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GYN-Endometrium.html
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GYN-Endometrium.html
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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<title>Endometrium cancers</title>
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<style>
table, th, td {
border: 1px solid silver;
border-collapse: collapse;
padding: 4px;
}
</style>
</head>
<body>
<img id="top" src="top.png" alt="">
<div id="form_container">
<div class="form_description">
<h2><a href=".\cap\Cancer-Protocols-2023-12-Update\Gynecologic Protocol Folder\Uterus_5.0.0.0.REL_CAPCP.pdf" target="_blank">
<div class="tooltip">Carcinoma and carcinosarcoma of the endometrium
<span class="tooltiptext">click to access explanations in the original CAP template</span>
</div>
</a></h2>
</div>
<form>
<!--
<p>
<fieldset style="border-color:#e6e6ff;">
<legend><label class="description">Gross descriptions:</label></legend>
<p><label class="description">- Procedure:</label>
<input class="element checkbox" type="checkbox" id="A01" value=" - Total hysterectomy and bilateral salpingo-oophorectomy"><label >Total hysterectomy and bilateral salpingo-oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A02" value=" - Radical hysterectomy"><label >Radical hysterectomy</label><br>
<input class="element checkbox" type="checkbox" id="A03" value=" - Simple hysterectomy"><label >Simple hysterectomy</label><br>
<input class="element checkbox" type="checkbox" id="A04" value=" - Supracervical hysterectomy"><label >Supracervical hysterectomy</label><br>
<input class="element checkbox" type="checkbox" id="A05" value=" - Bilateral salpingo-oophorectomy"><label >Bilateral salpingo-oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A06" value=" - Right salpingo-oophorectomy"><label >Right salpingo-oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A07" value=" - Left salpingo-oophorectomy"><label >Left salpingo-oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A08" value=" - Salpingo-oophorectomy, side not specified"><label >Salpingo-oophorectomy, side not specified</label><br>
<input class="element checkbox" type="checkbox" id="A09" value=" - Right oophorectomy"><label >Right oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A10" value=" - Left oophorectomy"><label >Left oophorectomy</label><br>
<input class="element checkbox" type="checkbox" id="A11" value=" - Oophorectomy, side not specified"><label >Oophorectomy, side not specified</label><br>
<input class="element checkbox" type="checkbox" id="A12" value=" - Bilateral salpingectomy"><label >Bilateral salpingectomy</label><br>
<input class="element checkbox" type="checkbox" id="A13" value=" - Right salpingectomy"><label >Right salpingectomy</label><br>
<input class="element checkbox" type="checkbox" id="A14" value=" - Left salpingectomy"><label >Left salpingectomy</label><br>
<input class="element checkbox" type="checkbox" id="A15" value=" - Salpingectomy, side not specified"><label >Salpingectomy, side not specified</label><br>
<input class="element checkbox" type="checkbox" id="A16" value=" - Omentectomy"><label >Omentectomy</label><br>
<input class="element checkbox" type="checkbox" id="A17" value=" - Peritoneal biopsies"><label >Peritoneal biopsies</label><br>
<input class="element checkbox" type="checkbox" id="A18" value=" - Peritoneal washing"><label >Peritoneal washing</label><br>
<input class="element checkbox" type="checkbox" id="A19" value=" - Other (specify):"><label >Other (specify):</label><br>
</p>
<p>
<label class="description">- Hysterectomy type:</label>
<select class="element select medium" ID="A20">
<option value=""></option>
<option value=" - Abdominal">Abdominal</option>
<option value=" - Vaginal">Vaginal</option>
<option value=" - Vaginal, laparoscopic-assisted">Vaginal, laparoscopic-assisted</option>
<option value=" - Laparoscopic">Laparoscopic</option>
<option value=" - Laparoscopic, robotic-assisted">Laparoscopic, robotic-assisted</option>
<option value=" - Other (specify):">Other (specify):</option>
<option value=" - Not specified">Not specified</option>
</select>
</p>
<p>
<label class="description">- Specimen integrity:</label>
<select class="element select medium" ID="A21">
<option value=""></option>
<option value=" - Intact">Intact</option>
<option value=" - Opened">Opened</option>
<option value=" - Morcellated">Morcellated</option>
<option value=" - Other (specify):">Other (specify):</option>
</select>
</p>
<p><label class="description">- Tumor site:</label>
<input class="element checkbox" type="checkbox" id="A22" value=" - Endometrium"><label >Endometrium</label><br>
<input class="element checkbox" type="checkbox" id="A23" value=" - Lower uterine segment"><label >Lower uterine segment</label><br>
<input class="element checkbox" type="checkbox" id="A24" value=" - Endometrial polyp"><label >Endometrial polyp</label><br>
