[604] | 1 | English French Notes Complete/Exclude
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| 2 | ABDOMINAL INFECTION..............: NA, no treatment
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| 3 | ABSCESS..........................: NA, no treatment
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| 4 | ADMISSION FOR NEUTROPENIA........: NA, no treatment
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| 5 | ANASTOMOTIC DEHISCENCE...........: NA, no treatment
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| 6 | BLEEDING/HEMATOMA................: NA, no treatment
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| 7 | DEHYDRATION......................: NA, no treatment
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| 8 | DIARRHEA.........................: NA, no treatment
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| 9 | EARLY BOWEL OBSTRUCTION..........: NA, no treatment
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| 10 | PERINEAL INFECTION...............: NA, no treatment
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| 11 | PNEUMONIA........................: NA, no treatment
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| 12 | PROCTITIS........................: NA, no treatment
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| 13 | PULMONARY EMBOLISM...............: NA, no treatment
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| 14 | RADIATION ENTERITIS..............: NA, no treatment
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| 15 | STOMA COMPLICATION...............: NA, no treatment
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| 16 | URINARY TRACT INFECTION..........: NA, no treatment
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| 17 | POSTOPERATIVE DEATH W/I 30 DAYS: NA, no surgery
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| 18 | 763 ADDITIONAL SURGICAL PROCEDURES..
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| 19 | 764 LAPAROSCOPY USED DURING SURGERY.
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| 20 | 765 METHOD OF ANASTOMOSIS...........
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| 21 | 766 DIST OF ANASTOMOSIS FROM DENTATE
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| 22 | 59 RESIDUAL PRIMARY TUMOR..........
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| 23 | 769 PATHOLOGICAL STATUS...........
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| 24 | 770 ABDOMINAL INFECTION...........
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| 25 | 772 ADMISSION FOR NEUTROPENIA.....
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| 26 | 773 ANASTOMOTIC DEHISCENCE........
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| 27 | 776 EARLY BOWEL OBSTRUCTION.......
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| 28 | 777 PERINEAL INFECTION............
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| 29 | 780 PULMONARY EMBOLISM............
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| 30 | 781 RADIATION ENTERITIS...........
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| 31 | 782 STOMA COMPLICATION............
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| 32 | 783 URINARY TRACT INFECTION.......
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| 33 | 441 POSTOPERATIVE DEATH W/I 30 DAYS.
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| 34 | DATE RADIATION STARTED..........:
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| 35 | DATE RADIATION THERAPY ENDED....: 00/00/0000
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| 36 | ENDOCAVITARY RADIATION..........: None
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| 37 | INTRA-OPERATIVE RAD THERAPY.....: No
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| 38 | PRIMARY TUMOR RAD DOSE W BOOST..: No radiation therapy
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| 39 | NUMBER OF RADIATION TREATMENTS..: None
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| 40 | DATE RADIATION THERAPY ENDED....: 99/99/9999
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| 41 | ENDOCAVITARY RADIATION..........: Unknown
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| 42 | INTRA-OPERATIVE RAD THERAPY.....: Unknown
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| 43 | PRIMARY TUMOR RAD DOSE W BOOST..: Unknown if received radiation therapy
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| 44 | NUMBER OF RADIATION TREATMENTS..: Unknown if radiation given
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| 45 | 361 DATE RADIATION THERAPY ENDED....
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| 46 | 784 ENDOCAVITARY RADIATION..........
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| 47 | 785 INTRA-OPERATIVE RAD THERAPY.....
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| 48 | 786 PRIMARY TUMOR RAD DOSE W BOOST..
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| 49 | 787 NUMBER OF RADIATION TREATMENTS..
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| 50 | DATE CHEMOTHERAPY STARTED.......:
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| 51 | ADJUVANT CHEMO W BEAM RADIATION.: No concomitant treatment
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| 52 | ADJUVANT THERAPY:
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| 53 | DURATION OF ADJUVANT THERAPY....: No adjuvant therapy
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| 54 | COMPLETED DURATION OF THERAPY...: No (0-1 cycle)
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| 55 | ADJUVANT CHEMO W BEAM RADIATION.: Unknown if therapy concomitant
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| 56 | DURATION OF ADJUVANT THERAPY....: Unknown if therapy given
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| 57 | COMPLETED DURATION OF THERAPY...: Unknown if therapy given
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| 58 | 788 ADJUVANT CHEMO W BEAM RADIATION.
