| 1 | English French Notes Complete/Exclude
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| 2 | 25. GLEASON'S SCORE FOR BIOPSY, LOCAL RESECTION, OR SIMPLE PROSTATECTOMY
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| 3 | 26. GLEASON'S SCORE FOR RADICAL PROSTATECTOMY
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| 4 | 18. BEHAVIOR CODE (ICD-O-2)
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| 5 | 10. CLASS OF CASE................:
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| 6 | 11. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS:
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| 7 | 659 LOWER BACK PAIN..............
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| 8 | 660 TROUBLE URINATING............
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| 9 | 12. INITIAL METHOD OF DIAGNOSIS:
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| 10 | 661 CLINICAL DX WITH BONE LESION.
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| 11 | 662 CLINICAL DX BY RECTAL EXAM...
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| 12 | 664 DIGITAL TRANSRECTAL BIOPSY...
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| 13 | 665 INCIDENTAL FINDING IN TURP FOR BENIGN DISEASE...........
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| 14 | 666 NEEDLE BIOPSY, NOS...........
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| 15 | 667 PERINEAL BIOPSY..............
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| 16 | 669 TRUS GUIDED BIOPSY...........
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| 17 | 13. DIAGNOSTIC EVALUATION:
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| 18 | 671 BONE MARROW ASPIRATION.......
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| 19 | 672 BONE SCAN....................
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| 20 | 675 CT SCAN OF ABDOMEN...........
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| 21 | 676 CT SCAN OF PELVIS............
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| 22 | 679 PELVIC LYMPH NODE DISSECTION.
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| 23 | 683 ULTRASOUND OF ABDOMEN........
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| 24 | 684 14. RESULTS OF MOST RECENT PRE- TREATMENT PSA TEST...........
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| 25 | 16. PRIMARY SITE (ICD-O-2).......: C61.9
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| 26 | 18. BEHAVIOR CODE (ICD-O-2)......:
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| 27 | 141 20. BIOSPY PROCEDURE.............
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| 28 | 21. GUIDANCE OF BIOPSY TO PRIMARY: Not guided, no biopsy
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| 29 | 22. BIOPSY APPROACH FOR PRIMARY..: No biopsy
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| 30 | 21. GUIDANCE OF BIOPSY TO PRIMARY: Unknown/death cert only
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| 31 | 22. BIOPSY APPROACH FOR PRIMARY..: Unknown/death cert only
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| 32 | 142 21. GUIDANCE OF BIOSPY TO PRIMARY
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| 33 | 145 22. BIOSPY APPROACH FOR PRIMARY..
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| 34 | 146 23. BIOSPY OF OTHER THAN PRIMARY.
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| 35 | 26 24. DIAGNOSTIC CONFIRMATION......
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| 36 | 25. GLEASON'S SCORE FOR BIOPSY, LOCAL RESECTION, OR SIMPLE PROSTATECTOMY:
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| 37 | Surgery codes not 02 through 40
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| 38 | GLEASON SCORE................: 99 Unknown, not reported, or NA
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| 39 | GLEASON SCORE................:
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| 40 | 623 GLEASON SCORE................
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| 41 | 26. GLEASON'S SCORE FOR RADICAL PROSTATECTOMY:
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| 42 | Surgery codes not 50 through 70
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| 43 | 623.3 GLEASON SCORE................
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| 44 | 27. SIZE OF TUMOR (mm)
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| 45 | 28. REGIONAL NODES EXAMINED
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| 46 | 29. REGIONAL NODES POSITIVE
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| 47 | 30. AJCC CLINICAL STAGE (cTNM)
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| 48 | 31. AJCC PATHOLOGIC STAGE (pTNM)
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| 49 | 32. STAGED BY
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| 50 | TABLE III - EXTENT AND STAGE OF DISEASE
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| 51 | 29 27. SIZE OF TUMOR (mm).....
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| 52 | 33 28. REGIONAL NODES EXAMINED
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| 53 | 32 29. REGIONAL NODES POSITIVE
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| 54 | 30. AJCC CLINICAL STAGE (cTNM):
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| 55 | 31. AJCC PATHOLOGIC STAGE (pTNM):
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| 56 | 32. STAGED BY:
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| 57 | 19 CLINICAL STAGE.........
