1 | English French Notes Complete/Exclude
|
---|
2 | 528 FINE NEEDLE ASPIRATION......
|
---|
3 | 529 CORE NEEDLE BIOPSY..........
|
---|
4 | 530 INCISIONAL BIOPSY...........
|
---|
5 | 531 EXCISIONAL BIOPSY...........
|
---|
6 | 518OUTSIDE CONFIRMATION OF BIOPSY
|
---|
7 | PRIMARY SITE..................:
|
---|
8 | HISTOLOGY/BEHAVIOR CODE.......:
|
---|
9 | 520ADDNL GRADE CODING SYSTEM.....
|
---|
10 | 521VALUE OF ADDNL CODING SYSTEM..
|
---|
11 | 26DIAGNOSTIC CONFIRMATION.......
|
---|
12 | PRETREATMENT TUMOR SIZE (mm)
|
---|
13 | PATHOLOGIC TUMOR SIZE (mm)
|
---|
14 | DEPTH OF TUMOR
|
---|
15 | 29PRETREATMENT TUMOR SIZE (mm)...
|
---|
16 | 522PATHOLOGIC TUMOR SIZE (mm).....
|
---|
17 | 523DEPTH OF TUMOR.................
|
---|
18 | CONSULTATIONS:
|
---|
19 | 524 MEDICAL ONCOLOGIST...........
|
---|
20 | 525 RADIATION ONCOLOGIST.........
|
---|
21 | TREATING SURGEON................: Not applicable, no surgery
|
---|
22 | ASA CLASS.......................: Class unknown or not applicable
|
---|
23 | POSTOPERATIVE DEATH.............: Not applicable, no surgery
|
---|
24 | 526 TREATING SURGEON................
|
---|
25 | 527 ASA CLASS.......................
|
---|
26 | 441 POSTOPERATIVE DEATH.............
|
---|
27 | EXTERNAL BEAM RADIATION.........: No
|
---|
28 | INTRAOPERATIVE RADIATION........: No
|
---|
29 | EXTERNAL BEAM RADIATION.........: Unknown
|
---|
30 | INTRAOPERATIVE RADIATION........: Unknown
|
---|
31 | 532 EXTERNAL BEAM RADIATION.........
|
---|
32 | 533 NUMBER OF FRACTIONS...........
|
---|
33 | 534 RADIATION ENERGY (MV).........
|
---|
34 | 567 DATE THERAPY STARTED..........
|
---|
35 | 361 DATE THERAPY ENDED............
|
---|
36 | 535 INTRAOPERATIVE RADIATION........
|
---|
37 | 537 RADIATION ENERGY (MV).........
|
---|
38 | 539 NUMBER OF DAYS GIVEN..........
|
---|
39 | 541 DATE THERAPY STARTED..........
|
---|
40 | 542 DATE THERAPY ENDED............
|
---|
41 | 51.3 RADIATION/SURGERY SEQUENCE......
|
---|
42 | NUMBER OF FRACTIONS...........: 000
|
---|
43 | RADIATION ENERGY (MV).........: 00
|
---|
44 | DATE THERAPY STARTED..........: 00/00/0000
|
---|
45 | DATE THERAPY ENDED............: 00/00/0000
|
---|
46 | NUMBER OF FRACTIONS...........: 999
|
---|
47 | RADIATION ENERGY (MV).........: 99
|
---|
48 | DATE THERAPY STARTED..........: 99/99/9999
|
---|
49 | DATE THERAPY ENDED............: 99/99/9999
|
---|
50 | NUMBER OF DAYS GIVEN..........: 000
|
---|
51 | NUMBER OF DAYS GIVEN..........: 999
|
---|
52 | DATE OF CHEMOTHERAPY............:
|
---|
53 | AGENTS ADMINISTERED, METHODS OF DELIVERY AND LOCATIONS:
|
---|
54 | CISPLATIN.........: No DOXORUBICIN.......: No
|
---|
55 | METHOD OF DELIVERY: Not applicable METHOD OF DELIVERY: Not applicable
|
---|
56 | LOCATION..........: Not applicable LOCATION..........: Not applicable
|
---|
57 | CYTOXAN...........: No ETOPOSIDE.........: No
|
---|
58 | DTIC..............: No IFOSFAMIDE........: No
|
---|
59 | METHOD OF DELIVERY..............: Not applicable
|
---|
60 | LOCATION........................: Not applicable
|
---|
61 | METHOD OF DELIVERY..............: Unknown
|
---|
62 | 547 METHOD OF DELIVERY..............
