| 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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