308 lines
14 KiB
Plaintext
308 lines
14 KiB
Plaintext
English French Notes Complete/Exclude
|
|
GRADE/DIFFERENTIATION must be: 2 (Grade II)
|
|
GRADE/DIFFERENTIATION must be: 4 (Grade IV)
|
|
GRADE/DIFFERENTIATION =
|
|
HISTOLOGY must be leukemia or lymphoma (9590-9948)
|
|
No TNM classification is available for LYMPHOMA
|
|
SUMMARY STAGE cannot be blank
|
|
No TNM classification is available for KAPOSI'S SAROMA
|
|
EXTENSION may not be 00 (In situ)
|
|
ICDO-TOPOGRAPHY =
|
|
PATHOLGIC EXTENSION =
|
|
PATHOLOGIC EXTENSION may only be coded for PROSTATE (C61.9) cases
|
|
REGIONAL NODES POSITIVE =
|
|
LYMPH NODES may not be 0 (No lymph nodes)
|
|
REGIONAL NODES EXAMINED = 99 (
|
|
REGIONAL NODES POSITIVE must be 99 (Unk if nodes + or -, NA)
|
|
HORMONE THERAPY =
|
|
Only BREAST and PROSTATE cases may be coded as receiving
|
|
endocrine surgery or endocrine radiation
|
|
Dead
|
|
STATUS =
|
|
PLACE OF DEATH may not be blank
|
|
CAUSE OF DEATH and STATE DEATH CERT may not both be blank
|
|
White
|
|
RACE 1 =
|
|
RACE 2 =
|
|
RACE 3 =
|
|
RACE 4 =
|
|
RACE 5 =
|
|
For race combinations RACE 1 may not be 'White'
|
|
A specific race code may not occur more than once
|
|
ONC*2.11*15
|
|
Please install ONC*2.11*15 first. Installation Halted.
|
|
ONC*2.11*20
|
|
ONCO*2.11*20
|
|
Please install ONC*2.11*20 first. Installation Halted.
|
|
The Accession Year is not 2001.
|
|
GI stromal sarcomas (8936) are being collected via paper data form.
|
|
The Behavior Code is not 3 (Malignant).
|
|
Invalid Histology code.
|
|
Select section
|
|
2001 Patient Care Evaluation Study of Gastric Cancers
|
|
PATIENT INFORMATION
|
|
1400.6 1. CO-MORBID CONDITIONS (YES/NO).
|
|
1571 CO-MORBID CONDITION #1.......
|
|
1571.1 CO-MORBID CONDITION #2.......
|
|
1571.2 CO-MORBID CONDITION #3.......
|
|
1571.3 CO-MORBID CONDITION #4.......
|
|
1571.4 CO-MORBID CONDITION #5.......
|
|
1571.5 CO-MORBID CONDITION #6.......
|
|
1500 2. PRIOR EXPOSURE TO RADIATION...
|
|
1501 3. ALCOHOL CONSUMPTION...........
|
|
1572 4. DURATION OF TOBACCO USE.......
|
|
5. MENOPAUSAL STATUS AND HORMONE
|
|
REPLACEMENT THERAPY..........: NA, male patient
|
|
1502 5. MENOPAUSAL STATUS AND HORMONE REPLACEMENT THERAPY..........
|
|
1503 6. H2 BLOCKER/PROTON PUMP INHIBITOR USE................
|
|
1504 7. FAMILY HISTORY OF GASTRIC CANCER.......................