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| 58 | 89 PATHOLOGIC STAGE.......
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| 59 | 33. DATE OF FIRST COURSE TREATMENT.:
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| 60 | 685 34. EXPECTED MGT/WATCHFUL WAITING..
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| 61 | 35. DATE OF NON CA-DIRECTED SURGERY:
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| 62 | 36. NON CANCER-DIRECTED SURGERY....:
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| 63 | 37. DATE OF CANCER-DIRECTED SURGERY:
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| 64 | 38. LENGTH OF STAY AFTER SURGERY...: 88 NA
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| 65 | 38. LENGTH OF STAY AFTER SURGERY...: 99 Unknown
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| 66 | 686 38. LENGTH OF STAY AFTER SURGERY...
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| 67 | 39. SURGICAL APPROACH..............:
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| 68 | 40. TYPE OF CANCER-DIRECTED SURGERY:
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| 69 | 41. SURGICAL MARGINS...............:
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| 70 | 42. SCOPE OF LYMPH NODE SURGERY....:
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| 71 | 43. TYPE OF LYMPH NODE SURGERY:
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| 72 | 44. SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S),
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| 73 | OR DISTANT LYMPH NODE(S).......:
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| 74 | 45. NUMBER OF LYMPH NODES REMOVED..:
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| 75 | 47. COMPLICATIONS FOLLOWING SURGICAL FIRST COURSE OF TREATMENT:
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| 76 | PERMANENT RECTAL INJURY........: NA, no surgery
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| 77 | THROMBOEMBOLISM................: NA, no surgery
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| 78 | URETHRAL STRICTURE.............: NA, no surgery
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| 79 | 48. POSTOPERATIVE DEATH W/I 30 DAYS: NA, no surgery
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| 80 | PERMANENT RECTAL INJURY........: Unknown
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| 81 | URETHRAL STRICTURE.............: Unknown
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| 82 | 48. POSTOPERATIVE DEATH W/I 30 DAYS: Unknown
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| 83 | 689 PERMANENT RECTAL INJURY........
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| 84 | 691 URETHRAL STRICTURE.............
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| 85 | 441 48. POSTOPERATIVE DEATH W/I 3O DAYS
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| 86 | 49. DATE RADIATION STARTED.........:
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| 87 | 50. RADIATION THERAPY..............:
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| 88 | 51. RADIATION FACILITY.............:
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| 89 | 52. INTERSTITIAL RADIATION/BRACHYTHERAPY ADMINISTERED:
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| 90 | OTHER INTERSTITIAL, NOS........:
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| 91 | 53. ROUTE OF INTERSTITIAL RADIATION/
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| 92 | BRACHYTHERAPY ADMINISTERED.....:
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| 93 | 54. EXTERNAL RADIATION ADMINISTERED:
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| 94 | DISTANT METASTATIC SITES.......:
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| 95 | PROSTATE & PELVIC NODES........:
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| 96 | PROSTATE & PARA-AORTIC NODES...:
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| 97 | PROSTATE REGION ONLY...........:
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| 98 | OTHER EXTERNAL SITES, NOS......:
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| 99 | 55. TYPE OF EXTERNAL RADIATION
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| 100 | 56. TOTAL EXTERNAL RAD DOSE (cGy) INCLUDING BOOST:
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| 101 | PELVIC NODES...................:
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| 102 | PARA-AORTIC NODES..............:
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| 103 | 57. COMPLICATIONS FOLLOWING RADIATION FIRST COURSE OF TREATMENT:
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| 104 | ACUTE GASTROINTESTINAL.........:
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| 105 | ACUTE GASTROURINARY............:
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| 106 | CHRONIC REQUIRING SURGERY OR
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| 107 | PROLONGED HOSPITALIZATION......:
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| 108 | URETHRAL OR BLADDER............:
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| 109 | 692 51. RADIATION FACILITY.............
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| 110 | 631 OTHER INTERSTITIAL, NOS........