<input class="element checkbox" type="checkbox" id="A25" value=" - Cannot be determined"><label >Cannot be determined</label><br>
<input class="element checkbox" type="checkbox" id="A26" value=" - Other (specify):"><label >Other (specify):</label><br>
</p>
<p>
<label class="description">- Tumor size:</label>
<select class="element select medium" ID="A27">
<option value=""></option>
<option value=" - Greatest dimension (mm): ">Greatest dimension (mm): </option>
<option value=" - All dimensions (mm x mm x mm): ">All dimensions (mm x mm x mm):</option>
<option value=" - Cannot be determined (explain): ">Cannot be determined (explain):</option>
</select>
</p>
<br>
</fieldset>
</p>
-->
<p>
<fieldset style="border-color:#e6e6ff;">
<legend><label class="description">Microscopic descriptions:</label></legend>
<p>
<label class="description">- Tumor histology and immunohistochemical studies: </label>
<textarea ID="A28" class="element textarea medium"></textarea>
</p>
<p>
<table border="1">
<col width="50%">
<tr>
<td>
<label class="description">- <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=16" target="_blank">Histologic type (WHO 5e)</a>:</label>
</td>
<td>
<select class="element select large" ID="A29">
<option value=""></option>
<option value="Endometrioid carcinoma, NOS">Endometrioid carcinoma, NOS</option>
<option value="Endometrioid carcinoma, POLE-ultramutated endometrioid carcinoma">Endometrioid carcinoma, POLE-ultramutated endometrioid carcinoma</option>
<option value="Endometrioid carcinoma, Mismatch repair–deficient endometrioid carcinoma">Endometrioid carcinoma, Mismatch repair–deficient endometrioid carcinoma</option>
<option value="Endometrioid carcinoma, p53-mutant endometrioid carcinoma">Endometrioid carcinoma, p53-mutant endometrioid carcinoma</option>
<option value="Endometrioid carcinoma, no specific molecular profile (NSMP) endometrioid carcinoma">Endometrioid carcinoma, no specific molecular profile (NSMP) endometrioid carcinoma</option>
<option value="Serous endometrial intraepithelial carcinoma">Serous endometrial intraepithelial carcinoma</option>
<option value="Serous carcinoma">Serous carcinoma</option>
<option value="Carcinosarcoma (malignant mixed Mullerian tumor)">Carcinosarcoma (malignant mixed Mullerian tumor)</option>
<option value="Mucinous carcinoma, intestinal type">Mucinous carcinoma, intestinal type</option>
<option value="Clear cell carcinoma">Clear cell carcinoma</option>
<option value="Small cell neuroendocrine carcinoma">Small cell neuroendocrine carcinoma</option>
<option value="Large cell neuroendocrine carcinoma">Large cell neuroendocrine carcinoma</option>
<option value="Mixed cell carcinoma (specify types and percentages):">Mixed cell carcinoma (specify types and percentages):</option>
<option value="Dedifferentiated carcinoma">Dedifferentiated carcinoma</option>
<option value="Undifferentiated carcinoma, NOS">Undifferentiated carcinoma, NOS</option>
<option value="Mesonephric adenocarcinoma">Mesonephric adenocarcinoma</option>
<option value="Squamous cell carcinoma, NOS">Squamous cell carcinoma, NOS</option>
<option value="Mesonephric-like adenocarcinoma">Mesonephric-like adenocarcinoma</option>
<option value="Other (specify):">Other (specify):</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=18" target="_blank">Histologic grade</a>:</label>
</td>
<td>
<select class="element select large" ID="A30">
<option value=""></option>
<option value="FIGO grade 1">FIGO grade 1</option>
<option value="FIGO grade 2">FIGO grade 2</option>
<option value="FIGO grade 3">FIGO grade 3</option>
<option value="Other (specify):">Other (specify):</option>
<option value="Cannot be assessed">Cannot be assessed</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="">+ <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=18" target="_blank">Two-Tier Grading System</a>:</label>
</td>
<td>
<select class="element select large" ID="A91">
<option value=""></option>
<option value="Low grade (encompassing FIGO 1 and 2)">Low grade (encompassing FIGO 1 and 2)</option>
<option value="High grade (FIGO 3)">High grade (FIGO 3)</option>
<option value="Other (specify):">Other (specify):</option>
<option value="Cannot be assessed">Cannot be assessed</option>
</select>
</td>
</tr>
<tr>
<td rowspan="4" valign="top">
<label class="description">- <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=19" target="_blank">Myometrial invasion</a>:</label>
</td>
<td>
<select class="element select large" ID="A31">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Estimated less than 50% myometrial invasion">Estimated less than 50% myometrial invasion</option>
<option value="Estimated 50% or greater myometrial invasion">Estimated 50% or greater myometrial invasion</option>
<option value="Cannot be assessed (explain):">Cannot be assessed (explain):</option>
</select>
</td>
</tr>
<tr>
<td align="right">- Depth of invasion (mm):
<input type="text" ID="A32" class="element text small" ></td>
</tr>
