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Endocrine-Colon-NET.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>Colorectal NET</title>
<link rel="stylesheet" type="text/css" href="view.css" media="all">
<script type="text/javascript" src="view.js"></script>
<script>
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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\Endocrine Protocol Folder\ColoRectal.NET_5.0.0.0.REL_CAPCP.pdf" target="_blank">
<div class="tooltip">
Colorectal neuroendocrine tumor
<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>
<table border="1">
<col width="40%">
<tr>
<td>
<label class="description">- Procedure:</label>
</td>
<td>
<select class="element select large" ID="A01">
<option value=""></option>
<option value="Right hemicolectomy">Right hemicolectomy</option>
<option value="Transverse colectomy"> Transverse colectomy</option>
<option value="Left hemicolectomy">Left hemicolectomy</option>
<option value="Sigmoidectomy">Sigmoidectomy</option>
<option value="Low anterior resection">Low anterior resection</option>
<option value="Total abdominal colectomy">Total abdominal colectomy</option>
<option value="Abdominoperineal resection">Abdominoperineal resection</option>
<option value="Transanal disk excision (local excision)">Transanal disk excision (local excision)</option>
<option value="Polypectomy">Polypectomy</option>
<option value="Other (specify):">Other (specify):</option>
<option value="Not specified">Not specified</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor site:</label>
</td>
<td>
<select class="element select large" ID="A02">
<option value=""></option>
<option value="Cecum">Cecum</option>
<option value="Right (ascending) colon">Right (ascending) colon</option>
<option value="Hepatic flexure">Hepatic flexure</option>
<option value="Transverse colon">Transverse colon</option>
<option value="Splenic flexure">Splenic flexure</option>
<option value="Left (descending) colon">Left (descending) colon</option>
<option value="Sigmoid colon">Sigmoid colon</option>
<option value="Rectosigmoid junction">Rectosigmoid junction</option>
<option value="Rectum">Rectum</option>
<option value="Ileocecal valve">Ileocecal valve</option>
<option value="Colon, not otherwise specified">Colon, not otherwise specified</option>
<option value="Cannot be determined (explain):">Cannot be determined (explain):</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor size:</label>
</td>
<td>
<select class="element select large" ID="A03">
<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>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor focality:</label>
</td>
<td>
<select class="element select large" ID="A35">
<option value=""></option>
<option value="Unifocal">Unifocal</option>
<option value="Multifocal (specify number of tumors):">Multifocal (specify number of tumors):</option>
<option value="Cannot be determined (explain):">Cannot be determined (explain):</option>
</select>
</td>
</tr>
</table>
</p>
</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="A04" name="A04" class="element textarea medium"></textarea>
</p>
<p>
<table border="1">
<col width="50%">
<tr>
<td valign="top" rowspan="3">
<label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\ColoRectal.NET_4.1.0.0.REL_CAPCP.pdf#page=9" target="_blank">Histologic type and grade (WHO 5e)</a>:</label>
Using 22 mm eyepiece at x40 objective, counting 42 fields = 10 mm<sup>2</sup>. Divide by 5 to get hot spot mitotic count of 2 mm<sup>2</sup>.
</td>
<td>
<select class="element select large" ID="A05">
<option value=""></option>
<option value="G1: Well-differentiated neuroendocrine tumor">G1: Well-differentiated neuroendocrine tumor (mitosis < 2, Ki67 < 3)</option>
<option value="G2: Well-differentiated neuroendocrine tumor">G2: Well-differentiated neuroendocrine tumor (mitosis 2-20, Ki67 3-20)</option>
<option value="G3: Well-differentiated neuroendocrine tumor">G3: Well-differentiated neuroendocrine tumor (mitosis > 20, Ki67 > 20)</option>
<option value="Other (specify):">Other (specify):</option>
<option value="GX: Grade cannot be assessed">GX: Grade cannot be assessed:</option>
<option value="Not applicable">Not applicable</option>
</select>
</td>
</tr>
<tr>
<td align="right">
<label>- <a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\ColoRectal.NET_4.1.0.0.REL_CAPCP.pdf#page=10" target="_blank">Mitotic rate</a>:</label>
<select class="element select medium" ID="A06">
<option value=""></option>
<option value="< 2 mitoses/2 mm2"> < 2 mitoses/2 mm2</option>
<option value="2 to 20 mitoses/2 mm2 (specify: )"> 2 to 20 mitoses/2 mm2 (specify: )</option>
<option value="> 20 mitoses per 2 mm2 (specify: )"> > 20 mitoses per 2 mm2 (specify: )</option>
<option value="Cannot be determined (explain):"> Cannot be determined (explain):</option>
<option value="Not applicable"> Not applicable</option>
</select>
</td>
</tr>
<tr>
<td align="right">
<label>- Ki-67 labeling index:</label>
<select class="element select medium" ID="A07">
<option value=""></option>
<option value="< 3%">< 3%</option>
<option value="3% to 20% (specify: )"> 3% to 20% (specify: )</option>
<option value="> 20% (specify: )"> > 20% (specify: )</option>
<option value="Cannot be determined (explain):"> Cannot be determined (explain):</option>
<option value="Not applicable"> Not applicable</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor size:</label>
</td>
<td>
