CancerReportingTemplate/Pedi-Rhadomyosarcoma.html at master · awiloQMH/CancerReportingTemplate · GitHub

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
<!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>Rhadomyosarcoma</title>
<link rel="stylesheet" type="text/css" href="view.css" media="all">
<script type="text/javascript" src="view.js"></script>
<script>
function updateDescription (frm)
{
    var Template = "";


if (frm.A01.value !== ""){
	Template += "- Procedure: " + frm.A01.value + "\n";
}

if (frm.A02.value !== ""){
	Template += "- Tumor site: " + frm.A02.value + "\n";
}

if (frm.A03.value !== ""){
	Template += "- Tumor size: " + frm.A03.value + "\n";
}

if (frm.A04.value !== ""){
	Template += "\n" + "- Tumor histology and immunohistochemical studies: " + "\n" + "  - " + frm.A04.value + "\n";
}

if (frm.A05.value !== ""){
	Template += "\n" + "- Histologic type: " + frm.A05.value + "\n";
}

if (frm.A06.value !== ""){
	Template += "- Preoperative treatment: " + frm.A06.value + "\n";
}

if (frm.A07.value !== ""){
	Template += "- Treatment effects:  " + frm.A07.value + "\n";
}

if (frm.A08.value !== ""){
	Template += "- Anaplasia: " + frm.A08.value + "\n";
}

if (frm.A09.value !== ""){
	Template += "- Fusion status: " + frm.A09.value + "\n";
}

if (frm.A10.value !== ""){
	Template += "- Lymphatic and/or Vascular invasion: " + frm.A10.value + "\n";
}

if (frm.A11.value !== ""){
	Template += "- Perineural invasion:  " + frm.A11.value + "\n";
}

if (frm.A12.value !== ""){
	Template += "\n" + "- Surgical margins: " + frm.A12.value + "\n";
}

if (frm.A13.value + frm.A14.value + frm.A15.value + frm.A16.value + frm.A17.value!== ""){
	Template += "\n" + "- Regional lymph nodes: " + "\n";
}

if (frm.A13.value !== ""){
	Template += "  - Number of regional lymph nodes examined: " + frm.A13.value + "\n";
}

if (frm.A14.value !== ""){
	Template += "  - Number of lymph nodes involved: " + frm.A14.value + "\n";
}

if (frm.A15.value !== ""){
	Template += "  - Extranodal extension: " + frm.A15.value + "\n";
}

if (frm.A16.value !== ""){
	Template += "  - Size of largest metastatic deposit (mm), specify site: " + frm.A16.value + "\n";
}

if (frm.A17.value !== ""){
	Template += "  - Size of largest lymph node involved (mm), specify site: " + frm.A17.value + "\n";
}

if (document.getElementById("A23").checked || document.getElementById("A24").checked ||
	document.getElementById("A25").checked || document.getElementById("A26").checked ){
	Template += "\n" + "- Distant metastasis:" + "\n";
}

if (document.getElementById("A23").checked){
	Template += frm.A23.value + "\n";
}

if (document.getElementById("A24").checked){
	Template += frm.A24.value + "\n";
}

if (document.getElementById("A25").checked){
	Template += frm.A25.value + "\n";
}

if (document.getElementById("A26").checked){
	Template += frm.A26.value + "\n";
}
/**
if (frm.A18.value + frm.A19.value !== ""){
	Template += "\n" + "- Status of metastases:" + "\n";
}

if (frm.A18.value !== ""){
	Template += "  - " + frm.A18.value + "\n";
}

if (frm.A19.value !== ""){
	Template += "  - Sites of distant metastasis: " + frm.A19.value + "\n";
}
**/
if (frm.A20.value !== ""){
	Template += "\n" + "- The Intergroup Rhabdomyosarcoma Study Postsurgical Clinical Grouping System: " + "\n" + "  - " +  frm.A20.value + "\n";
}

if (frm.A21.value !== ""){
	Template += "\n" + "- Modified Site, Size, Metastasis Staging for Rhabdomyosarcomas: " + "\n" + "  - " +  frm.A21.value + "\n";
}

if (frm.A22.value !== ""){
	Template += "\n" + "- Additional pathologic findings: " + "\n" + "  - " +  frm.A22.value + "\n";
}

frm.holdtext.value = Template;
}

function CopyToClipboard() {
  /* Get the text field */
  var copyText = document.getElementById("holdtext");

  /* Select the text field */
  copyText.select();

  /* Copy the text inside the text field */
  document.execCommand("copy");