<tr>
<td align="right">- Myometrial thickness (mm):
<input type="text" ID="A33" class="element text small" ></td>
</tr>
<tr>
<td align="right">- Myometrial invasion (%):
<input type="text" ID="A34" class="element text small" ></td>
</tr>
<tr>
<td>
<label > + Adenomyosis: </label>
</td>
<td>
<select class="element select large" ID="A35">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present, uninvolved by tumor">Present, uninvolved by tumor</option>
<option value="Present, involved by tumor">Present, involved by tumor</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Uterine serosa involvement: </label>
</td>
<td>
<select class="element select large" ID="A36">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present">Present</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td>
<label >- + <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=20" target="_blank">Lower uterine segment involvement</a>: </label>
</td>
<td>
<select class="element select large" ID="A37">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present, superficial (non-invasive)">Present, superficial (non-invasive)</option>
<option value="Present, myoinvasion">Present, myoinvasion</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td valign="top" rowspan="3">
<label class="description">- <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=20" target="_blank">Cervical stromal involvement</a>: </label>
</td>
<td>
<select class="element select large" ID="A38">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present">Present</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td align="right">
<label class="">+ Depth of Cervical Stroma Invasion:</label>
<input type="text" class="element text small" ID="A92" size="10">
</td>
</tr>
<tr>
<td align="right">
<label class="">+ Cervical Stroma Thickness:</label>
<input type="text" class="element text small" ID="A93" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- <a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=21" target="_blank">Lymphatic and / or vascular invasion</a>: </label>
</td>
<td>
<select class="element select large" ID="A59">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present">Present</option>
<option value="Present, Focal (less than 5 vessel involvement) (specify location, if possible):">Present, Focal (less than 5 vessel involvement) (specify location, if possible)</option>
<option value="Present, Extensive / substantial (greater than or equal to 5 vessel involvement) (specify location, if
possible):">Present, Extensive / substantial (greater than or equal to 5 vessel involvement) (specify location, if
possible):</option>
<option value="Equivocal (explain):">Equivocal (explain):</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td>
<label > + Perineural invasion: </label>
</td>
<td>
<select class="element select large" ID="A60">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present">Present</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td>
<label > + <a href=".\cap\Cancer-Protocols-2023-12-Update\Gynecologic Protocol Folder\Uterus_5.0.0.0.REL_CAPCP.pdf#page=22" target="_blank">Peritoneal/ascitic fluid (TIS)</a>: </label>
</td>
<td>
<select class="element select large" ID="A61">
<option value=""></option>
<option value="Not submitted/ unknown">Not submitted/ unknown</option>
<option value="Negative for malignancy (NFM)">Negative for malignancy (NFM)</option>
<option value="Atypia of undetermined significance (AUS) (explain):">Atypia of undetermined significance (AUS)(explain):</option>
<option value="Suspicious for malignancy (SFM) (explain):">Suspicious for malignancy (SFM) (explain):</option>
<option value="Malignant (MAL)">Malignant (MAL)</option>
<option value="Cannot be determined:">Cannot be determined:</option>
<option value="Results pending">Results pending</option>
</select>
</td>
</tr>
</table>
</p>
<p>
<label class="description">- Other tissue/ organ involvement:</label>
<input class="element checkbox" type="checkbox" id="A39" value=" - Not applicable"><label class="choice">Not applicable</label>
<input class="element checkbox" type="checkbox" id="A40" value=" - Not identified"><label class="choice" >Not identified</label>
<input class="element checkbox" type="checkbox" id="A41" value=" - Right ovary"><label class="choice">Right ovary</label>
<input class="element checkbox" type="checkbox" id="A42" value=" - Left ovary"><label class="choice">Left ovary</label>
<input class="element checkbox" type="checkbox" id="A43" value=" - Ovary (side not specified)"><label class="choice">Ovary (side not specified)</label>
<input class="element checkbox" type="checkbox" id="A44" value=" - Right fallopian tube"><label class="choice">Right fallopian tube</label>
<input class="element checkbox" type="checkbox" id="A45" value=" - Left fallopian tube"><label class="choice">Left fallopian tube</label>
<input class="element checkbox" type="checkbox" id="A46" value=" - Fallopian tube (side not specified)"><label class="choice">Fallopian tube (side not specified)</label>
