English French Notes Complete/Exclude EVIDENCE OF METASTASIS......: Not documented 1402 11. DATE OF FIRST TISSUE DIAGNOSIS 12. DISTANCE IN MILLIMETERS TO CLOSEST MARGIN: 1429 PROXIMAL MARGIN.............. 1429.1 DISTAL MARGIN................ 1417 13. FROZEN SECTION................ 1418.3 CHEST WALL................... 15. SCOPE OF OPERATIVE MEDIASTINAL LYMPH NODE ASSESSMENT: 1419 HIGHEST MEDIASTINAL (level 1) 1419.1 UPPER PARATRACHEAL (level 2) 1419.2 PREVASCULAR AND RETROTRACHEAL (level 3) 1419.3 LOWER PARATRACHEAL (level 4) 1419.8 PULMONARY LIGAMENT (level 9) 1430 16. HCT (HEMOCRIT) VALUES BEFORE TRANSFUSION.................. 1420 17. TOTAL PERI-OPERATIVE BLOOD REPLACEMENT.................. 1421 18. PERI-OPERATIVE DEATH.......... FIRST COURSE OF TREATMENT - RADIATION THERAPY 442 19. REGIONAL DOSE (cGy)........... 56 20. NUMBER OF TREATMENTS TO THIS VOLUME....................... 363 21. REGIONAL TREATMENT MODALITY... 51.3 22. RADIATION/SURGERY SEQUENCE.... 1422 23. BOOST DOSE (cGy).............. 127 24. INTENT OF RADIATION TREATMENT. 75 25. REASON FOR NO RADIATION....... 26. TYPE OF CHEMOTHERAPEUTIC AGENTS ADMINISTERED: 1424 27. CHEMOTHERAPEUTIC TOXICITY..... 1425 28. CHEMOTHERAPY/SURGERY SEQUENCE. Do not answer data items 15-18. Proceed to data item 19. 19. REGIONAL DOSE (cGy)...........: 20. NUMBER OF TREATMENTS TO THIS 21. REGIONAL TREATMENT MODALITY...: 22. RADIATION/SURGERY SEQUENCE....: 23. BOOST DOSE (cGy)..............: Not administered 24. INTENT OF RADIATION TREATMENT.: 25. REASON FOR NO RADIATION.......: Do not answer data items 26-28. Proceed to data item 29. COMPLICATION #1 may not be blank 81 30. INITIALS OF CASE ABSTRACTOR... 90 31. DATE CASE WAS ABSTRACTED...... 2. DURATION OF TOBACCO USE.......: 3. PERSONAL HISTORY OF OTHER 4. SYMPTOMS PRESENT AT INITIAL DIAGNOSIS: SHORTNESS OF BREATH..........: PALPABLE LYMPH NODES.........: 5. SCREENING FOR HIGH RISK/ASYMPTOMATIC PRESENTATION: CT SCAN......................: 6. INITIAL DIAGNOSTIC STUDIES (PRE-THERAPY): HISTORY AND PHYSICAL.........: THOROCOTOMY/OPEN BIOSPY......: Print Lung (NSCLC) PCE TUMOR EVALUATION 7. PULMONARY FUNCTION TESTS: FVC (forced vital capacity)..: FEV (forced expiratory vol)..: 8. LIVER FUNCTION TESTS..........: 9. RADIOLOGICAL EVALUATION: BONE SCAN....................: VASCULAR INVASION...........: MEDIASTINAL LYMPH NODES.....: SIZE OF DOMINANT TUMOR (mm).: NUMBER OF TUMORS............: EVIDENCE OF METASTASIS......: MRI SCAN OF CHEST............: MRI SCAN OF BRAIN............: X-RAY OF CHEST...............: 10. PRE-OP LYMPH NODE MAPPING: HIGHEST MEDIASTINAL (level 1): UPPER PARATRACHEAL (level 2): PREVASCULAR AND RETROTRACHEAL LOWER PARATRACHEAL (level 4): PULMONARY LIGAMENT (level 9): 11. DATE OF FIRST TISSUE DIAGNOSIS: 12. DISTANCE IN MILLIMETERS TO CLOSEST MARGIN: 13. FROZEN SECTION................: CHEST WALL...................: 15. SCOPE OF OPERATIVE MEDIASTINAL LYMPH NODE ASSESSMENT: 16. HCT (HEMATOCRIT) VALUES