1 | English French Notes Complete/Exclude
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2 | DATE OF LAST CONTACT:
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3 | TUMOR STATUS:
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4 | ICD Revision:
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5 | Place of Death:
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6 | Care Center at Death:
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7 | Autopsy:
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8 | Autopsy Date/Time:
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9 | Autopsy No:
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10 | ICD Cause of Death:
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11 | Cause of Death/Cancer:
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12 | Date of Death:
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13 | Path/autopsy:
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14 | Religion:
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15 | Marital Status at Dx:
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16 | Occupation:
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17 | Last Date:
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18 | Type of Tobacco user:
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19 | YR. Quit Tobacco Use:
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20 | Yrs. of Alcohol Use:
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21 | Drinks per-day:
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22 | Yr. Quit Drinking:
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23 | Family Member with Cancer:
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24 | Cancer:
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25 | Primary Surgeon:
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26 | Managing Physician:
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27 | Following Physician:
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28 | Other Physician 3:
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29 | Other Physician 4:
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30 | DX Date:
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31 | Class of Case:
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32 | Type of Reporting Source:
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33 | Histology:
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34 | Dx Facility:
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35 | Text Histology:
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36 | Grade:
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37 | Tumor Marker 2:
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38 | ICDO-Site:
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39 | Referring Facility:
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40 | Laterality:
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41 | Transfer Facility:
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42 | DX Confirmation:
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43 | Primary Payer at Diagnosis:
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44 | IP/OP status:
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45 | Screening Result:
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46 | Screening Date:
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47 | Presentation at Cancer Conference:
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48 | Date of Cancer Conference:
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49 | Referral to Support Services:
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50 | Site/Gp:
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51 | Primary Sequence No:
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52 | Text-Primary Site Title:
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53 | Text-Dx Proc-PE:
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54 | Text-Dx Proc-X-ray/scan:
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55 | Text-Dx Proc-Op:
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56 | Text-Dx Proc-Lab Tests:
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57 | Text-Dx Proc-Scopes:
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58 | Text-Dx Proc-Path:
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59 | Text Primary Site:
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60 | Text Dx Proc-Phys.Exam:
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61 | Text Dx Proc-Xray/Scan:
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62 | Text Dx Proc-Operation:
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63 | Text Dx Proc-Lab Tests:
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64 | Text Dx Proc-Endoscopy:
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65 | Text Dx Proc-Path/Cyto:
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66 | Clinical TNM:
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67 | Clinical T:
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68 | Pathologic T:
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69 | Clinical N:
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70 | Pathologic N:
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71 | Clinical M:
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72 | Pathologic M:
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73 | Clinical Stage Group:
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74 | Staged By (Clin):
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75 | Other Stage:
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76 | Size of Tumor:
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77 | Positive nodes:
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78 | Peripheral Blood Inv.:
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79 | Nodes Examined:
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80 | Associated with HIV:
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81 | Extension:
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82 | Metastasis-1:
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83 | Lymph Nodes:
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84 | Metastasis-2:
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85 | General Summary Stage:
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86 | Metastasis-3:
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87 | Dx/Stging/Palliative Proc:
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88 | Surgery of Primary Site Date:
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89 | Surgical Approach:
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90 | Reconstruction/Restoration:
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91 | - Text Rx-Surgery/No Surgery:
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92 | - Text Rx-Other Cancer Directed Surgery:
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93 | Surgical Margins:
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94 | Reason for No Surgery:
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95 | Radiation Date:
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96 | Regional Dose:
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97 | Radiation tx not administered
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98 | NA, brachytherapy/radioisotopes administered
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99 | Dose unknown/unknown if administered
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100 | Regional Treatment Modality:
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101 | Reason for No Radiation:
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102 | Sequence:
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103 | Radiation Treatment - (either radiation or prophylactic)
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104 | Target Place:
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105 | Target Site:
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106 | Radiation Source:
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107 | Total due to target:
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108 | Predominant FXN size:
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109 | Start Date:
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110 | Stop Date:
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111 | - Text Rx-Rad (BEAM):
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112 | - Text Rx-Rad-Other:
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113 | Radiation Therapy to CNS DAte:
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114 | Chemotherapy Date:
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115 | Reason for No Chemotherapy:
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116 | Text-Rx-Chemo:
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117 | Hormone Therapy Date:
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118 | Reason for No Hormone Therapy:
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119 | Text-Rx-Hormone:
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120 | Immunotherapy Date:
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121 | Text-RX-Immunotherapy:
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122 | Other Therapy Date:
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123 | Text-Rx-Other:
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124 | Protocol Eligibility Status:
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125 | Protocol Participation:
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126 | Text Remarks:
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127 | Physician's Staging:
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128 | MD:
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129 | QA Selected:
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130 | QA Review:
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131 | QA Date:
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132 | Recurrence Date:
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133 | Distant Site 1:
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134 | Type of 1st Recurrence:
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135 | Distant Site 2:
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136 | Distant Site 3:
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137 | Subsequent Recurrence Date:
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138 | Type of Subsequent Recurrence:
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139 | ********** Print Abstract-Brief **********
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140 | Reporting Hospital:
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141 | Date of First Contact:
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142 | Histology:
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143 | Acc/Seq Number:
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144 | Medical Record Number:
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145 | Telephone:
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146 | Type of Reporting Source:
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147 | Class of Case:
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148 | Age at Dx:
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149 | Birthplace:
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150 | Facility referred from:
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151 | Facility referred to:
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152 | Date Dx:
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153 | Following physician:
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154 | Primary surgeon:
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155 | Physician #3:
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156 | Physician #4:
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157 | Laterality:
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158 | Diagnostic confirmation:
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159 | Tumor size:
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160 | Extension:
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161 | Regional lymph nodes positive:
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162 | Regional lymph nodes examined:
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163 | Lymph nodes:
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164 | SEER Summary Stage 2000:
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165 | Sites of metastases:
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166 | Clinical TNM:
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167 | AJCC Stage (Clin):
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168 | AJCC Stage (Path):
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169 | FIRST COURSE OF TREATMENT SUMMARY:
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170 | Dx/Staging/Palliative Proc:
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171 | Surgery of primary site:
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172 | Reason for no surgery:
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173 | Radiation:
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174 | Reason for no radiation:
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175 | Hormone Therapy:
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176 | Immunotherapy:
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177 | Other treatment:
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178 | Abstract Date:
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179 | Abstracter:
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180 | Date of Last Patient Contact:
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181 | AVAILABLE CONTACTS
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182 | ***********DEATH INFORMATION**********
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183 | Date:
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184 | Cause of Death/Cancer:
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185 | ICD Cause:
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186 | Care Center:
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187 | ICD Revision:
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188 | Path/Autopsy (Gross & Micro):
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189 | State Hospital No:
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190 | IDCO SITE:
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191 | GRADE:
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192 | Sequence Number:
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193 | DATE of LAST CONTACT:
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194 | VITAL STATUS:
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195 | ABSTRACTER:
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196 | ABSTRACT DATE:
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197 | Spanish origin:
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198 | CONTACT NAME
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199 | Follow-up Status:
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200 | DATE LAST
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201 | Site/Gp:
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202 | PATIENT SUMMARY
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203 | Date of Last Contact or Death:
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204 | Autopsy Date/Time:
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205 | Autopsy #:
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206 | Cause of Death:
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207 | Abstract Status:
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208 | Date Case Completed:
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209 | Primary Site:
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210 | Patient Summary/Abstract for:
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211 | ** PATIENT IDENTIFICATION **
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212 | Address at Dx:
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213 | Accession No:
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214 | Hospital No:
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215 | Accession Yr:
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216 | Primary Sequence No:
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217 | Phone Residence:
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218 | Marital Status DX:
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219 | Agent Orange Exp:
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220 | Ionizing Rad Exp:
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221 | Chemical Exp:
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222 | Asbestos Exp:
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223 | Persian Gulf Svc:
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224 | Middle East Svc:
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225 | Somalia Svc:
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226 | Comorbidity/Complication #1:
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227 | Comorbidity/Complication #2:
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228 | Comorbidity/Complication #3:
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229 | Comorbidity/Complication #4:
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230 | Comorbidity/Complication #5:
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231 | Comorbidity/Complication #6:
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232 | Primary Surgeon:
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233 | Following Physician:
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234 | ** CANCER IDENTIFICATION **
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235 | Date DX:
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236 | Histology:
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237 | AFIP Submission:
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238 | Primary Site:
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239 | ** STAGE OF DISEASE AT DIAGNOSIS **
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240 | Clinical TNM:
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241 | Pathologic TNM:
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242 | Clinical Stage Group:
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243 | Pathologic Stage Group:
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244 | Staged By (Clinical Stage):
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245 | Staged By (Pathologic Stage):
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246 | Other Stage:
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247 | Pathologic Extension:
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248 | Lymph Nodes:
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249 | General Summary Stage:
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250 | Metastasis-1:
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251 | Metastasis-2:
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252 | Metastasis-3:
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253 | ** FIRST COURSE OF TREATMENT **
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254 | First Course of Treatment Date:
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255 | Date of No Treatment:
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256 | Surgery of Primary (F):
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257 | Surgery of Primary @Fac (F):
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258 | Surgical Margins:
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259 | Scope of LN Surgery (F):
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260 | Scope of LN Surgery @Fac (F):
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261 | Surg Proc/Other Site (F):
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262 | Surg Proc/Other Site @Fac (F):
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263 | Reason for No Surgery:
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264 | Regional Dose:
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265 | Regional Treatment Modality:
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266 | Chemotherapy:
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267 | Chemotherapy @Fac:
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268 | Hormone Therapy:
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269 | Hormone Therapy @Fac:
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270 | Immunotherapy:
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271 | Immunotherapy @Fac:
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272 | Other Treatment:
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273 | Other Treatment @Fac:
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274 | Year Put on Protocol:
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275 | ** SUBSEQUENT THERAPY **
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276 | Subsequent Treatment Date:
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277 | Surgery of Primary Site:
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278 | Hema Trans/Endocrine Proc:
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279 | ** FOLLOW-UP HISTORY **
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280 | Cause of Death:
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281 | 1998 Patient Care Evaluation Study of Prostate Cancer
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282 | 1998 Patient Care Evaluation Study of Prostate Cancer
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283 | 8. PRIMARY PAYER AT DIAGNOSIS
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284 | 9. FAMILY HISTORY OF PROSTATE CANCER
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285 | 8. PRIMARY PAYER AT DIAGNOSIS
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286 | 9. FAMILY HISTORY OF PROSTATE CANCER
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287 | TABLE I - GENERAL INFORMATION
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288 | 9 4. POSTAL CODE AT DIAGNOSIS.........
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289 | 9 7. SPANISH ORIGIN...................
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290 | 18 8. PRIMARY PAYER AT DIAGNOSIS.......
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291 | 657 9. FAMILY HISTORY OF PROSTATE CANCER
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292 | 10. CLASS OF CASE
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293 | 11. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS
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294 | 12. INITIAL METHODS OF DIAGNOSIS
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295 | 13. DIAGNOSTIC EVALUATION
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296 | 14. RESULTS OF MOST RECENT PRE-TREATMENT PSA TEST
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297 | 18. BEHAVIOR CODE(ICD-O-2)
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298 | 20. BIOPSY PROCEDURE
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299 | 21. GUIDANCE OF BIOPSY TO PRIMARY
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300 | 22. BIOPSY APPROACH FOR PRIMARY
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301 | 23. BIOPSY OF OTHER THAN PRIMARY
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302 | 24. DIAGNOSTIC CONFIRMATION
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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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