Canadian Sarcoma Clinical and Research Collaboration - Canadian Sarcoma Cancer and Research

Hospital ID 1ConsentConsent obtained byDeceasedCause of Death
Hospital ID 2Date consent obtainedIs the consent for on file?Date of death

Pathological DiagnosisPrimary site of disease
Initial PresentationDate of presentation
Date of DiagnosisDate of Birth
Age at DiagnosisPresentation Status at Sarcoma Centre
Metastatic disease at diagnosis?Tumor size dimensions (cm)
Tumor size CategoricalTumor Orientation
Predisposing FactorsWas the tumor incidentally found?
Primary disease treated at sarcoma centre and recurredPatient enrolled in QOL
Other cancer diagnosis?

Y/NRelationship to patient
Type of SarcomaDate of Diagnosis (DD-MM-YYYY)
Age at DiagnosisOther type of cancer

Y/NStart Date (DD-MM-YYYY)
End Date (DD-MM-YYYY)Radiation Type
Radiation SiteRadiation Dose
Number of Fractions

Y/NLine of Therapy
Start Date (DD-MM-YYYY)End Date (DD-MM-YYYY)
Number of Cycles ReceivedDrug Received
Reason for Treatment Discontinuation

Y/NDate of Surgery
InstitutionSurgeon
Type of ResectionProcedure

Biopsy date (DD-MMM-YYYY)Specimen Number
Biopsy InstitutionType of Biopsy
Pathological DiagnosisGrade at bx
Mitoses numeratorMitoses denominator

(if ER/PR) Test Results(if c-KIT) Exon Mutation
(if mdm2) Test ResultsTranslocation
(if PDGFRa) Exon MutationDescribe mutation/translocation (free text)

Surgery Date (DD-MM-YYYY)Name of Surgeon
Location of SurgeryType of Surgery
Status of SurgeryIf Emergency, indication
Intent of SurgeryDeep vs superficial
Type of ResectionType of Plastic Reconstruction
Type of Urologic ReconstructionVascular Reconstruction
Type of SurgeryComplications
Was Surgical Mesh Used?Was Ablation used?
Tumour Site

Date of the surgical path report (DD-MM-YYYY)Number on Path Report (SP- or S-)
Margin statusPercent Necrosis
Dimensions of tumor (cm) (Size 1, Size 2, Size 3)Tumor Orientation (Size 1, Size 2, Size 3)
Tumor size categoricalMitotic rate numerator
Mitotic rate denominator

Start Date (DD-MM-YYYY)End Date (DD-MM-YYYY)
Radiation TypeRadiation Site
Radiation IndicationRadiation Response
Radiation Dose (Gy)Number of Fractions
Was radiation interrupted?What was the reason for treatment interruption
Did the patient experience toxicity(ies) to treatment?Pre-RT tumour dimensions
Post-RT tumour dimensions

Start DateEnd Date
On Treatment (single check box)Line of Therapy
Indication for ChemoPatient BSA at chemo start
Number of cycles receivedDrug Received
- What was the dose of (drug name)- If other, please specify (drug name) dose
- Cumulative dose of (drug name)Date of first evaluation on treatment
Date of evaluation of end of treatmentBest response to chemotherapy
Reason for Treatment DiscontinuationIs patient part of a clinical trial? (If yes see fields below)
Trial NumberDate on Study
Type of Study

Date of Follow up (DD-MM-YYYY)Status of Patient
Visit StatusDisease Event (Recurrence/Progression)

Date of Imaging Study (DD-MM-YYYY)Reason for imaging
Modality of imagingSite
Finding of imagingMultifocal
Dimensions of TumorTumor Orientation (Size 1, Size 2, Size 3)
Tumor Orientation (Size 1, Size 2, Size 3)Categorical dimensions of tumor
Other Details

Type of SampleDate of Collection (DD-MM-YYY)
What is the OCGN Number assigned?What is the biospecimen number of the sample?
Location of the sample

Data Fields Request