<select class="element select large" ID="A03">
<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>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor focality:</label>
</td>
<td>
<select class="element select large" ID="A35">
<option value=""></option>
<option value="Unifocal">Unifocal</option>
<option value="Multifocal (specify number of tumors):">Multifocal (specify number of tumors):</option>
<option value="Cannot be determined (explain):">Cannot be determined (explain):</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Tumor extension:</label>
</td>
<td>
<select class="element select large" ID="A08">
<option value=""></option>
<option value="No evidence of primary tumor">No evidence of primary tumor</option>
<option value="Tumor invades the lamina propria">Tumor invades the lamina propria</option>
<option value="Tumor invades the submucosa">Tumor invades the submucosa</option>
<option value="Tumor invades the muscularis propria">Tumor invades the muscularis propria</option>
<option value="Tumor invades through the muscularis propria into subserosal tissue without penetration of overlying serosa">Tumor invades through the muscularis propria into subserosal tissue without penetration of overlying serosa</option>
<option value="Tumor perforates the visceral peritoneum (serosa)">Tumor perforates the visceral peritoneum (serosa)</option>
<option value="Tumor directly invades other organs or adjacent structures (specify):">Tumor directly invades other organs or adjacent structures (specify):</option>
<option value="Cannot be assessed">Cannot be assessed</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Lymphatic and / or Vascular Invasion: </label>
</td>
<td>
<select class="element select large" ID="A18">
<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 > + Perineural invasion: </label>
</td>
<td>
<select class="element select large" ID="A19">
<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">For transanal disk excision or polypectomy specimens:</legend>
<p>
<table border="1">
<col width="60%">
<tr>
<td>
<label class="description">- Deep margin:</label>
</td>
<td>
<select class="element select large" ID="A09">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Mucosal margin: </label>
</td>
<td>
<select class="element select large" ID="A10">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
- Other margin(s) (specify: ):
</td>
<td>
<select class="element select large" ID="A11">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend><label class="description"><a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\ColoRectal.NET_4.1.0.0.REL_CAPCP.pdf#page=12" target="_blank">For colectomy and rectal resection specimens:</a></label></legend>
<p>
<table border="1">
<col width="60%">
<tr>
<td>
<label class="description">- Proximal margin:</label>
</td>
<td>
<select class="element select large" ID="A13">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Distal margin:</label>
</td>
<td>
<select class="element select large" ID="A14">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description">- Radial or mesenteric margin:</label>
</td>
<td>
<select class="element select large" ID="A15">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
- Other margin(s) (specify: ):
</td>
<td>
<select class="element select large" ID="A16">
<option value=""></option>
<option value="Cannot be assessed">Cannot be assessed</option>
<option value="Uninvolved by tumor, specify distance (mm):">Uninvolved by tumor, specify distance (mm):</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label class="description"> Regional lymph nodes: </label></legend>
<p>
<table border="1">
<col width="75%">
<tr>
<td>
<label class="description">- Number of regional lymph nodes examined:</label>
</td>
<td>
<input type="text" class="element text large" ID="A20" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Number of lymph nodes involved:</label>
</td>
<td>
<input type="text" class="element text large" ID="A21" size="10">
</td>
</tr>
<tr>
<td>
<label > + Extranodal extension:</label>
</td>
<td>
<select class="element select large" ID="A22">
<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"> Distant Metastasis: </label></legend>
<input class="element checkbox" type="checkbox" id="A36" value=" - Not applicable"><label class="choice" >Not applicable</label>
<input class="element checkbox" type="checkbox" id="A37" value=" - Not identified"><label class="choice" >Not identified</label>
<input class="element checkbox" type="checkbox" id="A38" value=" - Non-regional lymph node(s) (specify):"><label class="choice" >Non-regional lymph node(s) (specify):</label>
<input class="element checkbox" type="checkbox" id="A39" value=" - Lung (specify):"><label class="choice" >Lung (specify):</label>
<input class="element checkbox" type="checkbox" id="A40" value=" - Liver (specify):"><label class="choice" >Liver (specify):</label>
<input class="element checkbox" type="checkbox" id="A41" value=" - Bone (specify):"><label class="choice" >Bone (specify):</label>
<input class="element checkbox" type="checkbox" id="A42" value=" - Peritoneum (specify):"><label class="choice" >Peritoneum (specify):</label>
<input class="element checkbox" type="checkbox" id="A43" value=" - Ovary (specify):"><label class="choice" >Ovary (specify):</label>
<input class="element checkbox" type="checkbox" id="A44" value=" - Other (specify):"><label class="choice" >Other (specify):</label>
