ID

9409

Description

S1011 Surgeon's Post-Op Data Form Standard Versus Extended LND (#19886) Standard or Extended Pelvic Lymphadenectomy in Treating Patients Undergoing Surgery for Invasive Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=940453E3-437B-BBC7-E040-BB89AD431F9F

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=940453E3-437B-BBC7-E040-BB89AD431F9F

Keywords

Versions (4)
  1. 8/26/12 8/26/12 -
  2. 11/28/14 11/28/14 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 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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Bladder Cancer NCT01224665 Treatment - S1011 Surgeon's Post-Op Data Form Standard Versus Extended LND (#19886) - 3153895v1.0

English

Instructions: To be completed by attending surgeon. Please complete within 7 days of hospital discharge. Surgeons should be provided with this form prior to the surgical event. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red and write AMENDED across top of form

1 forms  
Header Module
Description

Header Module

Alias
UMLS CUI-1
C1320722
SWOG Patient ID
Description

Trial subject ID SWOG

Data type

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1519429
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25699
SWOG Study No.
Description

Protocol ID SWOG

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1519429
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25699
Registration Step
Description

Registration Number

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1514821
NCI Thesaurus ObjectClass
C25646
UMLS CUI-2
C0237753
NCI Thesaurus Property
C16154
NCI Thesaurus ValueDomain-2
C16154
Patient Initials (L, F M)
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Date of completion (MM DD YYYY)
Description

FormCompletionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
Institution/Affiliate
Description

Institution Name

Data type

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Physician
Description

Investigator Name

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2826892
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C17089
NCI Thesaurus ObjectClass-2
C25644
Participating Group Name
Description

Participating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2347449
NCI Thesaurus ObjectClass
C25608
NCI Thesaurus ObjectClass-2
C17005
NCI Thesaurus Property
C25364
Participating Group Study No.
Description

Study Number Participating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Participating Group Patient ID
Description

Trial subject ID Participating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Hospitalization
Description

Hospitalization

Protocol Surgery Date (MM DD YYYY)
Description

ProtocolSurgeryDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus ObjectClass-2
C42651
UMLS 2011AA ObjectClass-2
C0442711
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
Discharge Date (MM DD YYYY)
Description

InpatientHospitalDischargeDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus ObjectClass-2
C25182
UMLS 2011AA ObjectClass-2
C0021562
NCI Thesaurus Property
C25166
UMLS 2011AA Property
C0030685
Number of days in ICU
Description

HospitalIntensiveCareUnitAdmissionDayCount

Data type

float

Alias
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
NCI Thesaurus Property-2
C53511
UMLS 2011AA Property-2
C0021708
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
Did patient require an unplanned admission to ICU at any time
Description

HospitalIntensiveCareUnitUnplannedAdmissionInd-2

Data type

text

Alias
NCI Thesaurus ObjectClass
C16696
NCI Thesaurus Property
C25385
NCI Thesaurus Property-2
C53511
NCI Thesaurus Property-3
C88009
NCI Thesaurus ValueDomain
C38147
UMLS CUI-1
C0019994
UMLS CUI-2
C0809949
UMLS CUI-3
C0021708
UMLS CUI-4
C1512698
Length of hospital stay (ICU and acute care)
Description

HospitalDischargeDayCount

Data type

float

Alias
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
NCI Metathesaurus Property
C0012621
Was TPN used postoperatively (Central/Total Parenteral Nutrition)
Description

NutritionalSupportIntravenousRouteofAdministrationAdministeredind-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus Property
C38276
NCI Thesaurus Property-2
C25382
NCI Thesaurus ObjectClass
C15433
UMLS CUI-1
C1512699
UMLS CUI-2
C1522726
UMLS CUI-3
C1521801
UMLS CUI-4
C0242739
Were enteral tube feedings used postoperatively
Description

GavageCurrentAdministrationInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus Property
C25471
NCI Thesaurus ObjectClass
C73430
NCI Thesaurus Property-2
C25409
UMLS CUI-1
C1512699
UMLS CUI-2
C0521116
UMLS CUI-3
C0041281
UMLS CUI-4
C1533734
Disease Description
Description

Disease Description

Pathologic T Stage
Description

BladderCarcinomaPathologicTStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12414
UMLS 2011AA ObjectClass-2
C0005682
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
NCI Thesaurus ValueDomain
C25610
UMLS 2011AA ValueDomain
C1521733
NCI Thesaurus ValueDomain-2
C4912
UMLS 2011AA ValueDomain-2
C0699885
NCI Thesaurus ValueDomain-3
C16899
UMLS 2011AA ValueDomain-3
C1300072
NCI Thesaurus ValueDomain-4
C25728
UMLS 2011AA ValueDomain-4
C0475455
Pathologic N Stage
Description

BladderCarcinomaPathologicNStage

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12414
UMLS 2011AA ObjectClass-2
C0005682
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
NCI Thesaurus ValueDomain
C25610
UMLS 2011AA ValueDomain
C1521733
NCI Thesaurus ValueDomain-2
C4912
UMLS 2011AA ValueDomain-2
C0699885
NCI Thesaurus ValueDomain-3
C16899
UMLS 2011AA ValueDomain-3
C1300072
NCI Thesaurus ValueDomain-4
C25580
UMLS 2011AA ValueDomain-4
C0456532
Histologic Type (select all that apply)
Description

BladderTumorHistologicCategory

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C12414
UMLS 2011AA ObjectClass-2
C0005682
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property-2
C25161
UMLS 2011AA Property-2
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ValueDomain-2
C25526
UMLS 2011AA ValueDomain-2
C0205462
Other specify
Description

Histologic Type, other

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C1299220
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25526
NCI Thesaurus Property-2
C25161
Type of Variant Histology (if selected please specify)
Description

TumorHistologicVariationCategory

Data type

text

Alias
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property-2
C25713
UMLS 2011AA Property-2
C0205419
Complications
Description

Complications

Alias
UMLS CUI-1
C0009566
UMLS CUI-2
C0348025
Was the assessment done
Description

SurgicalProcedureAdverseEventAssessmentInd-2

Data type

text

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus Property
C20989
NCI Thesaurus ObjectClass
C41331
NCI Thesaurus ObjectClass-2
C15329
UMLS CUI-1
C1512698
UMLS CUI-2
C0031809
UMLS CUI-3
C0877248
UMLS CUI-4
C0543467
Other, specify
Description

SurgicalProcedureComplicationSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus Property
C2959
UMLS 2011AA Property
C0009566
Other, specify
Description

SurgicalProcedureComplicationSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus Property
C2959
UMLS 2011AA Property
C0009566
Start date (MM DD YYYY should be the date of surgery)
Description

AdverseEventSymptomBeginDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus ValueDomain-2
C25431
UMLS 2011AA ValueDomain-2
C0439659
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
Stop date (MM DD YYYY should be the date of hospital discharge)
Description

AdverseEventSymptomEndDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
Surgical Complications
Description

SurgicalProcedureComplicationType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15329
UMLS 2011AA ObjectClass
C0543467
NCI Thesaurus Property
C2959
UMLS 2011AA Property
C0009566
Surgical Complication Grade
Description

PatientSurgicalProcedureComplicationGradePresentType

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C15329
UMLS 2011AA Property-2
C0543467
NCI Thesaurus Property-3
C2959
UMLS 2011AA Property-3
C0009566
NCI Thesaurus Property-4
C48309
UMLS 2011AA Property-4
C0441800
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Transfusions
Description

Transfusions

Alias
UMLS CUI-1
C1879316
Total units whole blood
Description

WholeBloodTransfusionCount

Data type

float

Alias
NCI Metathesaurus ObjectClass
C0370231
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ObjectClass
C15408
Total units fresh frozen plasma
Description