|
|
1573 8. PERSONAL HISTORY OF OTHER INVASIVE MALIGNANCIES PRIOR TO THIS CANCER DIAGNOSIS....//^S X=PHDEF
|
|
9. ASSOCIATED BENIGN CONDTIONS:
|
|
1505 H-PYLORI INFECTION...........
|
|
1506 DUODENAL ULCER...............
|
|
1507 GASTRIC ULCER................
|
|
1509 PERNICIOUS ANEMIA............
|
|
1510 POLYPS OF STOMACH............
|
|
1511 POLYPOSIS OF SMALL OR LARGE BOWEL.......................
|
|
1513 ATROPHIC GASTRITIS...........
|
|
1514 GASTRIC METAPLASIA...........
|
|
10. H-PYLORI DRUGS GIVEN:
|
|
1516 PROTON PUMP INHIBITORS.......
|
|
1518 BISMUTH COMPOUNDS............
|
|
1519 11. PRIOR INTRA-ABDOMINAL SURGERY.
|
|
1520 12. YEAR OF PRIOR GASTRIC RESECTION....................
|
|
CO-MORBID CONDITIONS (YES/NO) equals
|
|
CO-MORBID CONDITION #1 may not be blank
|
|
CO-MORBID CONDITION #1.......: 000.00 No co-morbidities
|
|
CO-MORBID CONDITION #2.......:
|
|
CO-MORBID CONDITION #3.......:
|
|
CO-MORBID CONDITION #4.......:
|
|
CO-MORBID CONDITION #5.......:
|
|
CO-MORBID CONDITION #6.......:
|
|
ANTIBIOTICS..................: H-pylori not present
|
|
PROTON PUMP INHIBITORS.......: H-pylori not present
|
|
H2 BLOCKERS..................: H-pylori not present
|
|
BISMUTH COMPOUNDS............: H-pylori not present
|
|
TUMOR INDENTIFICATION AND DIAGNOSIS
|
|
1521 13. PERFORMANCE STATUS AT INITIAL DIAGNOSIS....................
|
|
14. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS:
|
|
1523 FEVER/NIGHT SWEATS...........
|
|
1524 ACUTE HEMATEMESIS............
|
|
1525 TRANSFUSIONS FOR BLOOD LOSS..
|
|
1574 WEIGHT LOSS..................
|
|
1528 EARLY SATIETY................
|
|
15. INITIAL STAGING STUDIES:
|
|
1529 CT SCAN OF ABDOMEN...........
|
|
1530 CT SCAN OF CHEST.............
|
|
1531 CT PELVIS....................
|
|
1533 GALLIUM SCAN.................
|
|
1534 BIPEDAL LYMPHANGIOGRAM (LAG).
|
|
1536 PET SCAN.....................
|
|
1538 EUS (ENDOSCOPIC ULTRASOUND)..
|
|
1539 PERITONEAL LAVAGE............
|
|
16. LABORATORY STUDIES:
|
|
17. GASTROSCOPIC EXAMINATION RESULTS:
|
|
1545 CLINICAL/VISUAL EXAMINATION..
|
|
1546 18. GASTRO-ESOPHAGEAL JUNCTION (SIEWART TYPE II/III)........
|
|
19. ANATOMIC SITE OF INITIAL HISTOLOGIC DIAGNOSIS:
|
|
1547.3 LYMPH NODES..................
|
|
1548 20. DATE OF FIRST TISSUE DIAGNOSIS
|
|
23. MOLECULAR MARKERS:
|
|
1552 24. MITOTIC RATE..................
|
|
1553 25. TUMOR NECROSIS................
|
|
26. PHENOTYPE MODALITY USED:
|
|
1554 FLOW CYTOMETRY ON FRESH TISSUE......................
|
|
1554.1 IMMUNOHISTOCHEMISTRY ON FROZEN TISSUE......................
|
|
1554.2 IMMUNOHISTOCHEMISTRY ON PARAFIN EMBEDDED TISSUE.....
|
|
1554.3 MOLECULAR GENETICS...........
|
|
1554.4 POLYMERASE CHAIN REACTION TECHNIQUE..................
|
|
1554.5 SOUTHERN BLOT TECHNIQUE......
|
|
1555 27. ANN ARBOR STAGING.............
