ObjectClass-3)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25564 (NCI Thesaurus ValueDomain-2)
C0806909 (UMLS 2011AA ValueDomain-2)
FluorodeoxyglucosePositronEmissionTomographyLymphNodeInvolvementAssessmentInd-2
Item
Uptake in LN or other sites (check one)
boolean
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C964 (NCI Thesaurus ObjectClass-2)
C0046056 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C12745 (NCI Thesaurus Property-2)
C0024204 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property-3)
C1314939 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
DiagnosticImagingEndoscopicUltrasoundPerformedDate
Item
Date of EUS (mm/dd/yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C46078 (NCI Thesaurus Property-2)
C0376443 (UMLS 2011AA Property-2)
Item
Maximum depth of tumor invasion (check one)
text
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C25332 (NCI Thesaurus Property)
C0439792 (UMLS 2011AA Property)
C20625 (NCI Thesaurus Property-2)
C1269955 (UMLS 2011AA Property-2)
C46078 (NCI Thesaurus Property-3)
C0376443 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.34
Code List
Maximum depth of tumor invasion (check one)
CL Item
Into Adventitia (t3) (Into adventitia (T3))
CL Item
Into Mucosa/submucosa (t1) (Into mucosa/submucosa (T1))
CL Item
Into Muscularis Propria (t2) (Into muscularis propria (T2))
DiagnosticImagingEndoscopicUltrasoundTStagePerformedText
Item
EUS T stage
text
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C46078 (NCI Thesaurus Property-3)
C0376443 (UMLS 2011AA Property-3)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
DiagnosticImagingEndoscopicUltrasoundNStagePerformedText
Item
EUS N stage
text
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C46078 (NCI Thesaurus Property-3)
C0376443 (UMLS 2011AA Property-3)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
BiopsyPerformedInd-3
Item
Biopsy done (If Yes, check one)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
DiagnosticImagingEndoscopicUltrasoundMStagePerformedText
Item
EUS M stage
text
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C46078 (NCI Thesaurus Property-3)
C0376443 (UMLS 2011AA Property-3)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
LymphNodeBiopsySamplingInd-2
Item
Nodes biopsied (check one)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C51900 (NCI Thesaurus ObjectClass)
C0193842 (UMLS 2011AA ObjectClass)
C25662 (NCI Thesaurus Property)
C0441621 (UMLS 2011AA Property)
Item
Biopsy Result (If Yes, indicate)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.36
Code List
Biopsy Result (If Yes, indicate)
CL Item
Positive (positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
NeoplasmSpecimenLymphNodeAnatomicLocationSpecify
Item
LN 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)
C12745 (NCI Thesaurus Property-2)
C0024204 (UMLS 2011AA Property-2)
C25421 (NCI Thesaurus Property-3)
C0002808 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item
Clinical T Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (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)
CL.37
Code List
Clinical T Stage
CL Item
Tumor Invades Lamina Propria Or Submucosa (T1)
CL Item
Tumor Invades Muscularis Propria (T2)
CL Item
Tumor Invades Adventitia (T3)
Item
Clinical N Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (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)
CL.38
Code List
Clinical N Stage
CL Item
No Regional Lymph Node Metastasis (N0)
CL Item
Regional Lymph Node Metastasis (N1)
Item
Clinical M Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C37950 (NCI Thesaurus ObjectClass-2)
C1522619 (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)
CL.39
Code List
Clinical M Stage
CL Item
No Distant Metastasis (M0)
CL Item
Metastases Present - See Figo And Ajcc Staging For Complete Details (M1a)
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