FreshFrozenPlasmaTransfusionReceivedUnitCount

Data type

float

Alias
NCI Metathesaurus ObjectClass
C0016709
NCI Thesaurus ObjectClass
C15408
NCI Thesaurus Property
C25639
UMLS 2011AA Property
C1514756
NCI Thesaurus ValueDomain
C44278
UMLS 2011AA ValueDomain
C0439148
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
Total units PRBC
Description

PackedRedBloodCellTransfusionReceivedUnitCount

Data type

float

Alias
NCI Thesaurus ValueDomain
C44278
UMLS 2011AA ValueDomain
C0439148
NCI Thesaurus Property
C25639
UMLS 2011AA Property
C1514756
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
NCI Thesaurus ObjectClass
C15409
UMLS 2011AA ObjectClass
C0199962
Total units platelets
Description

PlateletTransfusionReceivedUnitCount

Data type

float

Alias
NCI Thesaurus ValueDomain
C44278
UMLS 2011AA ValueDomain
C0439148
NCI Thesaurus Property
C25639
UMLS 2011AA Property
C1514756
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
NCI Thesaurus ObjectClass
C15366
UMLS 2011AA ObjectClass
C0086818
Comments
Description

Comments

Alias
UMLS CUI-1
C0947611
Comments
Description

Research Comments

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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Similar models

