NSABP C-11 Worksheet for Follow-up Form Combination Chemotherapy Before or After Surgery in Treating Patients With Colorectal Cancer With Liver Metastases That Could Be Removed By Surgery Source Form: NCI FormBuilder:

  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on:

January 9, 2015

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.

Itemgroup comments for :

Item comments for :

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

Colorectal Cancer NCT01189227 Follow-Up - NSABP C-11 Worksheet for Follow-up Form - 3107456v1.0

This paper worksheet may be completed to faciliate the entry of the information in NSABP Coordinator Online. Partially completed forms may be saved in Coordinator Online.

Vital Status
Patient's Vital Status
Source of Survival Information (if alive)
Primary Cause of Death (if dead)
Was there evidence of recurrence at the time of death
Diagnostic Imaging
Did the patient have diagnostic imaging
Type of imaging
First Distant Recurrence
Has the patient been diagnosed with first recurrence
New Primary Cancer Or Mds
Has a new primary cancer or MDS/AML/ALL been diagnosed that has not been previously reported
Cea Level
Has the CEA level of the patient been determined
Footer Module

Similar models

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

Fields marked with * are required.

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