|
---|
63 | 548 METHOD OF DELIVERY..............
|
---|
64 | 549 METHOD OF DELIVERY..............
|
---|
65 | 550 METHOD OF DELIVERY..............
|
---|
66 | 551 METHOD OF DELIVERY..............
|
---|
67 | 552 METHOD OF DELIVERY..............
|
---|
68 | 559 COLONY STIMULATING FACTORS......
|
---|
69 | 560 NATIONAL TREATMENT PROTOCOL.....
|
---|
70 | 561 OTHER PROTOCOL..................
|
---|
71 | 562 REFERRED TO REHAB SERVICES......
|
---|
72 | 563 CONSULT W PHYSICAL THERAPY/REHAB
|
---|
73 | 564 TRANSFERRED TO REHAB FACILITY...
|
---|
74 | 565 NO OF HOSPITALIZATIONS W/I 6 MO.
|
---|
75 | 566 TOTAL LENGTH OF STAYS...........
|
---|
76 | DISTANT SITE(S) OF RECURRENCE
|
---|
77 | SUBSEQUENT TREATMENT FOR RECURRENCE OR PROGRESSION
|
---|
78 | TABLE V - FIRST RECURRENCE AND SUBSEQUENT TREATMENT
|
---|
79 | NO SUBSEQUENT TREATMENT
|
---|
80 | .07 HORMONE THERAPY
|
---|
81 | ACCESSION NUMBER..................:
|
---|
82 | SEQUENCE NUMBER...................:
|
---|
83 | POSTAL CODE AT DIAGNOSIS..........:
|
---|
84 | DATE OF BIRTH.....................:
|
---|
85 | RACE..............................:
|
---|
86 | SPANISH ORIGIN....................:
|
---|
87 | SEX...............................:
|
---|
88 | PRIMARY PAYER AT DIAGNOSIS........:
|
---|
89 | FAMILY HIST OF SOFT TISSUE SARCOMA:
|
---|
90 | PERSONAL HISTORY OF ANY CANCER....:
|
---|
91 | CLASS OF CASE.....................:
|
---|
92 | ANGIOGRAM OF PRIMARY............:
|
---|
93 | BONE MARROW ASPIRATE/BIOPSY.....:
|
---|
94 | BONE SCAN.......................:
|
---|
95 | CT SCAN OF CHEST................:
|
---|
96 | CT SCAN OF PRIMARY..............:
|
---|
97 | LIVER FUNCTION STUDIES..........:
|
---|
98 | MRI OF PRIMARY..................:
|
---|
99 | MRI OF OTHER....................:
|
---|
100 | ELECTRON MICROSCOPY.............:
|
---|
101 | FLOW CYTOMETRY..................:
|
---|
102 | IN SITU HYBRIDIZATION...........:
|
---|
103 | BIOPSIES: HISTOLOGY/BEHAVIOR/GRADE
|
---|
104 | FINE NEEDLE ASPIRATION..........:
|
---|
105 | CORE NEEDLE ASPIRATION..........:
|
---|
106 | INCISIONAL BIOPSY...............:
|
---|
107 | EXCISIONAL BIOPSY...............:
|
---|
108 | OUTSIDE CONFIRMATION OF BIOPSY....:
|
---|
109 | DATE OF INITIAL DIAGNOSIS.........:
|
---|
110 | PRIMARY SITE......................:
|
---|
111 | SUBSITE...........................:
|
---|
112 | HISTOLOGY/BEHAVIOR CODE...........:
|
---|
113 | GRADE.............................:
|
---|
114 | ADDNL GRADE CODING SYSTEM.........:
|
---|
115 | VALUE OF ADDNL CODING SYSTEM......:
|
---|
116 | DIAGNOSTIC CONFIRMATION...........:
|
---|
117 | PRETREATMENT TUMOR SIZE (mm)......:
|
---|
118 | PATHOLOGIC TUMOR SIZE (mm)........:
|
---|
119 | DEPTH OF TUMOR....................:
|
---|
120 | MULTIFOCAL........................:
|
---|
121 | REGIONAL NODES EXAMINED...........:
|
---|
122 | REGIONAL NODES POSITIVE...........:
|
---|
