This page is part of the RCPA Cancer Protocols IG (v0.1.0: Release 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions

Generated Example

{
  "resourceType" : "Colorectal",
  "id" : "Colorectal-genexample-7",
  "subject" : {
    "reference" : "Patient/8003608500020565"
  },
  "requester" : {
    "reference" : "Practitioner/8003616566682137"
  },
  "performer" : {
    "reference" : "Organization/8003623233350148"
  },
  "preAnalytic" : {
    "clinicalInformation" : "Rectum/anus, Rectal Ca",
    "perforation" : "not-stated",
    "clinicalObstruction" : "not-stated",
    "tumourLocation" : [
      "34402009"
    ],
    "typeOfOperation" : {
      "code" : "265414003"
    },
    "preoperativeRadiotherapy" : "not-stated"
  },
  "macro" : {
    "specimenLength" : {
      "value" : 280,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourSite" : "34402009",
    "maxTumourDiameter" : {
      "value" : 30,
      "unit" : "x 25mm, occupies 25% circumference",
      "system" : "http://unitsofmeasure.org",
      "code" : "x 25mm, occupies 25% circumference"
    },
    "distanceNearerProxOrDistal" : [
      {
        "value" : 40,
        "unit" : "mm (distal)",
        "system" : "http://unitsofmeasure.org",
        "code" : "mm (distal)"
      }
    ],
    "distNonperitonCircumMargin" : {
      "value" : 35,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourPerforation" : "2667000",
    "relToAntPeritonealReflection" : "entirely_below",
    "intactnessOfMesorectum" : "408657005",
    "otherMacroComments" : "Additional small polyps, 1-4mm in diameter, 4 within the c=vicinity of the tumour, 6 proximal to the tumour.",
    "natureAndSiteOfBlocks" : [
      "A - proximal resection margin, B/C - distal resection margin
D to H - tumour
D/E - T/S, deepest invasion, nearest radial margin in E (inked blue)
F - t/s, G - l/s proximal tumour edge, radial margin inked in blue; 
H - l/s distal tumour edge, with dentate line
I - scarred area all embedded
J, K - polyps proximal to level of anterior peritoneal reflection, three polyps in each block
L- polyps surrounding the tumour
M - diverticula
N - apical node
O - four nodes from mesentery
P to AA - mesocolic and mesorectal nodes proximal to tumour:
P, Q - six nodes in each block; R to U - one node in each block;
V - six nodes; W, X - one node in each block; Y - six nodes; Z -  one node; AA - four nodes
AB, AC - peritumoral, mesorectal and distal nodes
AB - one node, AC - four nodes. LZ6"
    ]
  },
  "micro" : {
    "tumourType" : "35917007",
    "histologicalGrade" : "399415002",
    "maxDegreeLocalInvasion" : "395706002",
    "proximalOrDistalResectionMargins" : "not_involved",
    "marginsMicroClearance" : "35mm",
    "microClearanceRectum" : {
      "value" : 35,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "lymphNodeInvolvement" : "52101004",
    "lymphNodesDetails" : [
      {
        "site" : "pN1a",
        "numPos" : "1  (4mm deposit in peritumoral / distal node)",
        "numExamined" : "41"
      }
    ],
    "extramuralTumourDeposits" : "2667000",
    "intramuralVeinInvasion" : "not_identified",
    "extramuralVeinInvasion" : "not_identified",
    "smallVesselInvasion" : "not_identified",
    "perineuralInvasion" : "385001000",
    "histoConfDistMetastases" : "not-stated",
    "relCoexistPathabnorm" : [
      {
        "code" : "254588001"
      }
    ],
    "microResidualTumourStatus" : "R0",
    "neoadjuvantTherapy" : "not_applicable"
  },
  "_ancillaryTests" : {
    "pms2" : "normal_staining",
    "msh6" : "normal_staining",
    "comments" : "High-level microsatellite instability (MSI-H) is very unlikely.",
    "msi" : {
      "code" : "373121007"
    },
    "braf" : {
      "code" : "373121007"
    },
    "kras" : {
      "code" : "373121007"
    }
  },
  "synthesisOverview" : {
    "tumourStageT" : "395706002",
    "tumourStageN" : "n1a",
    "tumourStageM" : "mx",
    "tumourStageGrouping" : "261638004",
    "tumourStagingSystem" : "AJCC 2010, 7th edition",
    "residualTumourStatus" : "r0",
    "diagnosticSummary" : "Diagnostic Summary:
Specimen type: Abdominoperineal resection
Tumour site: Distal rectum, 35mm below anterior peritoneal reflection, 12 mm above dentate line.
Tumour type: Low grade adenocarcinoma NOS, microsatellite stable (IHC)
Tumour stage: pT2N1aMX, stage IIIA
Completeness of excision: R0

Diagnosis:
Abdominoperineal resection, distal rectum
- low grade adenocarcinoma NOS, 30mm, microsatellite stable (IHC)

Lymph nodes 
-  +1/41, metastatic carcinoma in one of forty-one nodes, apical node clear

TNM class AJCC stage (7th)
- pT2N1aMX, stage IIIA, R0

Polyps 
- Hyperplastic polyps x9 (<5mm)"
  }
}