BEFORE 17. TOTAL PERI-OPERATIVE BLOOD 18. PERI-OPERATIVE DEATH..........: 19. REGIONAL DOSE (cGy)...........: 20. NUMBER OF TREATMENTS TO THIS 21. REGIONAL TREATMENT MODALITY...: 22. RADIATION/SURGERY SEQUENCE....: 23. BOOST DOSE (cGy)..............: 24. INTENT OF RADIATION TREATMENT.: 25. REASON FOR NO RADIATION.......: 26. TYPE OF CHEMOTHERAPEUTIC AGENTS ADMINISTERED: 27. CHEMOTHERAPEUTIC TOXICITY.....: 28. CHEMOTHERAPY/SURGERY SEQUENCE.: COMPLICATION #1..............: 000.00 No complications 29. INITIALS OF CASE ABSTRACTOR...: 30. DATE CASE WAS ABSTRACTED......: The Class of Case is not 0, 1, 2 or 6. The BEHAVIOR is not 2 (melanoma in situ) or 3 (malignant). 9:Print Melanoma PCE This primary does not satisfy the Melanoma PCE eligibility criteria: 1999 Patient Care Evaluation Study of Melanoma 10. PERSONAL HISTORY OF MELANOMA 11. PERSONAL HISTORY OF OTHER CANCER 12. PREGNANCY AT INITIAL DX 13. EXOGENOUS HORMONES 1. INSTITUTION ID NUMBER........: 2. ACCESSION NUMBER.............: 3. SEQUENCE NUMBER..............: 9 4. POSTAL CODE AT DIAGNOSIS..... 5. DATE OF BIRTH................: 9 7. SPANISH ORIGIN............... 18 9. PRIMARY PAYER AT DIAGNOSIS... 1100 10. PERSONAL HISTORY OF MELANOMA. 1101 11. PERSONAL HISTORY OF OTHER CA.// 1ST SITE CODE...............: C88.8 DATE DIAGNOSED..............: 88/8888 2ND SITE CODE...............: C88.8 1ST SITE CODE...............: C99.9 DATE DIAGNOSED..............: 99/9999 2ND SITE CODE...............: C99.9 1102 1ST SITE CODE...............// 1103 DATE DIAGNOSED..............// 1104 2ND SITE CODE...............// 1105 DATE DIAGNOSED..............// PREGNANCY AND HORMONES 12. PREGNANCY AT INITIAL DX......: NA, male 13. EXOGENOUS HORMONES...........: NA, male patient 1106 12. PREGNANCY AT INITIAL DX...... 1107 13. EXOGENOUS HORMONES........... 14. CLASS OF CASE 15. DATE OF INITIAL DIAGNOSIS 16. PRIMARY SITE (ICD-O-2) 17. LOCATION OF DISEASE PRESENTATION 20. BEHAVIOR CODE(ICD-O-2) 20. BEHAVIOR CODE (ICD-O-2) 14. CLASS OF CASE................: 15. DATE OF INITIAL DIAGNOSIS....: 16. PRIMARY SITE (ICD-O-2).......: 17. LOC OF DISEASE PRESENTATION..: NA, primary site known 1108 17. LOC OF DISEASE PRESENTATION.. 20. BEHAVIOR CODE (ICD-O-2)......: 26 22. DIAGNOSTIC CONFIRMATION...... 23. SIZE OF TUMOR (MELANOMA) 26. EXTRANODAL EXTENSION 28. NUMBER OF SATELLITE NODULES 29. LOCATION OF IN-TRANSIT NODULES 31. CLARK'S LEVEL OF INVASION 32. ANGIOLYMPHATIC INVASION 33. PERINEURAL INVASION 34. GENERAL SUMMARY STAGE 35. AJCC CLINICAL STAGE (cTNM) 37. CLINICALLY AMELANOTIC 38. AJCC PATHOLOGIC STAGE (pTNM) 39. STAGED BY TABLE III- EXTENT OF DISEASE AND AJCC STAGE 1132 23. SIZE OF TUMOR (MELANOMA)..... 33 24. REGIONAL NODES EXAMINED...... 32 25. REGIONAL NODES POSITIVE...... 1110 26. EXTRANODAL EXTENSION......... SATELLITE NODULES OF SKIN OR SUBCUTANEOUS TISSUE 28. NUMBER OF SATELLITE NODES....: No satellite nodules 28. NUMBER OF SATELLITE NODES....: NA, non-cutaneous melanoma 28. NUMBER OF SATELLITE NODES....: Unknown 1112 28. NUMBER OF SATELLITE NODULES.. 