|
|
18. GASTRO-ESOPHAGEAL JUNCTION (SIEWART TYPE II/III)........: NA (not C16.0 or C16.1)
|
|
21. LAUREN'S CLASSIFICATION.......: NA (not adenocarcinoma)
|
|
22. GOSEKI'S CLASSIFICATION.......: NA (not adenocarcinoma)
|
|
24. MITOTIC RATE..................: NA (not leimyosarcoma)
|
|
25. TUMOR NECROSIS................: NA (not leimyosarcoma)
|
|
FLOW CYTOMETRY ON FRESH TISSUE......................: NA (not lymphoma)
|
|
IMMUNOCHEMISTRY ON FROZEN TISSUE......................: NA (not lymphoma)
|
|
IMMUNOHISTOCHEMISTRY ON PARAFIN EMBEDDED TISSUE.....: NA (not lymphoma)
|
|
MOLECULAR GENETICS...........: NA (not lymphoma)
|
|
POLYMERASE CHAIN REACTION TECHNIQUE...................: NA (not lymphoma)
|
|
SOUTHERN BLOT TECHNIQUE......: NA (not lymphoma)
|
|
27. ANN ARBOR STAGING.............: NA (not lymphoma)
|
|
FIRST COURSE OF TREATMENT - SURGERY
|
|
1556 28. ADHERENCE OF RESECTED PRIMARY SPECIMEN.....................
|
|
1557 29. MARGIN STATUS OF RESECTED PRIMARY SPECIMEN.............
|
|
30. EXTENT OF FREE MARGIN:
|
|
1558 PROXIMAL MARGIN..............
|
|
1558.1 DISTAL MARGIN................
|
|
31. RESECTION BEYOND STOMACH:
|
|
1559.1 TRANVERSE COLON..............
|
|
1559.5 ABDOMINAL WALL...............
|
|
1559.6 ADRENAL GLAND................
|
|
1559.8 SMALL INTESTINE..............
|
|
1560 PERIGASTRIC LYMPH NODES......
|
|
1560.1 COMMON HEPATIC LYMPH NODES...
|
|
1560.2 CELIAC LYMPH NODES...........
|
|
1560.3 SPLENIC LYMPH NODES..........
|
|
1560.4 OTHER INTRA-ABDOMINAL NODES..
|
|
1561 32. GROSSLY INVOLVED REGIONAL LYMPH NODES..................
|
|
1562 33. HCT (HEMATOCRIT) VALUES BEFORE TRANSFUSION..................
|
|
1563 34. TOTAL OPERATIVE BLOOD REPLACEMENT..................
|
|
1564 35. INTRA/PERI-OPERATIVE DEATH....
|
|
36. COMPLICATIONS REQUIRING RE-OPERATION:
|
|
1565 ANASTOMOTIC LEAK.............
|
|
1565.1 STUMP LEAK...................
|
|
1565.3 WOUND INFECTION..............
|
|
1565.6 DEAD BOWEL...................
|
|
1566 37. DATE OF SURGICAL DISCHARGE....
|
|
FIRST COURSE OF TREATMENT - RADIATION
|
|
442 38. REGIONAL DOSE (cGy)...........
|
|
1575 39. BOOST DOSE (cGy)..............
|
|
1567 40. INTRA-OPERATIVE RADIATION THERAPY, DOSE (cGy)..........
|
|
1568 41. CONCURRENT CHEMOTHERAPY.......
|
|
FIRST COURSE OF TREATMENT - CHEMOTHERAPY
|
|
42. TYPE OF CHEMOTHERAPEUTIC AGENTS ADMINISTERED:
|
|
1569 43. INTRAPERITONEAL CHEMOTHERAPY..
|
|
1577 44. CHEMOTHERAPEUTIC TOXICITY.....
|
|
1578 45. CHEMOTHERAPY/SURGERY SEQUENCE.
|
|
FIRST COURSE OF TREATMENT - IMMUNOTHERAPY
|
|
1570 46. ADMINSTRATION OF INTERFERON...