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| 111 | 693 53. ROUTE OF INTERSTITIAL RADIATION/ BRACHYTHERAPY ADMINISTERED.....
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| 112 | 636 DISTANT METASTATIC SITES.......
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| 113 | 634 PROSTATE & PELVIC NODES........
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| 114 | 635 PROSTATE & PARA-AORTIC NODES...
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| 115 | 633 PROSTATE REGION ONLY...........
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| 116 | 637 OTHER EXTERNAL SITES, NOS......
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| 117 | 694 55. TYPE OF EXTERNAL RADIATION ADMINISTRATION.................
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| 118 | 639 PELVIC NODES...................
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| 119 | 640 PARA-AORTIC NODES..............
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| 120 | 695 ACUTE GASTROINTESTINAL.........
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| 121 | 696 ACUTE GASTROURINARY............
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| 122 | 698 CHRONIC REQUIRING SURGERY OR PROLONGED HOSPITALIZATION......
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| 123 | 699 URETHRAL OR BLADDER............
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| 124 | 58. DATE OF ORCHIECTOMY............: 00/00/0000
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| 125 | 699.1 58. DATE OF ORCHIECTOMY............
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| 126 | 59. DATE EXOGENOUS HT BEGAN........:
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| 127 | 60. HORMONE THERAPY................:
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| 128 | 61. EXOGENOUS HORMONE AGENTS ADMINISTERED:
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| 129 | LUTEINIZING HORMONES...........:
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| 130 | PROGESTATIONAL AGENTS..........:
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| 131 | 646 LUTEINIZING HORMONES...........
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| 132 | 645 PROGESTATIONAL AGENTS..........
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| 133 | 62. DATE CHEMOTHERAPY STARTED......:
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| 134 | 64. DATE OF FIRST RECURRENCE
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| 135 | 65. TYPE OF FIRST RECURRENCE
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| 136 | 64. TYPE OF FIRST RECURRENCE
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| 137 | 65. DATE OF FIRST RECURRENCE
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| 138 | 70 64. DATE OF FIRST RECURRENCE
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| 139 | 71 65. TYPE OF FIRST RECURRENCE
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| 140 | 66. DATE OF LAST CONTACT OR DEATH
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| 141 | 67. VITAL STATUS
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| 142 | 68. CANCER STATUS
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| 143 | 69. COMPLETED BY
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| 144 | 70. CLINICAL REVIEW BY CA COMMITTEE
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| 145 | 66. DATE OF LAST CONTACT OR DEATH..:
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| 146 | 15 67. VITAL STATUS...................
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| 147 | 68. CANCER STATUS..................:
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| 148 | 81 69. COMPLETED BY...................
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| 149 | 82 70. CLINICAL REVIEW BY CA COMMITTEE
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| 150 | 8. PRIMARY PAYER AT DIAGNOSIS.......:
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| 151 | 9. FAMILY HISTORY OF PROSTATE CANCER:
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| 152 | 10. CLASS OF CASE....................:
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| 153 | 11. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS:
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| 154 | LOWER BACK PAIN.................:
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| 155 | TROUBLE URINATING...............:
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| 156 | 12. INITIAL METHODS OF DIAGNOSIS:
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| 157 | CLINICAL DX W BONE LESION.......:
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| 158 | CLINICAL DX BY RECTAL EXAM......:
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| 159 | DIGITAL TRANSRECTAL BIOPSY......:
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| 160 | INCIDENTAL FINDING IN TURP FOR BENIGN DISEASE..................:
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| 161 | NEEDLE BIOPSY, NOS..............:
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| 162 | PERINEAL BIOPSY.................:
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| 163 | TRUS GUIDED BIOPSY..............:
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| 164 | 13. DIAGNOSTIC EVALUATION:
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| 165 | BONE MARROW ASPIRATION..........:
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| 166 | BONE SCAN.......................:
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| 167 | CT SCAN OF ABDOMEN..............:
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| 168 | CT SCAN OF PELVIS...............:
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| 169 | PELVIC LYMPH NODE DISSECTION....:
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| 170 | ULTRASOUND OF ABDOMEN...........:
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| 171 | 14. RESULTS OF MOST RECENT PRE-
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| 172 | TREATMENT PSA TEST...............:
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| 173 | 15. DATE OF INITIAL DIAGNOSIS........:
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| 174 | 16. PRIMARY SITE (ICD-O-2)...........:
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| 175 | 18. BEHAVIOR CODE (ICD-O-2)..........:
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| 176 | 20. BIOPSY PROCEDURE.................:
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| 177 | 21. GUIDANCE OF BIOPSY TO PRIMARY....:
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| 178 | 22. BIOPSY APPROACH FOR PRIMARY......:
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| 179 | 23. BIOPSY OF OTHER THAN PRIMARY.....:
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| 180 | 24. DIAGNOSTIC CONFIRMATION..........:
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| 181 | GLEASON SCORE...................:
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| 182 | 27. SIZE OF TUMOR (mm)...............:
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| 183 | 28. REGIONAL NODES EXAMINED..........:
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| 184 | 29. REGIONAL NODES POSITIVE..........:
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| 185 | 30. AJCC CLINICAL STAGE (cTNM):
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| 186 | 31. AJCC PATHOLOGIC STAGE (pTNM):
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| 187 | 32. STAGED BY:
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| 188 | 33. DATE OF FIRST COURSE TREATMENT...:
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| 189 | 34. EXPECTED MGT/WATCHFUL WAITING....:
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| 190 | 35. DATE OF NON CA-DIRECTED SURGERY..:
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| 191 | 36. NON CANCER-DIRECTED SURGERY......:
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| 192 | 37. DATE OF CANCER-DIRECTED SURGERY..:
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| 193 | 38. LENGTH OF STAY AFTER SURGERY.....:
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| 194 | 39. SURGICAL APPROACH................:
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| 195 | 40. TYPE OF CANCER-DIRECTED SURGERY..:
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| 196 | 41. SURGICAL MARGINS.................:
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| 197 | 42. SCOPE OF LYMPH NODE SURGERY......:
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| 198 | 43. TYPE OF LYMPH NODE SURGERY:
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| 199 | 44. SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S),
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| 200 | 45. NUMBER OF LYMPH NODES REMOVED....:
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| 201 | 47. COMPLICATIONS FOLLOWING SURGICAL FIRST COURSE OF TREATMENT:
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| 202 | PERMANENT RECTAL INJURY.........:
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| 203 | URETHRAL STRICTURE..............:
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| 204 | 48. POSTOPERATIVE DEATH W/I 30 DAYS..:
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| 205 | 49. DATE RADIATION STARTED...........:
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| 206 | 50. RADIATION THERAPY................:
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| 207 | 51. RADIATION FACILITY...............:
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| 208 | 52. INTERSTITIAL RADIATION/BRACHYTHERAPY ADMINISTERED:
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| 209 | OTHER INTERSTITIAL, NOS.........:
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| 210 | 53. ROUTE OF INTERSTITIAL RADIATION/
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| 211 | BRACHYTHERAPY ADMINISTERED.......:
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| 212 | 54. EXTERNAL RADIATION ADMINISTERED:
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| 213 | DISTANT METASTATIC SITES........:
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| 214 | PROSTATE & PELVIC NODES.........:
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| 215 | PROSTATE & PARA-AORTIC NODES....:
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| 216 | PROSTATE REGION ONLY............:
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| 217 | OTHER EXTERNAL SITES, NOS.......:
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| 218 | 55. TYPE OF EXTERNAL RADIATION
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| 219 | 56. TOTAL EXTERNAL RAD DOSE (cGy) INCLUDING BOOST:
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| 220 | PELVIC NODES....................:
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| 221 | PARA-AORTIC NODES...............:
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| 222 | 57. COMPLICATIONS FOLLOWING RADIATION FIRST COURSE OF TREATMENT:
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| 223 | ACUTE GASTROINTESTINAL..........:
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| 224 | ACUTE GASTROURINARY.............:
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| 225 | PROLONGED HOSPITALIZATION.......:
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| 226 | URETHRAL OR BLADDER.............:
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| 227 | 58. DATE OF ORCHIECTOMY.............:
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| 228 | 59. DATE EXOGENOUS HT BEGAN.........:
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| 229 | 60. HORMONE THERAPY.................:
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| 230 | 61. EXOGENOUS HORMONE AGENTS ADMINISTERED:
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| 231 | LUTEINIZING HORMONES............:
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| 232 | PROGESTATIONAL AGENTS...........:
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| 233 | 62. DATE CHEMOTHERAPY STARTED........:
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| 234 | 64. DATE OF FIRST RECURRENCE.........:
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| 235 | 65. TYPE OF FIRST RECURRENCE.........:
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| 236 | 66. DATE OF LAST CONTACT OR DEATH....:
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| 237 | 67. VITAL STATUS.....................:
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| 238 | 68. CANCER STATUS....................:
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| 239 | 69. COMPLETED BY.....................:
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| 240 | 70. REVIEWED BY CANCER COMMITTEE.....:
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| 241 | ROADS TO FORDS
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| 242 | 7 PLACE OF BIRTH.............