<input class="element checkbox" type="checkbox" id="A45" value=" - Cannot be determined: "><label class="choice" >Cannot be determined: </label>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label class="description"> <a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\ColoRectal.NET_4.1.0.0.REL_CAPCP.pdf#page=12" target="_blank">Pathologic Stage Classification (AJCC 9e)</a>: </label></legend>
<p>
<table border="1">
<col width="40%">
<tr>
<td valign="top">
<label class="description"> - TNM Descriptors: </label>
</td>
<td>
<input class="element checkbox" type="checkbox" id="A23" value="m (multiple primary tumors)"><label class="choice">m (multiple primary tumors)</label>
<input class="element checkbox" type="checkbox" id="A24" value="r (recurrent)"><label class="choice">r (recurrent)</label>
<input class="element checkbox" type="checkbox" id="A25" value="y (post treatment)"><label class="choice">y (post treatment)</label>
</td>
</tr>
<tr>
<td>
<label class="description"> - Primary tumor (pT):</label>
</td>
<td>
<select class="element select large" ID="A26">
<option value=""></option>
<option value="pT not assigned (cannot be determined based on available pathological information)">pT not assigned (cannot be determined based on available pathological information)</option>
<option value="pT0: No evidence of primary tumor">pT0: No evidence of primary tumor</option>
<option value="pT1(subcategory cannot be determined)">pT1(subcategory cannot be determined)</option>
<option value="pT1a: Tumor =<1 cm in greatest dimension">pT1a: Tumor =<1 cm in greatest dimension</option>
<option value="pT1b: Tumor >1 to =>2 cm in greatest dimension">pT1b: Tumor >1 to -=>2 cm in greatest dimension</option>
<option value="pT2: Tumor invades the muscularis propria or is >2 cm with invasion of the lamina propria or submucosa">pT2: Tumor invades the muscularis propria or is >2 cm with invasion of the lamina propria or submucosa</option>
<option value="pT3: Tumor invades through the muscularis propria into subserosal tissue without penetration of overlying serosa">pT3: Tumor invades through the muscularis propria into subserosal tissue without penetration of overlying serosa</option>
<option value="pT4: Tumor invades visceral peritoneum (serosa) or other organs or other adjacent structures">pT4: Tumor invades visceral peritoneum (serosa) or other organs or other adjacent structures</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description"> - Regional lymph nodes (pN): </label>
</td>
<td>
<select class="element select large" ID="A27">
<option value=""></option>
<option value="pN not assigned (no nodes submitted or found)">pN not assigned (no nodes submitted or found)</option>
<option value="pN not assigned (cannot be determined based on available pathological information)">pN not assigned (cannot be determined based on available pathological information)</option>
<option value="pN0: No regional lymph node metastasis">pN0: No regional lymph node metastasis</option>
<option value="pN1: Regional lymph node metastasis">pN1: Regional lymph node metastasis</option>
</select>
</td>
</tr>
<tr>
<td>
<label class="description"> - Distant metastasis (pM): </label>
</td>
<td>
<select class="element select large" ID="A28">
<option value=""></option>
<option value="Not applicable - pM cannot be determined from the submitted specimen(s)">Not applicable - pM cannot be determined from the submitted specimen(s)</option>
<option value="pM1(subcategory cannot be determined)">pM1(subcategory cannot be determined)</option>
<option value="pM1a: Microscopic confirmation of metastasis confined to liver">pM1a: Microscopic confirmation of metastasis confined to liver</option>
<option value="pM1b: Microscopic confirmation of metastasis in at least one extrahepatic site">pM1b: Microscopic confirmation of metastasis in at least one extrahepatic site</option>
<option value="pM1c: Microscopic confirmation of both hepatic and extrahepatic metastases">pM1c: Microscopic confirmation of both hepatic and extrahepatic metastases</option>
</select>
</td>
</tr>
<!--
<tr>
<td>
- Specify site(s), if known:
<input type="text" name="A29" class="element text small" ID="A29" size="35">
</td>
</tr>
-->
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label > + Additional pathologic findings: </label></legend>
<p>
<input class="element checkbox" type="checkbox" id="A31" value="Tumor necrosis"><label class="choice">Tumor necrosis</label>
</p>
<p>
- Other (specify):
<input type="text" name="A32" class="element text small" ID="A32" size="35">
</p>
<br>
</fieldset>
<p>
<label class="description">- Additional notes:</label>
<textarea ID="A34" name="A34" class = "element textarea medium" style="border-color:Grey;"></textarea>
</p>
<br><br>
<input type="button" name="copyform" value="Check your Report" onclick="updateDescription(this.form)"/>
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Last upated on 19-Dec-2023,<br>
based on <a href="https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates" target="_blank">US CAP cancer protocol templates</a>.<br>
ColonRectum NET 5.0.0.0 (Dec 2023), <br>
html form was created on <a href="https://www.phpform.org">pForm</a>, <a href="https://www.w3schools.com/">W3 School</a>, <a href="https://stackoverflow.com/">StackOverflow</a>, and <a href="https://icons8.com">Icons8</a>.<br><br>
Anatomical Pathology Division, Queen Mary Hospital, Hong Kong.
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