[1051]
POG/CCG Neuroblastoma Surgery Check List
From [www.childrensoncologygroup.org] Last viewed: 13.07.2004
POG/CCG
Neuroblastoma Surgery Check List
PATIENT’S NAME:
HOSPITAL #: __
Last, First, M.I.
INSTITUTION: _
N
B
1
0
(1-4)
POG #
Study #
Office
Disease Type
Accession #
(5-10)
(11-14)
1
(15)
3
(16)
(17-20)
Directions:
• It is the responsibility of the attending surgeon to dictate an operative note that includes essential information
specified in the protocol and to complete the surgery check list promptly after the operation.
• It is the responsibility of the local POG/CCG surgery co-principal investigator to review the operative note and
surgery check list to assure accuracy and completeness and to sign the surgery check list.
• If there is any question concerning the consistency of data reported on the surgery check list and on the patient
...
[1052]
The COG Users Guide for Neuroblastoma Specimens
From [www.childrensoncologygroup.org] Last viewed: 13.07.2004
REV. 3/2/01
NBL USERS’ GUIDE
The COG Users’ Guide for Neuroblastoma Specimens -
How to Register, Submit/Route Specimens, and Communicate Test Results Using
the RDE
This guide is intended to be used as a supplement to the protocols; it does not replace any
biologic or therapeutic protocol. There are many new procedures for specimen shipping
and communication of test results. We hope this guide will help COG members get used
to the changes. The responsibilities and procedures of the institutions (mainly CRAs), the
reference laboratories, the NBL Tumor Bank, the NBL Tracking Center, and the COG
Data Center are presented, step-by-step. The “step” numbers indicate the approximate
chronological ordering of the process; however, some steps may occur concurrently with
others.
This guide covers registration and all or part of the specimen submission for the
following protocols:
• ANBL00B1 (biology ...
[1053]
PEDIATRIC ONCOLOGY GROUP Neuroblastoma Prestudy Form
From [www.childrensoncologygroup.org] Last viewed: 13.07.2004
PEDIATRIC ONCOLOGY GROUP
Neuroblastoma Prestudy Form
NAME: _
HOSPITAL #: _
Last, First, M.I.
PRINCIPAL INVESTIGATOR: _
INSTITUTION:
Form Key
POG #
Study #
Office
Disease Type
Accession #
N
L
1
0
(1-4)
(5-10)
(11-14)
1
(15)
3
(16)
(17-20)
TREATMENT NUMBER: __
SIGNIFICANT OTHER DISEASE AT TIME OF DIAGNOSIS (Describe): _
__
_
SYMPTOMS
ENTER: 0 = NO, 1 = YES, U = Unknown
(21)
Coagulopathy
(22)
GI obstruction
(23)
IVC compression with renal/bowel ischemia
(24)
GU obstruction
(25)
Respiratory distress
Neurological Symptoms:
(26)
Due to spinal cord compression
(27)
Opsoclonus
/
Myoclonus
(28)
Other Neurological Symptoms
...
[1054]
4.1.3.6 4.1.3 Disease Committee 11/01 3 Neuroblastoma Committee EC ...
From [www.childrensoncologygroup.org] Last viewed: 13.07.2004
Policy
4.1.3.6
Section
4.1.3
Disease
Committee
Completion
Date
11/01
Pages
3
Subject
Neuroblastoma Committee
Approved by
EC 5/02
I Objectives
• The overall goal of the Neuroblastoma Committee is to achieve maximal cure rates for
patients with neuroblastoma through a better understanding of tumor biology and the
development of rational, risk-based therapeutic strategies.
• The Neuroblastoma Committee will improve the understanding of neuroblastoma biology
and refine the COG Neuroblastoma Risk Classification System by defining molecular and
biologic correlates of neuroblastoma clinical course and response to therapy.
• The Neuroblastoma Committee will facilitate the development of new therapeutic strategies
for high-risk neuroblastoma ...
[1055]
PEDIATRIC ONCOLOGY GROUP Neuroblastoma Off Study Summary/Relapse ...
From [www.childrensoncologygroup.org] Last viewed: 13.07.2004
PEDIATRIC ONCOLOGY GROUP
Neuroblastoma Off Study Summary/Relapse Report
NAME: __
HOSPITAL #: __
Last, First, M.I.
TREATING PHYSICIAN:
INSTITUTION: _
Form Key
POG #
Study #
Office
Disease Type:
Accession #
N O
1
0
(1-4)
(5-10)
(11-14)
1
(15)
3
(16)
(17-20)
Date On Therapy: _/_/_ Date Off Therapy: _/_/_
Basis of Assessment of Best Response
Date of
Specify Site of Response
Response*
Best Response
Physical Exam
_
_/_/_
CT or NMR
_
_/_/_
Other imaging
_
_/_/_
Lab
_
_/_/_
Surgery
_
_/_/_
Aspirate/biopsy
_
_/_/_
Other
_
_/_/_
Subjective
_
_/_/_
*Use these codes for assessment of best
response:
...
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