1113 29. LOC OF IN-TRANSIT NODULES.... 31. CLARK'S LEVEL OF INVASION....: NA, primary site unknown 1115 31. CLARK'S LEVEL OF INVASION.... 32. ANGIOLYMPHATIC INVASION......: NA, site unknown or ocular 1116 32. ANGIOLYMPHATIC INVASION...... 33. PERINEURAL INVASION..........: NA, site unknown or ocular 1117 33. PERINEURAL INVASION.......... 35 34. GENERAL SUMMARY STAGE........ 35. AJCC CLINICAL STAGE (cTNM): 36. ULCERATION,,,,,,,,,..........: NA, site unknown or ocular 37. CLINICALLY AMELANOTIC........: NA, site unknown or ocular 1119 37. CLINICALLY AMELANOTIC........ 38. AJCC PATHOLOGIC STAGE (pTNM): 39. STAGED BY: 19 CLINICAL STAGE............... 89 PATHOLOGIC STAGE............. SENTINEL NODES TABLE IV - FIRST COURSE OF TREATMENT 346 40. PROTOCOL ELIGIBILITY STATUS... 41. PROTOCOL PARTICIPATION........: Not on/NA 41. PROTOCOL PARTICIPATION........: Unknown 560 41. PROTOCOL PARTICIPATION........ 42. DATE OF FIRST COURSE TREATMENT: 43. DATE OF NON CA-DIR SURGERY....: 44. NON CANCER-DIRECTED SURGERY...: 1109 45. TYPE OF BIOPSY................ 46. DATE OF CANCER-DIR SURGERY....: 47. SURGICAL APPROACH.............: 48. SURGERY OF PRIMARY SITE.......: 49. SURGICAL MARGINS..............: 50. DISTANCE FROM TUMOR TO EDGE OF SPECIMEN......................: 998 NA, surgery not performed 1120 50. DISTANCE FROM TUMOR TO EDGE OF SPECIMEN...................... 51. SCOPE OF LYMPH NODE SURGERY...: 52. NUMBER OF LYMPH NODES REMOVED.: 53. SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S), 55. SURGICAL CLOSURE..............: NA, surgery not performed 55. SURGICAL CLOSURE..............: Unknown 1121 55. SURGICAL CLOSURE.............. 56. REASON FOR NO SURGERY.........: 57. PRE-OP LYMPHOSCINTIGRAPHY.....: NA, ocular site 1122 57. PRE-OP LYMPHOSCINTIGRAPHY..... 58. SENTINEL NODES DETECTED BY....: NA, not done, ocular site 59. SENTINEL NODE BIOPSY..........: NA, not done, ocular site 60. SENTINEL NODES EXAMINED.......: NA, not done, ocular site 58. SENTINEL NODES DETECTED BY....: Unknown 59. SENTINEL NODE BIOPSY..........: Unknown 60. SENTINEL NODES EXAMINED.......: Unknown 1123 58. SENTINEL NODES DETECTED BY.... 943 59. SENTINEL NODE BIOPSY.......... 1124 60. SENTINEL NODES EXAMINED....... 61. SENTINEL NODES POSITIVE.......: NA, not done, no exam, ocular site 62. HOW WAS SENTINEL NODE PATHOLOGICALLY EXAMINED.......: NA, not done, ocular site 61. SENTINEL NODES POSITIVE.......: Unknown 1125 61. SENTINEL NODES POSITIVE....... 1126 62. HOW WAS SENTINEL NODE PATHOLOGICALLY EXAMINED....... 63. IF SENTINEL NODE(S) POSITIVE: WAS COMPLETE LYMPH NODE DISSECTION PERFORMED..........: NA, not done, no + nodes, ocular site NUMBER OF BASINS DETECTED.....: NA, not done, no + nodes, ocular site NUMBER OF BASINS POSITIVE.....: NA, not done, no basins dissected, ocular NUMBER OF BASINS DETECTED.....: Unknown NUMBER OF BASINS POSITIVE.....: Unknown 1127 WAS COMPLETE LYMPH NODE DISSECTION PERFORMED.......... NUMBER OF BASINS DETECTED....: NA, not done, no + nodes, ocular site NUMBER OF BASINS POSITIVE....: NA, not done, no basins dissected, ocular NUMBER OF BASINS DETECTED....: Unknown NUMBER OF BASINS POSITIVE....: Unknown 1128 NUMBER OF BASINS DETECTED..... 