Zoekresultaten - Portaal voor medische datamodellen (MDM-portaal)

Follow-Up - Colorectal Cancer - Follow-Up Form - 2282337v3.0 - Colorectal Cancer - Follow-Up Form

- 09-01-15 - 1 Formulier, 6 Itemgroepen, 19 Data-elementen, 1 Taal

Itemgroepen: CRF Header, Colorectal: Vital Status, Colorectal: Disease Follow-Up Status, Colorectal: Notice of Progression, Colorectal: Notice of New Primary, Comments

Colorectal Cancer - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DB748B98-21DB-2FC3-E034-0003BA12F5E7

Colorectal Cancer NCT01167725 Follow-Up - USMCI 8214/Z6091: Follow Up Form - 2832822v1.0 - USMCI 8214/Z6091: Follow Up Form

- 20-09-21 - 1 Formulier, 9 Itemgroepen, 39 Data-elementen, 1 Taal

Itemgroepen: Header Module, Vital Status, Cancer Follow-Up Status, First Peritoneal Surface Recurrence, First Distant Recurrence, Notice of First Subsequent Treatment, Notice of New Primary, Late Adverse Event, Late Adverse Event Reporting

USMCI 8214/Z6091: Follow Up Form Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=620B3C7C-4FFC-9435-E040-BB89AD430464

Colorectal Cancer NCT00726622 Follow-Up - Z6051 Extended Follow-up (EFU) - 2717820v1.0 - Z6051 Extended Follow-up (EFU)

- 09-01-15 - 1 Formulier, 7 Itemgroepen, 25 Data-elementen, 1 Taal

Itemgroepen: Header Module, Header, Adjuvant Therapy Data, Disease Assessment Data, Notice of First Recurrence /Progression, Notice of New Primary, Footer Module

Z6051 Extended Follow-up (EFU) Laparoscopic-Assisted Resection or Open Resection in Treating Patients With Stage IIA, Stage IIIA, or Stage IIIB Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=42BEFB76-7A1D-58A8-E044-0003BA3F9857

Colorectal Cancer NCT00726622 Follow-Up - Z6051 Early Termination of Follow-up (ETFU) - 2717776v1.0 - Z6051 Early Termination of Follow-up (ETFU)

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 10 Data-elementen, 1 Taal

Itemgroepen: Header Module, Header, Footer Module

Z6051 Early Termination of Follow-up (ETFU) Laparoscopic-Assisted Resection or Open Resection in Treating Patients With Stage IIA, Stage IIIA, or Stage IIIB Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=42BEDFEF-2DFC-4E04-E044-0003BA3F9857

Colorectal Cancer NCT00499369 Follow-Up - Southwest Oncology Group Follow Up Form - 2485277v1.0 - Southwest Oncology Group Follow Up Form

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 27 Data-elementen, 1 Taal

Itemgroepen: Header, VITAL STATUS, Comments

Southwest Oncology Group Follow Up Form Irinotecan and Cetuximab With or Without Bevacizumab in Treating Patients With Metastatic Colorectal Cancer That Progressed During First-Line Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1540A9C1-B252-6EFF-E044-0003BA3F9857

Colorectal Cancer Follow-Up NCT00058474 - FOLLOW-UP FORM Colorectal Cancer NSABP R-04 NCT00058474

- 28-03-15 - 1 Formulier, 3 Itemgroepen, 29 Data-elementen, 1 Taal

Itemgroepen: Header, Follow-Up, Late Adverse Events

NSABP PROTOCOL R-04: FOLLOW-UP FORM Radiation Therapy and Either Capecitabine or Fluorouracil With or Without Oxaliplatin Before Surgery in Treating Patients With Resectable Rectal Cancer NCT00058474 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B7822451-67BC-24E6-E034-0003BA12F5E7

Colorectal Cancer NCT00096278 Follow-Up - NSABP PROTOCOL C-08: FOLLOW-UP FORM - 2276708v3.0 - NSABP PROTOCOL C-08: FOLLOW-UP FORM

- 09-01-15 - 1 Formulier, 5 Itemgroepen, 23 Data-elementen, 1 Taal

Itemgroepen: Header, Vital Status, Cancer Follow-up Status, First Recurrence, New Primary Cancer or MDS

NSABP PROTOCOL C-08: FOLLOW-UP FORM Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7F78B7A-6547-4FB6-E034-0003BA12F5E7

Colorectal Cancer NCT00268463 Follow-Up - NSABP PROTOCOL C-09: FOLLOW-UP FORM - 2319472v3.0 - NSABP PROTOCOL C-09: FOLLOW-UP FORM

- 09-01-15 - 1 Formulier, 6 Itemgroepen, 26 Data-elementen, 1 Taal

Itemgroepen: Header, Vital Status, Cancer Follow-up Status, First HEPATIC Recurrence Since Randomization, First Non-Hepatic Recurrence, New Primary Cancer or MDS

NSABP PROTOCOL C-09: FOLLOW-UP FORM Oxaliplatin and Capecitabine With or Without an Hepatic Arterial Infusion With Floxuridine in Treating Patients Who Are Undergoing Surgery and/or Ablation for Liver Metastases Due to Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FC7DA612-18CD-4443-E034-0003BA3F9857

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

- 09-01-15 - 1 Formulier, 7 Itemgroepen, 24 Data-elementen, 1 Taal

Itemgroepen: Header Module, Vital Status, Diagnostic Imaging, First Recurrence, New Primary Cancer or MDS, CEA Level, Footer Module

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: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8872BD9C-FAAE-BB88-E040-BB89AD432025

Colorectal Cancer NCT01167725 Follow-Up - USMCI 8214/Z6091 Early Termination of Follow-up (ETFU) - 3135012v1.0 - USMCI 8214/Z6091 Early Termination of Follow-up (ETFU)

- 09-01-15 - 1 Formulier, 3 Itemgroepen, 9 Data-elementen, 1 Taal

Itemgroepen: Header Module, Header, Footer Module

USMCI 8214/Z6091 Early Termination of Follow-up (ETFU) Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8FAFF4D8-E3FD-9D2E-E040-BB89AD435E44

Follow-Up Form Colorectal Cancer (NCT01150045)

- 08-01-15 - 1 Formulier, 8 Itemgroepen, 38 Data-elementen, 1 Taal

Itemgroepen: Header Module, SURVIVAL DATA, Disease Status, Progression/Relapse, Colonoscopy Information, Neuropathy, NON-PROTOCOL TREATMENT, NEW PRIMARY DATA

CALGB 80702 Follow-Up Form Oxaliplatin, Leucovorin Calcium, and Fluorouracil With or Without Celecoxib in Treating Patients With Stage III Colon Cancer Previously Treated With Surgery NCT01150045 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7ADB9225-BF4C-FA4C-E040-BB89AD4369EB

CALGB: 80203 Follow-up and Response Form NCT00077233

- 05-07-15 - 1 Formulier, 4 Itemgroepen, 28 Data-elementen, 1 Taal

Itemgroepen: Header, Patient demographics, Miscellaneous Patient Assessment, CCRR MODULE

CALGB: 80203 Follow-up and Response Form NCT00077233 Fluorouracil and Leucovorin Plus Either Irinotecan or Oxaliplatin With or Without Cetuximab in Treating Patients With Previously Untreated Metastatic Adenocarcinoma of the Colon or Rectum Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B4C3AFD5-EA93-071F-E034-0003BA12F5E7

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