Instructions: To be completed by attending surgeon. Please complete within 7 days of hospital discharge. Surgeons should be provided with this form prior to the surgical event. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red and write AMENDED across top of form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
C1320722 (UMLS CUI-1)
Trial subject ID SWOG
Item
SWOG Patient ID
float
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Protocol ID SWOG
Item
SWOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-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)
FormCompletionDate
Item
Date of completion (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Investigator Name
Item
Physician
text
C25191 (NCI Thesaurus ValueDomain)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
Participating Group
Item
Participating Group Name
text
C25191 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Item Group
Hospitalization
ProtocolSurgeryDate
Item
Protocol Surgery Date (MM DD YYYY)
date
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C42651 (NCI Thesaurus ObjectClass-2)
C0442711 (UMLS 2011AA ObjectClass-2)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
InpatientHospitalDischargeDate
Item
Discharge Date (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25182 (NCI Thesaurus ObjectClass-2)
C0021562 (UMLS 2011AA ObjectClass-2)
C25166 (NCI Thesaurus Property)
C0030685 (UMLS 2011AA Property)
HospitalIntensiveCareUnitAdmissionDayCount
Item
Number of days in ICU
float
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
C53511 (NCI Thesaurus Property-2)
C0021708 (UMLS 2011AA Property-2)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
Item
Did patient require an unplanned admission to ICU at any time
text
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C53511 (NCI Thesaurus Property-2)
C88009 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0019994 (UMLS CUI-1)
C0809949 (UMLS CUI-2)
C0021708 (UMLS CUI-3)
C1512698 (UMLS CUI-4)
CL.1
Code List
Did patient require an unplanned admission to ICU at any time
HospitalDischargeDayCount
Item
Length of hospital stay (ICU and acute care)
float
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C0012621 (NCI Metathesaurus Property)
Item
Was TPN used postoperatively (Central/Total Parenteral Nutrition)
text
C38148 (NCI Thesaurus ValueDomain)
C38276 (NCI Thesaurus Property)
C25382 (NCI Thesaurus Property-2)
C15433 (NCI Thesaurus ObjectClass)
C1512699 (UMLS CUI-1)
C1522726 (UMLS CUI-2)
C1521801 (UMLS CUI-3)
C0242739 (UMLS CUI-4)
CL.2
Code List
Was TPN used postoperatively (Central/Total Parenteral Nutrition)
Item
Were enteral tube feedings used postoperatively
text
C38148 (NCI Thesaurus ValueDomain)
C25471 (NCI Thesaurus Property)
C73430 (NCI Thesaurus ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1512699 (UMLS CUI-1)
C0521116 (UMLS CUI-2)
C0041281 (UMLS CUI-3)
C1533734 (UMLS CUI-4)
CL.3
Code List
Were enteral tube feedings used postoperatively
Item Group
Disease Description
Item
Pathologic T Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12414 (NCI Thesaurus ObjectClass-2)
C0005682 (UMLS 2011AA ObjectClass-2)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C25610 (NCI Thesaurus ValueDomain)
C1521733 (UMLS 2011AA ValueDomain)
C4912 (NCI Thesaurus ValueDomain-2)
C0699885 (UMLS 2011AA ValueDomain-2)
C16899 (NCI Thesaurus ValueDomain-3)
C1300072 (UMLS 2011AA ValueDomain-3)
C25728 (NCI Thesaurus ValueDomain-4)
C0475455 (UMLS 2011AA ValueDomain-4)
CL.4
Code List
Pathologic T Stage
CL Item
Tumor Invades Superficial Muscularis Propria (inner Half) (pT2a)
CL Item
Tumor Invades Deep Muscularis Propria (outer Half) (pT2b)
CL Item
Tumor Invades Perivesical Tissue Microscopically (pT3a)
CL Item
Tumor Invades Perivesical Tissue Macroscopically (extravesical Mass) (pT3b)
CL Item
Tumor Invades Prostatic Stroma, Uterus, Vagina (pT4a)
Item
Pathologic N Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12414 (NCI Thesaurus ObjectClass-2)
C0005682 (UMLS 2011AA ObjectClass-2)
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C25610 (NCI Thesaurus ValueDomain)
C1521733 (UMLS 2011AA ValueDomain)
C4912 (NCI Thesaurus ValueDomain-2)
C0699885 (UMLS 2011AA ValueDomain-2)
C16899 (NCI Thesaurus ValueDomain-3)