123 | SITE OF DISTANT METASTASIS #1...:
|
---|
124 | SITE OF DISTANT METASTASIS #2...:
|
---|
125 | SITE OF DISTANT METASTASIS #3...:
|
---|
126 | AJCC STAGE......................:
|
---|
127 | CLINICAL STAGED BY..............:
|
---|
128 | PATHOLOGIC STAGED BY............:
|
---|
129 | MEDICAL ONCOLOGIST..............:
|
---|
130 | RADIATION ONCOLOGIST............:
|
---|
131 | Print Soft Tissue Sarcoma PCE
|
---|
132 | PCE Study of Soft Tissue Sarcoma
|
---|
133 | FIRST COURSE TREATMENT DATE.......:
|
---|
134 | RESIDUAL PRIMARY TUMOR..........:
|
---|
135 | TREATING SURGEON................:
|
---|
136 | ASA CLASS.......................:
|
---|
137 | POSTOPERATIVE DEATH.............:
|
---|
138 | EXTERNAL BEAM RADIATION...:
|
---|
139 | BRACHYTHERAPY...........:
|
---|
140 | NUMBER OF FRACTIONS.......:
|
---|
141 | NUMBER OF DAYS GIVEN....:
|
---|
142 | DOSE....................:
|
---|
143 | RADIATION ENERGY (MV).....:
|
---|
144 | DATE THERAPY STARTED....:
|
---|
145 | DATE THERAPY STARTED......:
|
---|
146 | DATE THERAPY ENDED......:
|
---|
147 | DATE THERAPY ENDED........:
|
---|
148 | INTRAOPERATIVE RADIATION..:
|
---|
149 | RADIATION/SURGERY SEQUENCE:
|
---|
150 | DATE OF CHEMOTHERAPY:
|
---|
151 | AGENT ADMINISTERED METHOD OF DELIVERY LOCATION
|
---|
152 | COLONY STIMULATION FACTOR........:
|
---|
153 | NATIONAL TREATMENT PROTOCOL......:
|
---|
154 | OTHER PROTOCOL...................:
|
---|
155 | REFERRED TO REHAB SERVICES.......:
|
---|
156 | CONSULT W PHYSICAL THERAPY/REHAB.:
|
---|
157 | TRANSFERRED TO REHAB FACILITY....:
|
---|
158 | NO OF HOSPITALIZATIONS W/I 6 MO..:
|
---|
159 | TOTAL LENGTH OF STAYS............:
|
---|
160 | TYPE OF FIRST RECURRENCE..........:
|
---|
161 | OTHER TYPE OF FIRST RECURRENCE....:
|
---|
162 | DISTANT SITE(S) OF FIRST RECURRENCE:
|
---|
163 | RECURRENCE SITE 1.................:
|
---|
164 | RECURRENCE SITE 2.................:
|
---|
165 | RECURRENCE SITE 3.................:
|
---|
166 | NO SUBSEQUENT TREATMENT
|
---|
167 | HORMONE THERAPY:
|
---|
168 | SURGERY OF PRIMARY SITE DATE...:
|
---|
169 | SCOPE OF LYMPH NODE SURGERY...:
|
---|
170 | RECON/RESTORE - DELAYED.......:
|
---|
171 | RECON/RESTORE - DELAYED DATE..:
|
---|
172 | too long:
|
---|
173 | Text should not exceed NAACCR length of
|
---|
174 | Do you want to re-edit this field
|
---|
175 | Patient Care Evaluation Study of Thyroid Cancer
|
---|
176 | FAMILY HISTORY OF THYROID CANCER
|
---|
177 | PERSONAL HISTORY OF NON-THYROID CANCER
|
---|
178 | PRIOR EXPOSURE TO RADIATION
|
---|
179 | PERSONAL HISTORY OF GOITER
|
---|
180 | FAMILY HISTORY OF THYROID DISEASE
|
---|
181 | PERSONAL HISTORY OF GRAVES DISEASE
|
---|
182 | PERSONAL HISTORY OF THYROIDITIS
|
---|
183 | FAMILY HISTORY OF GOITER OR OTHER THYROID DISEASE
|
---|
184 | 9POSTAL CODE AT DIAGNOSIS..........
|
---|
185 | 9SPANISH ORIGIN....................
|
---|
186 | 18PRIMARY PAYER AT DIAGNOSIS........