  /* Alert the copied text */
  alert("Report copied to clipboard");
}
</script>
<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-2025-06-Update\Pediatric Protocol Folder\Rhabdomyosarcoma_5.0.0.1.REL_CAPCP.pdf" target="_blank">
		<div class="tooltip">
		Rhadomyosarcoma
		<span class="tooltiptext">click to access explanations in the original CAP template</span>
		</div>
		</a></h2>
	</div>

<p> This is additional protocol for <a href=".\cap\Cancer-Protocols-2025-06-Update\Pediatric Protocol Folder\Rhabdomyosarcoma.Bx_5.0.0.1.REL_CAPCP.pdf" target="_blank">biopsy specimen</a>.</p>
<p>
+ Optional Expert Consultation before completion of the reporting.
</p>


<form>

<p>
<fieldset style="border-color:#e6e6ff;">
	<legend><label class="description">Gross descriptions:</label></legend>


<table border="1">
<col width="60%">

<tr>
<td><label class="description">- Procedure:</label></td>
<td><select class="element select large" ID="A01">
	<option value=""></option>
	<option value="Marginal resection">Marginal resection</option>
	<option value="Wide local resection">Wide local resection</option>
	<option value="Radical resection">Radical resection</option>
	<option value="Amputation (specify type): ">Amputation (specify type): </option>
	<option value="Resection">Resection </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="Bile duct">Bile duct</option>
	<option value="Bladder/prostate">Bladder/prostate</option>
	<option value="Cranial parameningeal">Cranial parameningeal</option>
	<option value="Extremity">Extremity</option>
	<option value="Genitourinary (not bladder/prostate)">Genitourinary (not bladder/prostate)</option>
	<option value="Head and neck (excluding parameningeal)">Head and neck (excluding parameningeal)</option>
	<option value="Orbit">Orbit</option>
	<option value="Specify site(s): ">Specify site(s): </option>
	<option value="Not specified">Not specified</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>
</table>
<br>
</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" class="element textarea medium"></textarea>
</p>


<table border="1">
<col width="40%">

<tr>
<td><label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Pediatric-Protocol-Folder\Rhabdomyosarcoma_4.1.0.0.REL_CAPCP.pdf#page=8" target="_blank">Histologic type</a>: </label>
</td>
<td><select class="element select large" ID="A05">
	<option value=""></option>
	<option value="Embryonal">Embryonal</option>
	<option value="Alveolar">Alveolar</option>
	<option value="Spindle cell/sclerosing">Spindle cell/sclerosing</option>
	<option value="Ectomesenchymoma">Ectomesenchymoma</option>
	<option value="Rhabdomyosarcoma, not otherwise specified (NOS)">Rhabdomyosarcoma, not otherwise specified (NOS)</option>
	<option value="Other (specify): ">Other (specify): </option>
</select></td>
</tr>

<tr>
<td><label class="description">- Preoperative treatment: </label></td>
<td><select class="element select large" ID="A06">
	<option value=""></option>
	<option value="No known preoperative therapy">No known preoperative therapy</option>
	<option value="Chemotherapy given">Chemotherapy given</option>
	<option value="Radiation therapy given">Radiation therapy given</option>
	<option value="Preoperative therapy given, type not specified">Preoperative therapy given, type not specified</option>
	<option value="Other (specify): ">Other (specify): </option>
</select></td>
</tr>

<tr>
<td><label class=""> + Treatment effect: </label></td>
<td><select class="element select large" ID="A07">
	<option value=""></option>
	<option value="Necrosis not identified">Necrosis not identified</option>
	<option value="Necrosis present (specify tumor necrosis % and therapy-induced cytodifferentiation: )">Necrosis present (specify tumor necrosis % and therapy-induced cytodifferentiation: )</option>
	<option value="Cannot be determined">Cannot be determined</option>
	<option value="Not applicable">Not applicable</option>
</select></td>
</tr>

<tr>
<td><label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Pediatric-Protocol-Folder\Rhabdomyosarcoma_4.1.0.0.REL_CAPCP.pdf#page=13" target="_blank">Anaplasia</a>:</label>
</td>
<td><select class="element select large" ID="A08">
	<option value=""></option>
	<option value="Not identified">Not identified</option>
	<option value="Focal (single or few scattered anaplastic cells)">Focal (single or few scattered anaplastic cells)</option>
	<option value="Diffuse (clusters or sheets of anaplastic cells)">Diffuse (clusters or sheets of anaplastic cells)</option>
	<option value="Cannot be determined (explain)">Cannot be determined (explain)</option>
</select></td>
</tr>