<input class="element checkbox" type="checkbox" id="A47" value=" - Vagina"><label class="choice">Vagina</label>
<input class="element checkbox" type="checkbox" id="A48" value=" - Right parametrium"><label class="choice">Right parametrium</label>
<input class="element checkbox" type="checkbox" id="A49" value=" - Left parametrium"><label class="choice">Left parametrium</label>
<input class="element checkbox" type="checkbox" id="A50" value=" - Parametrium (side not specified)"><label class="choice">Parametrium (side not specified)</label>
<input class="element checkbox" type="checkbox" id="A51" value=" - Pelvic wall"><label class="choice">Pelvic wall</label>
<input class="element checkbox" type="checkbox" id="A52" value=" - Bladder wall"><label class="choice">Bladder wall</label>
<input class="element checkbox" type="checkbox" id="A53" value=" - Bladder mucosa"><label class="choice">Bladder mucosa</label>
<input class="element checkbox" type="checkbox" id="A54" value=" - Rectal wall"><label class="choice">Rectal wall</label>
<input class="element checkbox" type="checkbox" id="A55" value=" - Bowel mucosa"><label class="choice">Bowel mucosa</label>
<input class="element checkbox" type="checkbox" id="A56" value=" - Omentum"><label class="choice">Omentum</label>
<input class="element checkbox" type="checkbox" id="A57" value=" - Other organs/tissue (specify):"><label class="choice">Other organs/tissue (specify):</label>
<input class="element checkbox" type="checkbox" id="A58" value=" - Cannot be determined (explain):"><label class="choice">Cannot be determined (explain):</label>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend><label class="description"><a href=".\cap\Cancer-Protocols-2022-12-Update\Gynecologic Protocol Folder\Uterus_4.4.0.0.REL_CAPCP.pdf#page=21" target="_blank">Surgical margins of excision specimen</a>: </label></legend>
<p>
<table border="1">
<col width="40%">
<tr>
<td>
<label class="description">- Ectocervical/vaginal cuff margin:</label>
</td>
<td>
<select class="element select large" ID="A62">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by carcinoma, specify location and closest distance:">Uninvolved by invasive carcinoma, specify location and closest distance:</option>
<option value="Involved by carcinioma">Involved by carcinioma</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Parametrial/paracervical margin:</label>
</td>
<td>
<select class="element select large" ID="A63">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by carcinoma, specify location and closest distance:">Uninvolved by invasive carcinoma, specify location and closest distance:</option>
<option value="Involved by carcinioma">Involved by carcinioma</option>
</select>
</td>
</tr>
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label class="description"> Pelvic lymph nodes: </label></legend>
<p>
<table border="1">
<col width="80%">
<tr>
<td>
<label class="description">- Number of lymph nodes examined:</label>
</td>
<td>
<input type="text" class="element text large" ID="A64" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Number of lymph nodes with macrometastasis (> 2 mm):</label>
</td>
<td>
<input type="text" class="element text large" ID="A65" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Number of lymph nodes with micrometastasis (> 0.2 to 2 mm):</label>
</td>
<td>
<input type="text" class="element text large" ID="A66" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Number of lymph nodes with isolated tumor cells (< or = 0.2 mm):</label>
</td>
<td>
<input type="text" class="element text large" ID="A67" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Laterality of lymph nodes with tumor cells: </label>
</td>
<td>
<select class="element select large" ID="A68">
<option value=""></option>
<option value="Right">Right</option>
<option value="Left">Left</option>
<option value="Bilateral">Bilateral</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Size of largest metastatic deposit (mm), specify site:</label>
</td>
<td>
<input type="text" class="element text large" ID="A69" size="20">
</td>
</tr>
<tr>
<td>
<label class="description">- Size of largest lymph node involved (mm), specify site:</label>
</td>
<td>
<input type="text" class="element text large" ID="A70" size="20">
</td>
</tr>
<tr>
<td>
<label class="description">- Extranodal extension:</label>
</td>
<td>
<select class="element select large" ID="A89">
<option value=""></option>
<option value="Not identified">Not identified</option>
<option value="Present">Present</option>
<option value="Cannot be determined">Cannot be determined</option>
</select>
</td>
</tr>
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label class="description"> Para-aortic lymph nodes: </label></legend>
<p>
<table border="1">
<col width="80%">
<tr>
<td>
<label class="description">- Number of lymph nodes examined:</label>
</td>
<td>