|
---|
187 | 400FAMILY HISTORY OF THYROID CANCER..
|
---|
188 | PERSONAL HISTORY OF NON-THYROID CANCER:
|
---|
189 | 402 CHILDHOOD MALIGNANCY............
|
---|
190 | 403PRIOR EXPOSURE TO RADIATION.......
|
---|
191 | 404PERSONAL HISTORY OF GOITER........
|
---|
192 | 405FAMILY HISTORY THYROID DISEASE....
|
---|
193 | 406PERSONAL HISTORY OF GRAVES DISEASE
|
---|
194 | 407PERSONAL HISTORY OF THYROIDITIS...
|
---|
195 | SYMPTOMS/SIGNS PRESENT
|
---|
196 | DIAGNOSTIC/SURGICAL WORKUP
|
---|
197 | HISTOLOGY/BEHAVIOR CODE (ICD-O-2)
|
---|
198 | BLOOD VESSEL INVASION
|
---|
199 | EXTRA-THYROID EXTENSION
|
---|
200 | SYMPTOMS/SIGNS PRESENT:
|
---|
201 | 409 HOARSENESS OR VOICE CHANGE.....
|
---|
202 | 410 NECK NODAL MASS................
|
---|
203 | 413 PATHOLOGIC FRACTURE............
|
---|
204 | 414 STRIDOR OR DIFFICULTY BREATHING
|
---|
205 | 415 THYROID MASS...................
|
---|
206 | 416 WEIGHT LOSS....................
|
---|
207 | DIAGNOSTIC/SURGICAL WORKUP:
|
---|
208 | 418 BONE SCAN......................
|
---|
209 | 420 CT SCAN OF NECK................
|
---|
210 | 422 INCISIONAL BIOPSY..............
|
---|
211 | 425 NEEDLE ASPIRATION OF NECK NODE.
|
---|
212 | 426 NEEDLE ASPIRATION OF THYROID...
|
---|
213 | 427 MRI OF NECK....................
|
---|
214 | 428 THYROID SCAN...................
|
---|
215 | 429 ULTRASOUND OF THYROID..........
|
---|
216 | HISTOLOGY/BEHAVIOR CODE (ICD-O-2):
|
---|
217 | 431BLOOD VESSEL INVASION............
|
---|
218 | 432EXTRA-THYROIDAL EXTENSION........
|
---|
219 | SIZE OF TUMOR
|
---|
220 | LOCATION OF POSITIVE NODES
|
---|
221 | 29SIZE OF TUMOR..................
|
---|
222 | 434LOCATION OF POSITIVE NODES.....
|
---|
223 | 19CLINICAL STAGE..................
|
---|
224 | 89PATHOLOGIC STAGE................
|
---|
225 | DATE OF FIRST COURSE TREATMENT.......:
|
---|
226 | DATE OF NON CANCER-DIRECTED SURGERY:
|
---|
227 | NON CANCER-DIRECTED SURGERY........:
|
---|
228 | DATE OF SURGERY OF PRIMARY SITE....:
|
---|
229 | DATE OF DISCHARGE AFTER SURGERY....: 00/00/0000
|
---|
230 | 435 DATE OF DISCHARGE AFTER SURGERY....
|
---|
231 | SURGERY OF PRIMARY SITE............:
|
---|
232 | RESIDUAL PRIMARY TUMOR.............: NA
|
---|
233 | AIRWAY PROBLEM REQ TRACHEOSTOMY..: Not applicable, no surgery
|
---|
234 | BLEEDING HEMATOMA................: Not applicable, no surgery
|
---|
235 | HYPOCALCEMIA.....................: Not applicable, no surgery
|
---|
236 | RECURRENT NERVE INJURY...........: Not applicable, no surgery
|
---|
237 | WOUND INFECTION..................: Not applicable, no surgery
|
---|
238 | POSTOPERATIVE DEATH WITH 30 DAYS.: Not applicable, no surgery
|
---|
239 | 59 RESIDUAL PRIMARY TUMOR.............
|
---|
240 | 436 AIRWAY PROBLEM REQ TRACHEOSTOMY..
|
---|
241 | 437 BLEEDING HEMATOMA................
|
---|
242 | 439 RECURRENT NERVE INJURY...........
|
---|
243 | 440 WOUND INFECTION..................
|
---|
244 | 441 POSTOPERATIVE DEATH WITHIN 30 DAYS.