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| 59 | 794 DURATION OF ADJUVANT THERAPY....
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| 60 | 795 COMPLETED DURATION OF THERAPY...
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| 61 | WERE OTHER REFERRALS MADE
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| 62 | TABLE V - QUALITY OF LIFE
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| 63 | WERE OTHER REFERRALS MADE:
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| 64 | 796 NUTRITIONAL CONSULTATION
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| 65 | 797 OCCUPATIONAL THERAPY....
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| 66 | 563 PHYSICAL THERAPY........
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| 67 | 798 OSTOMY CONSULTATION.....
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| 68 | 70DATE OF FIRST RECURRENCE......
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| 69 | 71TYPE OF FIRST RECURRENCE......
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| 70 | DATE OF LAST CONTACT OR DEATH:
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| 71 | 15VITAL STATUS.................
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| 72 | CANCER STATUS................:
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| 73 | 81COMPLETED BY.................
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| 74 | 82REVIEWED BY CANCER COMMITTEE.
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| 75 | 10. FAMILY HISTORY OF COLORECTAL CA..:
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| 76 | 11. PERSONAL HISTORY OF COLORECTAL CA:
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| 77 | 12. MULTI 1997 COLON/RECTUM PRIMARIES:
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| 78 | 13. PERSONAL HISTORY OF NON-COLORECTAL CANCER:
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| 79 | PROSTATE.........:
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| 80 | STOMACH..........:
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| 81 | THYROID..........:
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| 82 | UTERUS...........:
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| 83 | OVARIAN CARCINOMA:
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| 84 | OTHER............:
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| 85 | 14. PREVIOUS TAH/BSO.................:
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| 86 | 15. OTHER PRIOR CONDITIONS:
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| 87 | PRIOR POLYPS.....:
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| 88 | POLYPS...........:
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| 89 | 17. DURATION OF SIGNS/SYMPTOMS PRESENT AT INITIAL DIAGNOSIS (months):
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| 90 | BOWEL OBSTRUCTION..............:
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| 91 | CHANGE IN BOWEL HABIT..........:
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| 92 | EMER PRESENTATION-OBSTRUCTION..:
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| 93 | OCCULT BLOOD ONLY IN STOOL.....:
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| 94 | RECTAL BLEEDING (MELENA).......:
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| 95 | 18. INITIAL METHODS OF DIAGNOSIS:
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| 96 | SCREENING DIGITAL RECTAL EXAM..:
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| 97 | SCREENING PHYSICAL EXAM........:
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| 98 | 19. REASON LEADING TO EVENTUAL DX....:
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| 99 | 20. DIAGNOSTIC EVALUATION:
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| 100 | BARIUM ENEMA, DOUBLE CONTRAST..:
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| 101 | BARIUM ENEMA, SINGLE CONTRAST..:
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| 102 | BARIUM ENEMA, NOS..............:
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| 103 | BIOPSY OF PRIMARY SITE.........:
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| 104 | BIOPSY OF METASTATIC SITE......:
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| 105 | CT SCAN OF CHEST...............:
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| 106 | CT SCAN OF LIVER...............:
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| 107 | CT SCAN OF PRIMARY SITE........:
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| 108 | CHEST ROENTGENOGRAM............:
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| 109 | DIGITAL RECTAL EXAM............:
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| 110 | FLEXIBLE SIGMOIDOSCOPY.........:
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| 111 | INTRAVENOUS PYELOGRAM..........:
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| 112 | SERUM-LIVER FUNCTION TEST......:
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| 113 | STOOL GUAIAC (OCCULT BLOOD)....:
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| 114 | 21. LEVEL OF TUMOR BY ENDOSCOPIC EXAM:
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| 115 | 22. LEVEL OF RECTAL TUMOR............:
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| 116 | 23. DATE OF INITIAL DIAGNOSIS........:
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| 117 | 24. PRIMARY SITE.....................:
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| 118 | 25. HISTOLOGY/26. BEHAVIOR CODE......:
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| 119 | 28. DIAGNOSTIC CONFIRMATION..........:
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| 120 | Print Colorectal Cancer PCE
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| 121 | PCE Study of Colorectal Cancer