|
|
No surgery of the primary site was performed.
|
|
Proceed to data item 38.
|
|
No radiation therapy was administered.
|
|
Code data items 38-40 to 00000.
|
|
Do not answer data item 41, and proceed to data item 42.
|
|
38. REGIONAL DOSE (cGy)...........: 00000
|
|
39. BOOST DOSE (cGy)..............: Not administered
|
|
40. INTRA-OPERATIVE RADIATION
|
|
THERAPY, DOSE (cGy)..........: Not administered
|
|
41. CONCURRENT CHEMOTHERAPY.......:
|
|
No chemotherapy was administered.
|
|
Proceed to data item 46.
|
|
No immunotherapy administered.
|
|
Proceed to Treatment Complications.
|
|
TREATMENT COMPLICATIONS
|
|
COMPLICATION #1..............: 000.00 No complications
|
|
CASE REGISTRATION
|
|
81 48. INITIALS OF CASE ABSTRACTOR...
|
|
90 49. DATE CASE WAS ABSTRACTED......
|
|
PATIENT INFORMATION
|
|
1. CO-MORBID CONDITIONS:
|
|
CO-MORBID CONDITION #1.......: 000.00 No co-morbidities
|
|
CO-MORBID CONDITION #1.......:
|
|
CO-MORBID CONDITION #2.......:
|
|
CO-MORBID CONDITION #3.......:
|
|
CO-MORBID CONDITION #4.......:
|
|
CO-MORBID CONDITION #5.......:
|
|
CO-MORBID CONDITION #6.......:
|
|
2. PRIOR EXPOSURE TO RADIATION...:
|
|
3. ALCOHOL CONSUMPTION...........:
|
|
4. DURATION OF TOBACCO USE.......:
|
|
5. MENOPAUSAL STATUS AND HORMONE
|
|
REPLACEMENT THERAPY..........:
|
|
6. H2/BLOCKER PROTON PUMP
|
|
7. FAMILY HISTORY OF GASTRIC
|
|
8. PERSONAL HISTORY OF OTHER
|
|
INVASIVE MALIGNANCIES PRIOR
|
|
TO THIS CANCER DIAGNOSIS....:
|
|
9. ASSOCIATED BENIGN CONDITIONS:
|
|
H-PYLORI INECTION............:
|
|
DUODENAL ULCER...............:
|
|
GASTRIC ULCER................:
|
|
PERNICIOUS ANEMIA............:
|
|
POLYPS OF STOMACH............:
|
|
POLYPOSIS OF SMALL OR LARGE
|
|
ATROPHIC GASTRITIS...........:
|
|
GASTRIC METAPLASIA...........:
|
|
10. H-PYLORI DRUGS GIVEN:
|
|
PROTON PUMP INHIBITORS.......:
|
|
BISMUTH COMPOUNDS............:
|
|
11. PRIOR INTRA-ABDOMINAL SURGERY.:
|
|
12. YEAR OF PRIOR GASTRIC
|
|
Print Gastric Cancers PCE
|
|
TUMOR IDENTIFICATION AND DIAGNOSIS
|
|
13. PERFORMANCE STATUS AT INITIAL
|
|
14. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS:
|
|
FEVER/NIGHT SWEATS...........:
|
|
ACUTE HEMATEMESIS............:
|
|
TRANSFUSIONS FOR BLOOD LOSS..:
|
|
WEIGHT LOSS..................:
|
|
EARLY SATIETY................:
|
|
15. INITIAL STAGING STUDIES:
|
|
CT SCAN OF ABDOMEN...........:
|
|
CT SCAN OF CHEST.............:
|
|
CT PELVIS....................:
|
|
GALLIUM SCAN.................:
|
|
BIPEDAL LYMPHANGIOGRAM (LAG).:
|
|
PET SCAN.....................:
|
|
