archetype (adl_version=1.4)
	openEHR-EHR-CLUSTER.tnm_staging_7th-colorectal.v1
specialise
	openEHR-EHR-CLUSTER.tnm_staging_7th.v1

concept
	[at0000.1]	-- Tumour - Colorectal Cancer TNM staging 7th Edition
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Dr Ian McNicoll">
		["organisation"] = <"Ocean Informatics Scotland">
		["email"] = <"ian.mcnicoll@oceaninformatics.com">
		["date"] = <"27/07/2009">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record the classification and grading of colorectal cancer using the TNM classification 7th Edition.">
			use = <"">
			keywords = <"tumour", "TNM", "malignancy", "cancer", "staging", "classification", "grade", "grading", "stage", "lymph node", "metastasis", "colorectal">
			misuse = <"Use only for TNM 7th Edition colorecal cancer staging.">
			copyright = <"copyright (c) 2010 openEHR foundation">
		>
	>
	lifecycle_state = <"AuthorDraft">
	other_contributors = <"Heather Leslie Ocean Informatics Australia", "Sam Heard Ocean Informatics Australia", "Koray Atalag, University of Auckland, New Zealand">
	other_details = <
		["MD5-CAM-1.0.1"] = <"AD3C9868BD585A9611A94C812D64EDFD">
		["references"] = <"Sobin LH. TNM Classification of Malignant Tumours 7th Edition.  John Wiley and Sons; 2009.">
	>

definition
	CLUSTER[at0000.1] matches {	-- Tumour - Colorectal Cancer TNM staging 7th Edition
		items cardinality matches {1..*; unordered} matches {
			ELEMENT[at0003] occurrences matches {0..1} matches {	-- Primary tumour (T)
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0.52, 	-- TX
							at0.53, 	-- T0
							at0.54, 	-- Tis
							at0.55, 	-- T1
							at0.56, 	-- T2
							at0.57, 	-- T3
							at0.58, 	-- T4a
							at0.59]	-- T4b
						}
					}
				}
			}
			ELEMENT[at0004] occurrences matches {0..1} matches {	-- Regional lymph nodes (N)
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0.60, 	-- NX
							at0.61, 	-- N0
							at0.62, 	-- N1
							at0.63, 	-- N1a
							at0.64, 	-- N1b
							at0.65, 	-- N1c
							at0.66, 	-- N2
							at0.67, 	-- N2a
							at0.68]	-- N2b
						}
					}
				}
			}
			ELEMENT[at0005] occurrences matches {0..1} matches {	-- Distant metastasis (M)
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0.69, 	-- MX
							at0.70, 	-- M0
							at0.71, 	-- M1
							at0.72, 	-- M1a
							at0.73]	-- M1b
						}
					}
				}
			}
			ELEMENT[at0025] occurrences matches {0..1} matches {	-- Residual tumour (R)
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0.74, 	-- R0
							at0.75, 	-- R1
							at0.76]	-- R2
						}
					}
				}
			}
			ELEMENT[at0046] occurrences matches {0..1} matches {	-- Histopathological grading (G)
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0047, 	-- GX
							at0048, 	-- G1
							at0049, 	-- G2
							at0050, 	-- G3
							at0051]	-- G4
						}
					}
				}
			}
			ELEMENT[at0010] occurrences matches {0..1} matches {	-- Overall staging
				value matches {
					DV_TEXT matches {*}
				}
			}
			CLUSTER[at0052] occurrences matches {0..1} matches {	-- Descriptors
				items cardinality matches {1..*; unordered} matches {
					ELEMENT[at0053] occurrences matches {0..*} matches {	-- Descriptor
						value matches {
							DV_TEXT matches {*}
						}
					}
				}
			}
			ELEMENT[at0014] occurrences matches {0..1} matches {	-- Stage grouping
				value matches {
					DV_CODED_TEXT matches {
						defining_code matches {
							[local::
							at0.77, 	-- Stage 0
							at0.78, 	-- Stage I
							at0.79, 	-- Stage IIA
							at0.80, 	-- Stage IIB
							at0.81, 	-- Stage IIC
							at0.82, 	-- Stage IIIA
							at0.83, 	-- Stage IIIB
							at0.84, 	-- Stage IIIC
							at0.85, 	-- Stage IVA
							at0.86]	-- Stage IVB
						}
					}
				}
			}
			ELEMENT[at0012] occurrences matches {0..1} matches {	-- Comment
				value matches {
					DV_TEXT matches {*}
				}
			}
		}
	}

ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0.52"] = <
					text = <"TX">
					description = <"Primary tumour cannot be assessed.">
				>
				["at0.53"] = <
					text = <"T0">
					description = <"No evidence of primary tumour.">
				>
				["at0.54"] = <
					text = <"Tis">
					description = <"Carcinoma in situ: intraepithelial or invasion of lamina propria.">
				>
				["at0.55"] = <
					text = <"T1">
					description = <"Tumour invades submucosa.">
				>
				["at0.56"] = <
					text = <"T2">
					description = <"Tumour invades muscularis propria.">
				>
				["at0.57"] = <
					text = <"T3">
					description = <"Tumour invades through the muscularis propria into pericolorectal tissues.">
				>
				["at0.58"] = <
					text = <"T4a">
					description = <"Tumour penetrates to the surface of the visceral peritoneum.">
				>
				["at0.59"] = <
					text = <"T4b">
					description = <"Tumour directly invades or is adherent to other organs or structures.">
				>
				["at0.60"] = <
					text = <"NX">
					description = <"Regional lymph nodes cannot be assessed.">
				>
				["at0.61"] = <
					text = <"N0">
					description = <"No regional lymph node metastasis.">
				>
				["at0.62"] = <
					text = <"N1">
					description = <"Metastasis in 1-3 regional lymph nodes.">
				>
				["at0.63"] = <
					text = <"N1a">
					description = <"Metastasis in one regional lymph node.">
				>
				["at0.64"] = <
					text = <"N1b">
					description = <"Metastasis in 2-3 regional lymph nodes.">
				>
				["at0.65"] = <
					text = <"N1c">
					description = <"Tumour deposit(s) in the subserosa, mesentery, or nonperitonealised pericolic or perirectal tissues without regional nodal metastasis.">
				>
				["at0.66"] = <
					text = <"N2">
					description = <"Metastasis in 4 or more regional lymph nodes">
				>
				["at0.67"] = <
					text = <"N2a">
					description = <"Metastasis in 4-6 regional lymph nodes.">
				>
				["at0.68"] = <
					text = <"N2b">
					description = <"Metastasis in 7 or more regional lymph nodes.">
				>
				["at0.69"] = <
					text = <"MX">
					description = <"Distant metastasis cannot be assessed.">
				>
				["at0.70"] = <
					text = <"M0">
					description = <"No distant metastasis.">
				>
				["at0.71"] = <
					text = <"M1">
					description = <"Distant metastasis.">
				>
				["at0.72"] = <
					text = <"M1a">
					description = <"Metastasis confined to one organ or site (e.g., liver, lung, ovary, nonregional node).">
				>
				["at0.73"] = <
					text = <"M1b">
					description = <"Metastases in more than one organ/site or the peritoneum.">
				>
				["at0.74"] = <
					text = <"R0">
					description = <"R0 - as per AJCC TNM classification 7th Edition.">
				>
				["at0.75"] = <
					text = <"R1">
					description = <"R1 - as per AJCC TNM classification 7th Edition.">
				>
				["at0.76"] = <
					text = <"R2">
					description = <"R2 - as per AJCC TNM classification 7th Edition.">
				>
				["at0.77"] = <
					text = <"Stage 0">
					description = <"Stage 0 - as per AJCC TNM classification 7th Edition.">
				>
				["at0.78"] = <
					text = <"Stage I">
					description = <"Stage 1 - as per AJCC TNM classification 7th Edition.">
				>
				["at0.79"] = <
					text = <"Stage IIA">
					description = <"Stage IIA - as per AJCC TNM classification 7th Edition.">
				>
				["at0.80"] = <
					text = <"Stage IIB">
					description = <"Stage IIB - as per AJCC TNM classification 7th Edition.">
				>
				["at0.81"] = <
					text = <"Stage IIC">
					description = <"Stage IIC - as per AJCC TNM classification 7th Edition.">
				>
				["at0.82"] = <
					text = <"Stage IIIA">
					description = <"Stage IIIA - as per AJCC TNM classification 7th Edition.">
				>
				["at0.83"] = <
					text = <"Stage IIIB">
					description = <"Stage IIIB - as per AJCC TNM classification 7th Edition.">
				>
				["at0.84"] = <
					text = <"Stage IIIC">
					description = <"Stage IIIC - as per AJCC TNM classification 7th Edition.">
				>
				["at0.85"] = <
					text = <"Stage IVA">
					description = <"Stage IVA - as per AJCC TNM classification 7th Edition.">
				>
				["at0.86"] = <
					text = <"Stage IVB">
					description = <"Stage IVB - as per AJCC TNM classification 7th Edition.">
				>
				["at0000"] = <
					text = <"Tumour - TNM Cancer staging 7th Edition">
					description = <"A framework for the classification and grading of malignancies using the TNM classification system 7th Edition.">
				>
				["at0000.1"] = <
					text = <"Tumour - Colorectal Cancer TNM staging 7th Edition">
					description = <"For the classification and grading of colorectal cancer using the TNM classification 7th Edition.">
				>
				["at0003"] = <
					text = <"Primary tumour (T)">
					description = <"Assessment of the primary tumour.">
				>
				["at0004"] = <
					text = <"Regional lymph nodes (N)">
					description = <"Assessment of the regional lymph nodes.">
				>
				["at0005"] = <
					text = <"Distant metastasis (M)">
					description = <"Assessment of distant metastasis.">
				>
				["at0010"] = <
					text = <"Overall staging">
					description = <"The overall staging derived from each T, N and M component e.g T1aM0NX. May include additional TNM descriptors.">
				>
				["at0012"] = <
					text = <"Comment">
					description = <"A text comment on the staging.">
				>
				["at0014"] = <
					text = <"Stage grouping">
					description = <"The TNM Stage grouping.">
				>
				["at0025"] = <
					text = <"Residual tumour (R)">
					description = <"Assessment of post-treatment residual tumour.">
				>
				["at0046"] = <
					text = <"Histopathological grading (G)">
					description = <"TNM histopathological grading classification. ">
				>
				["at0047"] = <
					text = <"GX">
					description = <"Grade of differentiation cannot be assessed.">
				>
				["at0048"] = <
					text = <"G1">
					description = <"Well differentiated.">
				>
				["at0049"] = <
					text = <"G2">
					description = <"Moderately differentiated.">
				>
				["at0050"] = <
					text = <"G3">
					description = <"Poorly differentiated.">
				>
				["at0051"] = <
					text = <"G4">
					description = <"Undifferentiated.">
				>
				["at0052"] = <
					text = <"Descriptors">
					description = <"Additional tumour specific TNM descriptors.">
				>
				["at0053"] = <
					text = <"Descriptor">
					description = <"Additional tumour specific TNM descriptor.">
				>
			>
		>
	>