|
---|
245 | RADIATION:
|
---|
246 | DATE RADIATION STARTED.............:
|
---|
247 | REGIONAL RAD (cGy) DOSE............: 00000
|
---|
248 | BOOST DOSAGE.......................: 00000
|
---|
249 | TOTAL MILLICURIES (mCi) OF RADIOIODINE:
|
---|
250 | INITAL DOSE........................: 00000
|
---|
251 | SECOND DOSE........................: 00000
|
---|
252 | REGIONAL RAD (cGy) DOSE............: 99999
|
---|
253 | BOOST DOSAGE.......................: 99999
|
---|
254 | INITAL DOSE........................: 99999
|
---|
255 | SECOND DOSE........................: 99999
|
---|
256 | 442 REGIONAL RAD (cGy) DOSE............
|
---|
257 | 443 BOOST DOSAGE.......................
|
---|
258 | 444 INITIAL DOSE.......................
|
---|
259 | 445 SECOND DOSE........................
|
---|
260 | ADJUVANT CHEMO W BEAM RADIATION....: No concomitant treatment
|
---|
261 | ADJUVANT CHEMO W BEAM RADIATION....: Unknown if therapy concomitant
|
---|
262 | 446 ADJUVANT CHEMO W BEAM RADIATION....
|
---|
263 | THYROID HORMONE THERAPY............:
|
---|
264 | FAMILY HISTORY OF THYROID CANCER..:
|
---|
265 | CHILDHOOD MALIGNANCY............:
|
---|
266 | PRIOR EXPOSURE TO RADIATION.......:
|
---|
267 | PERSONAL HISTORY OF GOITER........:
|
---|
268 | FAMILY HISTORY OF THYROID DISEASE.:
|
---|
269 | PERSONAL HISTORY OF GRAVES DISEASE:
|
---|
270 | PERSONAL HISTORY OF THYROIDITIS...:
|
---|
271 | TABLE II - INITIAL DIAGNOSIS/CANCER IDENTIFICATION
|
---|
272 | HOARSENESS OR VOICE CHANGE......:
|
---|
273 | NECK NODAL MASS.................:
|
---|
274 | PATHOLOGIC FRACTURE.............:
|
---|
275 | STRIDOR/DIFFICULTY BREATHING....:
|
---|
276 | THYROID MASS....................:
|
---|
277 | WEIGHT LOSS.....................:
|
---|
278 | DIAGNOISTIC/SURGICAL WORKUP:
|
---|
279 | CT SCAN OF NECK.................:
|
---|
280 | NEEDLE ASPIRATION OF NECK NODE..:
|
---|
281 | NEEDLE ASPIRATION OF THYROID....:
|
---|
282 | MRI OF NECK.....................:
|
---|
283 | THYROID SCAN....................:
|
---|
284 | ULTRASOUND OF THYROID...........:
|
---|
285 | PRIMARY SITE (ICD-O-2)............:
|
---|
286 | HISTOLOGY/BEHAVIOR CODE (ICD-O-2).:
|
---|
287 | BLOOD VESSEL INVASION.............:
|
---|
288 | EXTRA-THYROIDAL EXTENSION.........:
|
---|
289 | SIZE OF TUMOR (mm)................:
|
---|
290 | LOCATION OF POSITIVE NODES........:
|
---|
291 | CLINICAL STAGE................:
|
---|
292 | PATHOLOGIC STAGE..............:
|
---|
293 | Print Thyroid PCE
|
---|
294 | PCE Study of Thyroid Cancer
|
---|
295 | DISCHARGE AFTER SURGERY DATE....:
|
---|
296 | AIRWAY PROBLEM W TRACHEOSTOMY.:
|
---|
297 | BLEEDING HEMOTOMA.............:
|
---|
298 | RECURRENT NERVE INJURY........:
|
---|
299 | WOUND INFECTION...............:
|
---|
300 | POSTOPERATIVE DEATH W/I 30 DAYS.:
|
---|
301 | REGIONAL RAD (cGy) DOSE.........:
|
---|
302 | BOOST DOSAGE....................:
|
---|
303 | #################### #################### ####################
|
---|
304 | #################### #################### ####################
|
---|
305 | #################### #################### ####################
|
---|
306 | #################### #################### ####################
|
---|
307 | #################### #################### ####################
|
---|