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-8",
  "subject" : {
    "reference" : "Patient/8003608833354889"
  },
  "requester" : {
    "reference" : "Practitioner/8003616566682137"
  },
  "performer" : {
    "reference" : "Organization/8003623233350148"
  },
  "preAnalytic" : {
    "clinicalInformation" : "No mets. Equivocal lymph nodes on imaging.",
    "perforation" : "not-stated",
    "clinicalObstruction" : "not-stated",
    "tumourLocation" : [
      "34402009"
    ],
    "typeOfOperation" : {
      "other" : "Laparoscopic ultralow anterior resection"
    },
    "preoperativeRadiotherapy" : "not-stated",
    "RecurrenceDescription" : "Presence of distant metastasis:  Absent."
  },
  "macro" : {
    "specimenLength" : {
      "value" : 260,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourSite" : "34402009",
    "maxTumourDiameter" : {
      "value" : 30,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "distanceNearerProxOrDistal" : [
      {
        "value" : 12,
        "unit" : "mm (distal)",
        "system" : "http://unitsofmeasure.org",
        "code" : "mm (distal)"
      }
    ],
    "distNonperitonCircumMargin" : {
      "value" : 3,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourPerforation" : "2667000",
    "relToAntPeritonealReflection" : "entirely_below",
    "intactnessOfMesorectum" : "408659008",
    "otherMacroComments" : "Pedunculated polyp 8mm, situated 55mm proximal to tumour.",
    "natureAndSiteOfBlocks" : [
      "A - proximal margin; B - distal margin
C/D - paired transverse slice of tumour (radial margin in C)
E/F - paired transverse slice of tumour (E - radial margin)
G -  transverse slice of tumour with radial margin
H - tumour with adjacent mucosa
I - pedunculated polyp 55mm proximal to tumour
J - apical lymph node
K to N - peritumoural/distal lymph nodes (up to 6 lymph nodes per cassette)
O to S - lymph nodes proximal to tumour (O to R - 6 lymph nodes per cassette, S - 4 lymph node4s per cassette)
T to Z - fat with possible lymph nodes."
    ]
  },
  "micro" : {
    "tumourType" : "35917007",
    "histologicalGrade" : "399415002",
    "maxDegreeLocalInvasion" : "395707006",
    "proximalOrDistalResectionMargins" : "not_involved",
    "marginsMicroClearance" : "5mm (anterior)",
    "nonperitonealisedCircumMargin" : "not_involved",
    "microClearanceRectum" : {
      "value" : 5,
      "unit" : "mm (anterior)",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm (anterior)"
    },
    "lymphNodeInvolvement" : "2667000",
    "lymphNodesDetails" : [
      {
        "site" : "pN0",
        "numPos" : "0",
        "numExamined" : "36"
      }
    ],
    "extramuralTumourDeposits" : "2667000",
    "apicalNodeInvolvement" : "2667000",
    "intramuralVeinInvasion" : "not_identified",
    "extramuralVeinInvasion" : "369734008",
    "smallVesselInvasion" : "not_identified",
    "perineuralInvasion" : "385001000",
    "histoConfDistMetastases" : "2667000",
    "relCoexistPathabnorm" : [
      {
        "code" : "254588001"
      }
    ],
    "microResidualTumourStatus" : "R0",
    "neoadjuvantTherapy" : "not_applicable"
  },
  "_ancillaryTests" : {
    "mlh1" : "373121007",
    "pms2" : "normal_staining",
    "msh2" : "373121007",
    "msh6" : "normal_staining",
    "comments" : "High-level microsatellite instability (MSI-H) is very unlikely.",
    "msi" : {
      "code" : "373121007"
    },
    "braf" : {
      "code" : "373121007"
    },
    "kras" : {
      "code" : "373121007"
    }
  },
  "synthesisOverview" : {
    "tumourStageT" : "395707006",
    "tumourStageN" : "n0",
    "tumourStageM" : "m0",
    "tumourStageGrouping" : "261614003",
    "tumourStagingSystem" : "AJCC 2010, 7th edition",
    "residualTumourStatus" : "r0",
    "diagnosticSummary" : "Diagnostic Summary:
Specimen type: Ultra-low anterior resection
Tumour site: Rectum
Tumour type: Adenocarcinoma, poorly differentiated tumour budding
Tumour stage: pT3N0 cM, stage IIA
Completeness of excision: Complete

Diagnosis:
1. Rectum and Sigmoid, ultrlow anterior resection:
- Adenocarcinoma NOS, 30x28x15mm, poorly differentiated tumour budding, focal extramural venous invasion.
- radial clearance 5mm, distal clearance 12mm.
Lymph nodes: 0/36; thirty-six benign lymph nodes.
TNM class, AJCC stage (7th): pT3N0 cM0, stage IIA, R0
Polyp, upper rectum: Tubulovillous adenoma, 8mm.
2. Distal donut: No evidence of malignancy"
  }
}