C1300072 (UMLS 2011AA ValueDomain-3)
C25580 (NCI Thesaurus ValueDomain-4)
C0456532 (UMLS 2011AA ValueDomain-4)
CL.5
Code List
Pathologic N Stage
CL Item
Lymph Nodes Cannot Be Assessed (pNX)
CL Item
No Lymph Node Metastasis (pN0)
CL Item
Single Regional Lymph Node Metastasis In The True Pelvis (hypogastric, Obturator, External Iliac Or Presacral Lymph Node) (pN1)
CL Item
Multiple Regional Lymph Node Metastasis In The True Pelvis (hypogastric, Obturator, External Iliac Or Presacral Lymph Node Metastasis) (pN2)
CL Item
Lymph Node Metastasis To The Common Iliac Lymph Nodes (pN3)
Item
Histologic Type (select all that apply)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12414 (NCI Thesaurus ObjectClass-2)
C0005682 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)
CL.6
Code List
Histologic Type (select all that apply)
CL Item
Urothelial Carcinoma (Urothelial cell carcinoma)
C4030 (NCI Thesaurus)
C0007138 (UMLS 2011AA)
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Adenocarcinoma (Adenocarcinoma)
C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)
CL Item
Micropapillary Transitional Cell Carcinoma (Micropapillary carcinoma)
C65182 (NCI Thesaurus)
C1266012 (UMLS 2011AA)
CL Item
Other Specify (Other, specify)
Histologic Type, other
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1299220 (UMLS CUI-1)
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
Item
Type of Variant Histology (if selected please specify)
text
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25713 (NCI Thesaurus Property-2)
C0205419 (UMLS 2011AA Property-2)
CL.7
Code List
Type of Variant Histology (if selected please specify)
CL Item
Urothelial Carcinoma (< 50% Urothelial cell carcinoma)
C4030 (NCI Thesaurus)
C0007138 (UMLS 2011AA)
C4030 (NCI Thesaurus-3)
C0007138 (UMLS 2011AA-4)
CL Item
Urothelial Carcinoma (>= 50% Urothelial cell carcinoma)
C4030 (NCI Thesaurus)
C0007138 (UMLS 2011AA)
C4030 (NCI Thesaurus-3)
C0007138 (UMLS 2011AA-4)
CL Item
Squamous Cell Carcinoma (< 50% Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
C2929 (NCI Thesaurus-3)
C0007137 (UMLS 2011AA-4)
CL Item
Squamous Cell Carcinoma (>= 50% Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
C2929 (NCI Thesaurus-3)
C0007137 (UMLS 2011AA-4)
CL Item
Adenocarcinoma (< 50% Adenocarcinoma)
C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)
C2852 (NCI Thesaurus-3)
C0001418 (UMLS 2011AA-4)
CL Item
Adenocarcinoma (>= 50% Adenocarcinoma)
C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)
C2852 (NCI Thesaurus-3)
C0001418 (UMLS 2011AA-4)
CL Item
Micropapillary Transitional Cell Carcinoma (< 50% Micropapillary carcinoma)
C65182 (NCI Thesaurus)
C1266012 (UMLS 2011AA)
C65182 (NCI Thesaurus-3)
C1266012 (UMLS 2011AA-4)
CL Item
Micropapillary Transitional Cell Carcinoma (>= 50% Micropapillary carcinoma)
C65182 (NCI Thesaurus)
C1266012 (UMLS 2011AA)
C65182 (NCI Thesaurus-3)
C1266012 (UMLS 2011AA-4)
Item Group
Complications
C0009566 (UMLS CUI-1)
C0348025 (UMLS CUI-2)
Item
Was the assessment done
text
C38147 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus Property)
C41331 (NCI Thesaurus ObjectClass)
C15329 (NCI Thesaurus ObjectClass-2)
C1512698 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
C0877248 (UMLS CUI-3)
C0543467 (UMLS CUI-4)
CL.8
Code List
Was the assessment done
SurgicalProcedureComplicationSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C2959 (NCI Thesaurus Property)
C0009566 (UMLS 2011AA Property)
SurgicalProcedureComplicationSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C2959 (NCI Thesaurus Property)
C0009566 (UMLS 2011AA Property)
AdverseEventSymptomBeginDate
Item
Start date (MM DD YYYY should be the date of surgery)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
AdverseEventSymptomEndDate
Item
Stop date (MM DD YYYY should be the date of hospital discharge)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
Item
Surgical Complications
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C2959 (NCI Thesaurus Property)
C0009566 (UMLS 2011AA Property)
CL.9
Code List
Surgical Complications
CL Item
Superficial Wound Infection (Superficial wound infection)
C45234 (NCI Thesaurus)
C0043241 (UMLS 2011AA)
C25239 (NCI Thesaurus-3)
C0205124 (UMLS 2011AA-4)
CL Item
