Contents |
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Record details of surgery performed as part of the treatment when required by the protocol.
Field Name | Description / Instructions | Format |
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Visit Date | The Visit Date is optional on this case report form. Hit the "Tab" key to leave it empty and move to the Date of Vitals field. | DD-MMM-YYYY |
Day in Course (d) | Indicates the day since the beginning of course the cardiac ejection fraction results are related to based on their date and time. | 5 digits |
Date of Surgery (m) | Enter the date of the surgical procedure. | DD-MMM-YYYY |
Procedure (m) | Enter the type of procedure performed to diagnose / to treat the patient's disease. | 100 characters |
Findings | Briefly describe the findings of the procedure. | 24 characters |
Residual Disease | Briefly describe the extent of the residual disease, if any, at the conclusion of the operation. (i.e.: microscopic, macroscopic). | 24 characters |
Were Margin Clear? | Select the results of tissue margin examination. | Use pick list. |
Margin Comments | Enter the comment for margin examination. | 200 characters |
Total Lymph Nodes Involved | Enter the number of lymph nodes involved with disease as determined by pathologic examination. | 5 digits |
Total Lymph Nodes Evaluated | Enter the total number of lymph nodes removed and pathologically assessed for disease. | 5 digits |
Legend: (d) derived field, (m) RDC mandatory, (c) for CTEP reporting only. |
Code | Description | Resolutions |
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SUG01 | Date of Surgery is in the future. | Enter a date that is equal to or earlier than the current date. |
Code | Field Name | Description |
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SUG1002 | Day in Course | Derived from the respective course initiation start date. |