ࡱ> U Vbjbjnn aax P&P&P&P&P&d&d&d&8&0'd&Z ( ((4(4(4(Z+p+$+(******$aTNP&,++@,,NP&P&4(4(c\N/N/N/,P&4(P&4(PN/,(N/N/&~4(߳Oj-.d<HkJ.Xk^kP&D,,N/,,,,,NN.,,,,,,,k,,,,,,,,,B %: Appendix C Reporting proforma for testicular cancer (orchidectomy) Surname.. Forenames Date of birth. Sex.. Hospital... Hospital no....... NHS/CHI no.... Date of surgery... Date of report authorisation. Report number.... Date of receipt. Pathologist................ Surgeon Nature of specimen/procedure and core macroscopic items Biopsy ( Radical orchidectomy ( Partial orchidectomy ( Laterality: Right (( Left ( Tumour location .... Tumour description ..................... Macroscopic tunica vaginalis invasion:Present (Not identified (Cannot be assessed (Cord invasion:Present (Not identified ( Cannot be assessed (Tumour focality:Multifocal (Unifocal (Indeterminate ( Cannot be assessed ( Maximum tumour size if assessable: .. (mm) Core microscopic items Tumour typing state percentage of each tumour element present Tumour type(s) (one or more) Germ cell tumour%Other%SeminomaLeydig cell tumourEmbryonal carcinomaSertoli cell tumourYolk sac tumour, post-pubertal typeSpermatocytic tumourChoriocarcinomaTeratoma, pre-pubertal type Teratoma, post-pubertal typeTeratoma, pre-pubertal type (dermoid cyst)Scar/necrosis/non-viable germ cell tumourTeratoma, pre-pubertal type (epidermoid cyst)Regressed germ cell tumourYolk sac tumour, pre-pubertal typeTeratoma with somatic type malignancy2. Tumour parameters Maximum tumour dimension (if not assessed macroscopically): .................. mm Lymphovascular invasion (score equivocal foci as negative, i.e. not identified): Present ( Not identified ( Cannot be assessed ( If lymphovascular invasion present, state which element is showing lymphovascular invasion: Embryonal carcinoma ( Yolk sac tumour ( Choriocarcinoma ( Teratoma ( Seminoma ( Cannot be assessed ( Rete testis stroma invasion: Present ( Not identified ( Cannot be assessed ( Hilar soft tissue invasion (pT2): Present ( Not identified ( Cannot be assessed ( Direct spermatic cord invasion (pT3): Present ( Not identified ( Cannot be assessed ( Separate soft tissue deposit in the spermatic cord: Present ( Not identified ( Cannot be assessed ( Microscopic tunica vaginalis invasion: Present ( Not identified ( Cannot be assessed ( Epididymis invasion: Present ( Not identified ( Cannot be assessed ( GCNIS identified: Present ( Not identified ( Cannot be assessed ( Spermatic cord margin status (radical orchidectomy only) Involved ( Not involved ( Uncertain ( Not applicable ( Margin status (partial orchidectomy only): Involved ( Not involved ( Uncertain ( Not applicable ( If not involved, distance to margin ........mm Tumour viability (post-chemotherapy only): Viable ( Non- or semi-viable ( pT stage: ............ (TNM 8) SNOMED codes: T.. M. T.. M. Signature of pathologist Date .. Data items that are used in version 1.0 of the ICCR Neoplasia of the Testis Orchidectomy dataset. Data items that are currently part of the Cancer Outcomes and Services Dataset (COSD) version 9.     CEff 130520  PAGE \* MERGEFORMAT 2 V4 Final CEff 130520  PAGE \* MERGEFORMAT 1 V4 Final   BCSUgh{}  * + / : P Q _ ` a ˽˽ֲooo! jhqhlOJQJ\^JhlOJQJ^JhqOJQJ^Jhd?hI CJaJhNCJaJhbxOJQJ\^Jh7OJQJ\^Jhqh]cOJQJ\^Jh]cOJQJ\^JhqhnmtOJQJ\^JhqhL0OJQJ\^J hqhn~ hqhL0'CD ` a xx$ $ S$If]a$gdd? $gdd? $gdd?$ $  yU"d&d P a$gdPu$ $  yU"da$gdd? $  yp#d]gdd?$ $d]a$gdd?  $ gdd?           ! 1 2 7 < A H S T Z k m p άΞΞzzl^z^Ph\h6+[OJQJ\^JhqhqOJQJ\^Jhqh5OJQJ\^Jh$OJQJ\^JhqhL0OJQJ\^Jh6+[OJQJ\^Jhqh6+[OJQJ\^J! jhqh6+[OJQJ\^J! jhqhlOJQJ\^J'hqh6+[OJQJ\^JaJmH sH !hlOJQJ\^JaJmH sH hqhlOJQJ^J       $ $d$Ifa$gdd? $ $$Ifa$gdd?$ $Wd$If]^W`a$gdd? ! 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