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Endocrine-Stomach-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>Stomach 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;
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</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\Stomach.NET_5.0.0.0.REL_CAPCP.pdf" target="_blank">
Stomach neuroendocrine tumor</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="Endoscopic resection">Endoscopic resection</option>
<option value="Partial gastrectomy, proximal">Partial gastrectomy, proximal</option>
<option value="Partial gastrectomy, distal">Partial gastrectomy, distal</option>
<option value="Partial gastrectomy, other (specify):">Partial gastrectomy, other (specify):</option>
<option value="Total gastrectomy">Total gastrectomy</option>
<option value="Other (specify):">Other (specify):</option>
<option value="Cannot be determined (explain):">Cannot be determined (explain):</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="Gastric cardia/fundus">Gastric cardia/fundus</option>
<option value="Gastric body">Gastric body</option>
<option value="Gastric antrum">Gastric antrum</option>
<option value="Gastric pylorus">Gastric pylorus</option>
<option value="Stomach, not otherwise specified">Stomach, not otherwise specified</option>
<option value="Other (specify):">Other (specify):</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\Stomach.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\Stomach.NET_4.1.0.0.REL_CAPCP.pdf#page=10" target="_blank">Mitotic count</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>- <a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\Stomach.NET_4.1.0.0.REL_CAPCP.pdf#page=11" target="_blank">Ki-67 labeling index</a>:</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">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Endocrine-Protocol-Folder\Stomach.NET_4.1.0.0.REL_CAPCP.pdf#page=12" target="_blank">Tumor size</a>:</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 penetrates visceral peritoneum (serosa)">Tumor penetrates 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>
<fieldset style="border-color:#e6e6ff;">
<legend><label class="description">For endoscopic resections:</legend>
<p>
<table border="1">
<col width="80%">
<tr>
<td>
- Deep margin:
</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">Uninvolved by tumor</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
- Mucosal margin:
</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">Uninvolved by tumor</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">Uninvolved by tumor</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">For gastrectomy specimens:</label></legend>
<p>
<table border="1">
<col width="80%">
<tr>
<td>
- Proximal margin:
</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">Uninvolved by tumor</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
- Distal margin:
</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">Uninvolved by tumor</option>
<option value="Involved by tumor">Involved by tumor</option>
</select>
</td>
</tr>
<tr>
<td>
- Omental (radial) margin:
</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">Uninvolved by tumor</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">Uninvolved by tumor</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="80%">
<tr>
<td>
<label class="description">- Number of regional lymph nodes examined:</label>
</td>
<td>
<input type="text" name="A20" class="element text large" size="10">
</td>
</tr>
<tr>
<td>
<label class="description">- Number of lymph nodes involved:</label>
</td>
<td>
<input type="text" name="A21" class="element text large" size="10">
</td>
</tr>
<tr>
<td>
+ Extranodal extension:
</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\Stomach.NET_4.1.0.0.REL_CAPCP.pdf#page=13" 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: Invades the lamina propria or submucosa and less than or equal to 1 cm in size">pT1: Invades the lamina propria or submucosa and less than or equal to 1 cm in size</option>
<option value="pT2: Invades the muscularis propria or greater than 1 cm in size">pT2: Invades the muscularis propria or greater than 1 cm in size</option>
<option value="pT3: Invades through the muscularis propria into subserosal tissue without penetration of overlying serosa">pT3: Invades through the muscularis propria into subserosal tissue without penetration of overlying serosa</option>
<option value="pT4: Invades visceral peritoneum (serosa) or other organs or adjacent structures">pT4: Invades visceral peritoneum (serosa) or other organs or 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" ID="A29" size="10">
</td>
</tr>
-->
</table>
</p>
</fieldset>
</p>
<p>
<fieldset style="border-color:#e6e6ff;">
<legend> <label > + Additional pathologic findings: </label></legend>
<input class="element checkbox" type="checkbox" id="A32" value="Atrophic gastritis"><label class="choice">Atrophic gastritis</label>
<input class="element checkbox" type="checkbox" id="A32a" value="Intestinal metaplasia of gastric mucosa"><label class="choice">Intestinal metaplasia of gastric mucosa</label>
<input class="element checkbox" type="checkbox" id="A32b" value="Glandular dysplasia of gastric mucosa"><label class="choice">Glandular dysplasia of gastric mucosa</label>
<input class="element checkbox" type="checkbox" id="A32c" value="Endocrine cell hyperplasia"><label class="choice">Endocrine cell hyperplasia</label>
<input class="element checkbox" type="checkbox" id="A32d" value="Absence of parietal cells"><label class="choice">Absence of parietal cells</label>
<input class="element checkbox" type="checkbox" id="A31" value="Tumor necrosis"><label class="choice">Tumor necrosis</label>
<p>- Other (specify):
<input type="text" name="A33" ID="A33" size="35">
</p>
<br>
</fieldset>
<p>
<p>
<label class="description">- Additional notes:</label>
<textarea ID="A34" name="A34" class = "textarea medium" style="border-color:grey;"></textarea>
</p>
<br><br>
<input type="button" name="copyform" value="Check your Report" onclick="updateDescription(this.form)"/>
<br>
<TEXTAREA ID="holdtext" name="holdtext" class="textarea large" style="border-color:coral;"></TEXTAREA>
<br><br>
<!-- The button used to copy the text -->
<button onclick="CopyToClipboard()">Copy text to Clipboard</button>
<input type="reset" value="Reset Form" name="reset" style="float: right;">
</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>
Stomach NET 5.0.0.0 (Dec 2023), <br>
html was form 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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