Deep Wound Infection (Deep wound infection)
C45234 (NCI Thesaurus)
C0043241 (UMLS 2011AA)
C25240 (NCI Thesaurus-3)
C0205125 (UMLS 2011AA-4)
CL Item
Wound Disruption (Wound disruption)
C25486 (NCI Thesaurus)
C0332453 (UMLS 2011AA)
C3671 (NCI Thesaurus-3)
C0043250 (UMLS 2011AA-4)
CL Item
Pneumonia (PNEUMONIA)
C3333 (NCI Thesaurus)
C0032285 (UMLS 2011AA)
CL Item
Intubation (Re-intubation)
C37981 (NCI Thesaurus)
C0021925 (UMLS 2011AA)
CL Item
Pulmonary Embolism (Pulmonary Embolism)
C50713 (NCI Thesaurus)
C0034065 (UMLS 2011AA)
CL Item
Deep Vein Thrombosis (Deep venous thrombosis)
C49343 (NCI Thesaurus)
C0149871 (UMLS 2011AA)
CL Item
Failure To Wean From Ventilator Within 48 Hours (Failure to wean from ventilator within 48 hours)
CL Item
Sepsis (Sepsis)
E11560 (CTCAE)
CL Item
Anastomotic Bowel Leak (Anastomotic bowel leak)
CL Item
Renal Insufficiency Dialysis (Renal insufficiency requiring dialysis)
C1565489 (NCI Metathesaurus)
C15221 (NCI Thesaurus)
C0011946 (UMLS 2011AA)
CL Item
Symptomatic Lymph Leakage/lymphocele (Symptomatic lymph leakage/lymphocele)
CL Item
Lymph Leakage/lymphocele Requiring Intervention (Lymph leakage/lymphocele requiring intervention)
CL Item
Acute Renal Failure (Acute renal failure)
C26808 (NCI Thesaurus)
C0022660 (UMLS 2011AA)
CL Item
Urinary Tract Infection (Urinary tract infection)
C50791 (NCI Thesaurus)
C0042029 (UMLS 2011AA)
CL Item
Cerebrovascular Accident Stroke (CVA/stroke)
C3390 (NCI Thesaurus)
C0038454 (UMLS 2011AA)
E12826 (CTCAE)
CL Item
Cardiac Event With Cpr (Cardiac event with CPR)
CL Item
Myocardial Infarction (Myocardial infarction)
E10152 (CTCAE)
CL Item
Ileus (Ileus)
E10812 (CTCAE)
CL Item
Bowel Obstruction (Bowel obstruction)
CL Item
Hemorrhage Postoperative (Bleeding > 4 units postoperative)
C26791 (NCI Thesaurus)
C0019080 (UMLS 2011AA)
C28006 (NCI Thesaurus-3)
C0032790 (UMLS 2011AA-4)
CL Item
Death Within 30 Days Of Cystectomy (Death within 30 days of cystectomy)
CL Item
Death Prior To Hospital Discharge (Death prior to hospital discharge)
CL Item
Other, Specify (Other, Specify)
Item
Surgical Complication Grade
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C15329 (NCI Thesaurus Property-2)
C0543467 (UMLS 2011AA Property-2)
C2959 (NCI Thesaurus Property-3)
C0009566 (UMLS 2011AA Property-3)
C48309 (NCI Thesaurus Property-4)
C0441800 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.10
Code List
Surgical Complication Grade
CL Item
Use Of Oral Medications Or Bedside Intervention (Use of oral medications or bedside intervention)
CL Item
Use Of Intravenous Medication, Total Parenteral Nutrition (tpn), Enteral Nutrition, Or Blood Transfusion (Use of intravenous medication, total parenteral nutrition (TPN), enteral nutrition, or blood transfusion)
CL Item
Interventional Radiology, Therapeutic Endoscopy, Intubation, Angiography, Or Operation (Interventional radiology, therapeutic endoscopy, intubation, angiography, or operation)
CL Item
Residual Lasting Disability Requiring Major Rehabilitation Or Organ Resection (Residual lasting disability requiring major rehabilitation or organ resection)
CL Item
Death (Death of patient)
C28554 (NCI Thesaurus)
C0011065 (UMLS 2011AA)
Item Group
Transfusions
C1879316 (UMLS CUI-1)
WholeBloodTransfusionCount
Item
Total units whole blood
float
C0370231 (NCI Metathesaurus ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C15408 (NCI Thesaurus ObjectClass)
FreshFrozenPlasmaTransfusionReceivedUnitCount
Item
Total units fresh frozen plasma
float
C0016709 (NCI Metathesaurus ObjectClass)
C15408 (NCI Thesaurus ObjectClass)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C44278 (NCI Thesaurus ValueDomain)
C0439148 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
PackedRedBloodCellTransfusionReceivedUnitCount
Item
Total units PRBC
float
C44278 (NCI Thesaurus ValueDomain)
C0439148 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
PlateletTransfusionReceivedUnitCount
Item
Total units platelets
float
C44278 (NCI Thesaurus ValueDomain)
C0439148 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C15366 (NCI Thesaurus ObjectClass)
C0086818 (UMLS 2011AA ObjectClass)
Item Group
Comments
C0947611 (UMLS CUI-1)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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