EUS (ENDOSCOPIC ULTRASOUND)..:
|
|
PERITONEAL LAVAGE............:
|
|
16. LABORATORY STUDIES:
|
|
17. GASTROSCOPIC EXAMINATION RESULTS:
|
|
CLINICAL/VISUAL EXAMINATION..:
|
|
18. GASTRO-ESOPHAGEAL JUNCTION
|
|
(SIEWART TYPE II/III)........: NA (not C16.0 or C16.1)
|
|
(SIEWART TYPE II/III)........:
|
|
19. ANATOMIC SITE OF INITIAL HISTOLOGIC DIAGNOSIS:
|
|
LYMPH NODES..................:
|
|
20. DATE OF FIRST TISSUE DIAGNOSIS:
|
|
21. LAUREN'S CLASSIFICATION.......: NA (not adenocarcinoma)
|
|
22. GOSEKI'S CLASSIFICATION.......: NA (not adenocarcinoma)
|
|
23. MOLECULAR MARKERS:
|
|
24. MITOTIC RATE..................: NA (not leimyosarcoma)
|
|
25. TUMOR NECROSIS................: NA (not leimyosarcoma)
|
|
24. MITOTIC RATE..................:
|
|
25. TUMOR NECROSIS................:
|
|
26. PHENOTYPE MODALITY USED:
|
|
FLOW CYTOMETRY ON FRESH
|
|
TISSUE......................: NA (not lymphoma)
|
|
IMMUNOCHEMISTRY ON FROZEN
|
|
IMMUNOHISTOCHEMISTRY ON
|
|
PARAFIN EMBEDDED TISSUE.....: NA (not lymphoma)
|
|
MOLECULAR GENETICS...........: NA (not lymphoma)
|
|
POLYMERASE CHAIN REACTION
|
|
TECHNIQUE...................: NA (not lymphoma)
|
|
SOUTHERN BLOT TECHNIQUE......: NA (not lymphoma)
|
|
27. ANN ARBOR STAGING.............: NA (not lymphoma)
|
|
FLOW CYTOMETRY ON FRESH
|
|
IMMUNOCHEMISTRY ON FROZEN
|
|
IMMUNOHISTOCHEMISTRY ON
|
|
PARAFIN EMBEDDED TISSUE.....:
|
|
MOLECULAR GENETICS...........:
|
|
POLYMERASE CHAIN REACTION
|
|
SOUTHERN BLOT TECHNIQUE......:
|
|
27. ANN ARBOR STAGING..............:
|
|
FIRST COURSE OF TREATMENT - SURGERY
|
|
28. ADHERENCE OF RESECTED PRIMARY
|
|
29. MARGIN STATUS OF RESECTED
|
|
PRIMARY SPECIMAN.............:
|
|
30. EXTENT OF FREE MARGIN:
|
|
PROXIMAL MARGIN..............:
|
|
DISTAL MARGIN................:
|
|
31. RESECTION BEYOND STOMACH:
|
|
TRANVERSE COLON..............:
|
|
ABDOMINAL WALL...............:
|
|
ADRENAL GLAND................:
|
|
SMALL INTESTINE..............:
|
|
PERIGASTRIC LYMPH NODES......:
|
|
COMMON HEPATIC LYMPH NODES...:
|
|
CELIAC LYMPH NODES...........:
|
|
SPLENIC LYMPH NODES..........:
|
|
OTHER INTRA-ABDOMINAL NODES..:
|
|
32. GROSSLY INVOLVED REGIONAL
|
|
33. HCT (HEMATOCRIT) VALUES BEFORE
|
|
34. TOTAL OPERATIVE BLOOD
|
|
35. INTRA/PERI-OPERATIVE DEATH....:
|
|
36. COMPLICATIONS REQUIRING RE-OPERATION:
|
|
ANASTOMOTIC LEAK.............:
|
|
STUMP LEAK...................:
|
|
WOUND INFECTION..............:
|
|
DEAD BOWEL...................:
|
|
37. DATE OF SURGICAL DISCHARGE....:
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|