1129 NUMBER OF BASINS POSITIVE..... 64. DATE RADIATION STARTED........: 65. RADIATION THERAPY.............: 66. REASON FOR NO RADIATION.......: 67. DATE CHEMOTHERAPY STARTED.....: 69. INTRAVENOUS THERAPY...........: NA, chemotherapy not administered 69. INTRAVENOUS THERAPY...........: Unknown if administered 1130 69. INTRAVENOUS THERAPY........... 70. DATE HORMONE THERAPY STARTED..: 71. HORMONE THERAPY...............: 72. DATE IMMUNOTHERAPY STARTED....: 74. IMMUNOTHERAPEUTIC AGENTS ADMINISTERED: VACCINE THERAPY...............: NA GENE THERAPY..................: NA COLONY STIMULATING FACTORS....: NA OTHER GIVEN, TYPE UNKNOWN.....: NA VACCINE THERAPY...............: Unknown GENE THERAPY..................: Unknown COLONY STIMULATING FACTORS....: Unknown OTHER GIVEN, TYPE UNKNOWN.....: Unknown 884 VACCINE THERAPY............... 1131 GENE THERAPY.................. 559 COLONY STIMULATING FACTORS.... 386 OTHER GIVEN, TYPE UNKNOWN..... 75. DATE OTHER TREATMENT STARTED..: 76. OTHER TREATMENT...............: 77. DATE OF FIRST RECURRENCE 78. TYPE OF FIRST RECURRENCE 79. OTHER TYPE OF FIRST RECURRENCE 77. TYPE OF FIRST RECURRENCE 78. DATE OF FIRST RECURRENCE TABLE V - FIRST RECURRENCE 70 77. DATE OF FIRST RECURRENCE...... 71 78. TYPE OF FIRST RECURRENCE...... 71.4 79. OTHER TYPE OF 1ST RECURRENCE.. 80. DATE OF LAST CONTACT OR DEATH 81. VITAL STATUS 82. CANCER STATUS TABLE VI - STATUS AT LAST CONTACT 80. DATE OF LAST CONTACT OR DEATH.: 15 81. VITAL STATUS.................. 82. CANCER STATUS.................: 83. COMPLETED BY 84. REVIEWED BY CANCER COMMITTEE TABLE VII - OTHER INFORMATION 81 83. COMPLETED BY.................. 82 84. REVIEWED BY CANCER COMMITTEE.. 1. INSTITUTION ID NUMBER...........: 2. ACCESSION NUMBER................: 3. SEQUENCE NUMBER.................: 4. POSTAL CODE AT DIAGNOSIS........: 5. DATE OF BIRTH...................: 7. SPANISH ORIGIN..................: 9. PRIMARY PAYER AT DIAGNOSIS......: 10. PERSONAL HISTORY OF MELANOMA....: 11. PERSONAL HISTORY OF OTHER CA....: 1ST SITE CODE..................: DATE DIAGNOSED.................: 2ND SITE CODE..................: PREGNANCY AND HORMONES 12. PREGNANCY AT INITIAL DX.........: 13. EXOGENOUS HORMONES..............: 14. CLASS OF CASE...................: 15. DATE OF INITIAL DIAGNOSIS.......: 16. PRIMARY SITE (ICD-O-2)..........: 17. LOC OF DISEASE PRESENTATION.....: 20. BEHAVIOR CODE (ICD-O-2).........: 22. DIAGNOSTIC CONFIRMATION.........: Print Melanoma PCE 1999 Patient Care Evaluation Study of Melanoma TABLE III - EXTENT AND STAGE OF DISEASE 23. SIZE OF TUMOR (mm)..............: #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################