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| 122 | 29. SIZE OF TUMOR (mm)...............:
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| 123 | 30. REGIONAL NODES EXAMINED..........:
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| 124 | 31. REGIONAL NODES POSITIVE..........:
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| 125 | 32. AJCC CLINICAL STAGE (cTNM):
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| 126 | AJCC STAGE.....................:
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| 127 | 33. AJCC PATHOLOGIC STAGE (pTNM):
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| 128 | 34. STAGED BY:
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| 129 | CLINICAL STAGE.................:
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| 130 | PATHOLOGIC STAGE...............:
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| 131 | 35. MARGIN OF RESECTION:
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| 132 | PROXIMAL MARGIN................:
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| 133 | DISTAL MARGIN..................:
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| 134 | RADIAL MARGIN..................:
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| 135 | 36. DISTANCE TO MUCOSAL MARGIN.......:
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| 136 | 37. DISTANCE TO RADIAL MARGIN........:
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| 137 | 38. BLOOD VESSEL/LYMPHATIC INVASION..:
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| 138 | 39. EXTRAMURAL VENOUS INVASION.......:
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| 139 | 40. PROMINENT LYMPHOID INFILTRATE....:
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| 140 | 41. PHYSICIAN PROVIDING TREATMENT....:
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| 141 | 42. FIRST COURSE OF TREATMENT DATE...:
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| 142 | 43. DATE OF INPATIENT ADMISSION......:
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| 143 | 44. DATE OF INPATIENT DISCHARGE......:
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| 144 | 45. NON CANCER-DIRECTED SURGERY DATE.:
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| 145 | 46. NON CANCER-DIRECTED SURGERY......:
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| 146 | 47. SURGERY OF PRIMARY SITE DATE.....:
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| 147 | 48. SURGERY OF PRIMARY SITE..........:
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| 148 | 49. ADDITIONAL SURGICAL PROCEDURES...:
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| 149 | 50. LAPAROSCOPY USED DURING SURGERY..:
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| 150 | 51. METHOD OF ANASTOMOSIS............:
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| 151 | 52. DIST OF ANASTOMOSIS FROM DENTATE.:
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| 152 | 53. RESIDUAL PRIMARY TUMOR...........:
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| 153 | 54. OTHER SURGERY:
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| 154 | PATHOLOGICAL STATUS............:
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| 155 | 55. COMPLICATIONS AFTER FIRST COURSE OF TREATMENT:
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| 156 | ABDOMINAL INFECTION......:
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| 157 | PERINEAL INFECTION.......:
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| 158 | PNEUMONIA................:
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| 159 | ADMISSION FOR NEUTROPENIA:
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| 160 | PROCTITIS................:
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| 161 | ANASTOMOTIC DEHISCENCE...:
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| 162 | PULMONARY EMBOLISM.......:
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| 163 | RADIATION ENTERITIS......:
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| 164 | STOMA COMPLICATION.......:
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| 165 | URINARY TRACT INFECTION..:
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| 166 | EARLY BOWEL OBSTRUCTION..:
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| 167 | 56. POSTOPERATIVE DEATH W/I 30 DAYS:
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| 168 | 57. DATE RADIATION STARTED...........:
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| 169 | 58. DATE RADIATION THERAPY ENDED.....:
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| 170 | 59. ENDOCAVITARY RADIATION...........:
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| 171 | 60. INTRA-OPERATIVE RAD THERAPY......:
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| 172 | 61. PRIMARY TUMOR RAD DOSE W BOOST...:
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| 173 | 62. NUMBER OF RADIATION TREATMENTS...:
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| 174 | 64. DATE CHEMOTHERAPY STARTED........:
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| 175 | 65. ADJUVANT CHEMO W BEAM RADIATION..:
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| 176 | 66. ADJUVANT THERAPY:
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| 177 | CPT 11.............:
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| 178 | TAXOL..............:
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| 179 | OTHER..............:
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| 180 | 67. DURATION OF ADJUVANT THERAPY.....:
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| 181 | 68. COMPLETED DURATION OF THERAPY....:
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| 182 | 69. WERE OTHER REFERRALS MADE:
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| 183 | NUTRITIONAL CONSULTATION.......:
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| 184 | OCCUPATIONAL THERAPY...........:
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| 185 | PHYSICAL THERAPY...............:
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| 186 | OSTOMY CONSULTATION............:
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| 187 | 70. DATE OF FIRST RECURRENCE..........:
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| 188 | 71. TYPE OF FIRST RECURRENCE..........:
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| 189 | 72. DATE OF LAST CONTACT OR DEATH....:
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| 190 | 73. VITAL STATUS.....................:
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| 191 | 74. CANCER STATUS....................:
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| 192 | 75. COMPLETED BY.....................:
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| 193 | 76. REVIEWED BY CANCER COMMITTEE.....:
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| 194 | Deleting data from the following fields...
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| 195 | SURGICAL DX/STAGING PROC
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| 196 | SURGICAL DX/STAGING PROC DATE
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| 197 | SURGERY OF PRIMARY (R)
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| 198 | SURGICAL APPROACH (R)
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| 199 | SURGERY OF PRIMARY (F)
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| 200 | SURGERY OF PRIMARY DATE
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| 201 | SURGICAL MARGINS
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| 202 | DATE OF SURGICAL DISCHARGE
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| 203 | REASON FOR NO SURGERY
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| 204 | SURGERY OF PRIMARY SITE
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| 205 | SURGERY OF PRIMARY SITE DATE
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| 206 | SCOPE OF LN SURGERY (R)
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| 207 | NUMBER OF LN REMOVED (R)
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| 208 | SCOPE OF LN SURGERY (F)
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| 209 | SCOPE OF LYMPH NODE SURG DATE
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| 210 | SURG PROC/OTHER SITE (R)
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| 211 | SURG PROC/OTHER SITE (F)
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| 212 | SURG PROC/OTHER SITE DATE
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| 213 | DATE RADIATION STARTED
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| 214 | LOCATION OF RADIATION TX
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| 215 | RADIATION TREATMENT VOLUME
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| 216 | REGIONAL TREATMENT MODALITY
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| 217 | REGIONAL DOSE:cGy
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| 218 | BOOST TREATMENT MODALITY
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| 219 | BOOST DOSE:cGy
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| 220 | NUMBER OF TXS TO THIS VOLUME
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| 221 | RADIATION/SURGERY SEQUENCE
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| 222 | DATE RADIATION ENDED
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| 223 | REASON FOR NO RADIATION
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| 224 | TEXT-RX-RADIATION OTHER
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| 225 | CHEMOTHERAPY DATE
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| 226 | REASON FOR NO CHEMOTHERAPY
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| 227 | HORMONE THERAPY
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| 228 | HORMONE THERAPY DATE
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| 229 | REASON FOR NO HORMONE THERAPY
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| 230 | IMMUNOTHERAPY DATE
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| 231 | HEMA TRANS/ENDOCRINE PROC
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| 232 | HEMA TRANS/ENDOCRINE PROC DATE
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| 233 | OTHER TREATMENT
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| 234 | OTHER TREATMENT DATE
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| 235 | PALLIATIVE PROCEDURE @FAC
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| 236 | SURGICAL DX/STAGING @FAC
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| 237 | SURGICAL DX/STAGING @FAC DATE
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| 238 | SURGERY OF PRIMARY @FAC (R)
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| 239 | SURGERY OF PRIMARY @FAC (F)
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| 240 | SURGERY OF PRIMARY @FAC DATE
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| 241 | SCOPE OF LN SURGERY @FAC (R)
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| 242 | NUMBER OF LN REMOVED @FAC (R)
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| 243 | SCOPE OF LN SURGERY @FAC (F)
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| 244 | SCOPE OF LN SURGERY @FAC DATE
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| 245 | SURG PROC/OTHER SITE @FAC (R)
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| 246 | SURG PROC/OTHER SITE @FAC (F)
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| 247 | SURG PROC/OTHER SITE @FAC DATE