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| 243 | 9 SPANISH ORIGIN.............//^S X=
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| 244 | Non-Spanish, non-Hispanic
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| 245 | 48 AGENT ORANGE EXPOSURE......//^S X=AOE
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| 246 | 50 IONIZING RADIATION EXPOSURE//^S X=IRE
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| 247 | 52 CHEMICAL EXPOSURE..........
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| 248 | 61 ASBESTOS EXPOSURE..........
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| 249 | 51 PERSIAN GULF SERVICE.......//^S X=PGS
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| 250 | 55 MIDDLE EAST SERVICE........//^S X=MES
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| 251 | 56 SOMALIA SERVICE............//^S X=SS
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| 252 | Reporting Hospital..........:
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| 253 | Marital status at Dx........:
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| 254 | Patient address at Dx.......:
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| 255 | Patient address at Dx - Supp:
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| 256 | City/town at Dx.............:
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| 257 | State at Dx.................:
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| 258 | Postal code at Dx...........:
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| 259 | County at Dx................:
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| 260 | Census Tract................:
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| 261 | Following physician.........:
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| 262 | Primary surgeon.............:
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| 263 | Primary payer at Dx.........:
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| 264 | Type of reporting source....:
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| 265 | Class of Case................:
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| 266 | Facility referred from.......:
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| 267 | Facility referred to.........:
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| 268 | Date of First Contact........:
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| 269 | Date Dx......................:
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| 270 | Dx Facility..................:
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| 271 | Histology/Behavior Code......:
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| 272 | AFIP submission..............:
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| 273 | Diagnostic Confirmation......:
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| 274 | Presentation at Cancer Conf..:
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| 275 | Place of birth.............:
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| 276 | Spanish origin.............:
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| 277 | Agent Orange exposure......:
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| 278 | Ionizing radiation exposure:
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| 279 | Chemical exposure..........:
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| 280 | Asbestos exposure..........:
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| 281 | Persian Gulf service.......:
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| 282 | Middle East service........:
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| 283 | Somalia service............:
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| 284 | Usual Occupation...........:
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| 285 | Usual Industry.............:
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| 286 | Tobacco History............:
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| 287 | Alcohol History............:
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| 288 | Family History of Cancer...:
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| 289 | Family Member with Cancer..:
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| 290 | PREVIOUS HISTORY OF CANCER
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| 291 | Previous History of Cancer.....:
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| 292 | 1///Unknown if BRM therapy administered
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| 293 | Patient Care Evaluation Studies of Cancer of the Prostate
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| 294 | DATE OF ADMISSION
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| 295 | ACCESSION/SEQUENCE NUMBER.:
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| 296 | CLASS OF CASE.............:
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| 297 | 9ZIP CODE..................
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| 298 | BIRTHDATE.................:
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| 299 | 18PRIMARY PAYER AT DIAGNOSIS
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| 300 | 1DATE OF ADMISSION.........
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| 301 | 1.1DATE OF DISCHARGE.........
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| 302 | METHOD OF DIAGNOSIS
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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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