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| 248 | RADIATION @FAC DATE
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| 249 | CHEMOTHERAPY @FAC DATE
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| 250 | HORMONE THERAPY @FAC
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| 251 | HORMONE THERAPY @FAC DATE
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| 252 | IMMUNOTHERAPY @FAC DATE
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| 253 | OTHER TREATMENT @FAC
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| 254 | OTHER TREATMENT @FAC DATE
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| 255 | STATE AT DX = YY (
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| 256 | POSTAL CODE AT DX must be 888888888
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| 257 | STATE AT DX = ZZ (
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| 258 | POSTAL CODE AT DX must be 999999999
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| 259 | REPORTING HOSPITAL = FACILITY REFERRED FROM
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| 260 | REPORTING HOSPITAL = FACILITY REFERRED TO
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| 261 | CLASS OF CASE =
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| 262 | FACILITY REFERRED FROM may not be blank
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| 263 | DATE OF FIRST CONTACT..:
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| 264 | later than
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| 265 | SURGERY OF PRIMARY SITE DATE.:
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| 266 | RADIATION DATE...............:
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| 267 | RADIATION THERAPY TO CNS DATE:
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| 268 | CHEMOTHERAPY DATE............:
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| 269 | HORMONE THERAPY DATE.........:
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| 270 | IMMUNOTHERAPY DATE...........:
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| 271 | OTHER TREATMENT DATE.........:
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| 272 | earlier than
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| 273 | DATE DX......................:
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| 274 | TYPE OF REPORTING SOURCE = 6 (
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| 275 | CLASS OF CASE must be 5 (Dx at autopsy)
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| 276 | CLASS OF CASE = 5 (
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| 277 | TYPE OF REPORTING SOURCE must be 6 (Autopsy only)
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| 278 | TYPE OF REPORTING SOURCE = 7 (
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| 279 | DIAGNOSTIC CONFIRMATION must be 9 (Unk if microscopically confirmed)
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| 280 | DIAGNOSTIC CONFIRMATION must be 1 (Pos histology) or
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| 281 | 6 (Direct visualization)
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| 282 | is a paired site
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| 283 | LATERALITY must be provided for specified paired organs/sites
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| 284 | NOTE: If NASAL CARTILAGE or NASAL SEPTUM, override this warning.
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| 285 | NOTE: If CARINA, override this warning.
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| 286 | NOTE: If STERNUM, override this warning.
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| 287 | NOTE: If SACRUM, COCCYX or SYMPHYSIS PUBIS, override this warning.
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| 288 | is an unpaired site
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| 289 | LATERALITY must be 0 (Not a paired site)
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| 290 | BEHAVIOR CODE = 2 (In situ)
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| 291 | SUMMARY STAGE =
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| 292 | BEHAVIOR CODE and SUMMARY STAGE confict
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| 293 | BEHAVIOR CODE = 3 (Malignant)
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| 294 | SUMMARY STAGE = 0 (In situ)
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| 295 | HISTOLOGY =
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| 296 | TYPE OF REPORTING SOURCE =
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| 297 | SUMMARY STAGE must be 7 (Distant Mets/systemic disease)
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| 298 | GRADE/DIFFERENTIATION must be 1 (Grade I)
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| 299 | GRADE/DIFFERENTIATION must be 2 (Grade II)
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| 300 | GRADE/DIFFERENTIATION must be 4 (Grade IV)
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| 301 | GRADE/DIFFERENTIATION must be: 3 (Grade III)
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| 302 | 7 (Null cell)
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| 303 | #################### #################### ####################
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| 304 | #################### #################### ####################
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| 305 | #################### #################### ####################
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| 306 | #################### #################### ####################
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| 307 | #################### #################### ####################
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