<tr>
<td><label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Pediatric-Protocol-Folder\Rhabdomyosarcoma_4.1.0.0.REL_CAPCP.pdf#page=16" target="_blank">Fusion Status</a>: </label></td>
<td><select class="element select large" ID="A09">
	<option value=""></option>
	<option value="Not performed">Not performed</option>
	<option value="Pending">Pending</option>
	<option value="No FOXO1 rearrangement">No FOXO1 rearrangement</option>
	<option value="FOXO1 rearrangement present, specify amplification, PAX3 or PAX7">FOXO1 rearrangement present, specify amplification, PAX3 or PAX7</option>
	<option value="Other (eg, PAX3-NCOA1 or other variant translocation) (specify): ">Other (eg, PAX3-NCOA1 or other variant translocation) (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">- Lymphatic and/or Vascular invasion:</label> </td>
<td><select class="element select large" ID="A10">
	<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 class="description">- Perineural invasion:</label> </td>
<td><select class="element select large" ID="A11">
	<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 rowspan="2" valign="top"><label class="description">- Distant metastasis:</label></td>
<td><select class="element select large" ID="A18">
	<option value=""></option>
	<option value="Not applicable">Not applicable</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>- Sites of distant metastasis:
<input type="text" class="element text small" ID="A19" size="35"></td>
</tr>
-->
</table>
</fieldset>

<p>
<fieldset style="border-color:#e6e6ff;">
	<legend><label class="description">Surgical margins: </label></legend>
<p>
<select class="element select medium" ID="A12">
	<option value=""></option>
	<option value="Cannot be assessed">Cannot be assessed</option>
	<option value="Uninvolved by tumor, closest bone margin, specify distance (mm):">Uninvolved by tumor, closest bone margin, specify distance (mm):</option>
	<option value="Uninvolved by tumor, closest soft tissue margin, specify distance (mm):">Uninvolved by tumor, closest soft tissue margin, specify distance (mm):</option>
	<option value="Uninvolved by tumor, closest margin, specify distance and locations (mm):">Uninvolved by tumor, closest margin, specify distance and locations (mm):</option>
	<option value="Involved by tumor, specify margins: ">Involved by invasive carcinoma, specify margins: </option>
</select>
</p>
<br>
</fieldset>
</p>

<p>
<fieldset style="border-color:#e6e6ff;">
	<legend> <label class="description"> Regional lymph nodes: </label></legend>

<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="A13" size="15">
</td>
</tr>

<tr>
<td>
<label class="description">- Number of lymph nodes involved (specify locations):</label>
</td>
<td>
<input type="text" class="element text large" ID="A14" size="15">
</td>
</tr>

<tr>
<td>
<label class="description">- Extranodal extension:</label>
</td>
<td>
<select class="element select large" ID="A15">
	<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 class="description">- Size of largest metastatic deposit (mm), specify site:</label>
</td>
<td>
<input type="text" class="element text large" ID="A16" size="15">
</td>
</tr>

<tr>
<td>
<label class="description">- Size of largest lymph node involved (mm), specify site:</label>
</td>
<td>
<input type="text" class="element text large" ID="A17" size="15">
</td>
</tr>
</table>

<br>
</fieldset>
</p>

<p>
<fieldset style="border-color:#e6e6ff;">
	<legend> <label class="description"> Distant Metastasis: </label></legend>

<input class="element checkbox" type="checkbox" id="A23"  value="  - Not applicable"><label class="choice" >Not applicable</label>
<input class="element checkbox" type="checkbox" id="A24"  value="  - Not identified"><label class="choice" >Not identified</label>
<input class="element checkbox" type="checkbox" id="A25"  value="  - Specify:"><label class="choice" >Specify:</label>
<input class="element checkbox" type="checkbox" id="A26"  value="  - Cannot be determined: "><label class="choice" >Cannot be determined: </label>

</fieldset>
</p>

<p>
<fieldset style="border-color:#e6e6ff;">
<p>
<label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Pediatric-Protocol-Folder\Rhabdomyosarcoma_4.1.0.0.REL_CAPCP.pdf#page=14" target="_blank">The Intergroup Rhabdomyosarcoma Study Postsurgical Clinical Grouping System (Raney 2001)</a>: </label>
<select class="element select medium" ID="A20">
	<option value=""></option>
	<option value="Not applicable">Not applicable</option>
	<option value="Cannot be assessed (explain): ">Cannot be assessed (explain): </option>
	<option value="Group IA: Localized tumor, confined to site of origin, completely resected">Group IA: Localized tumor, confined to site of origin, completely resected</option>
	<option value="Group IB:Localized tumor, infiltrating beyond site of origin, completely resected">Group IB:Localized tumor, infiltrating beyond site of origin, completely resected</option>
	<option value="Group IIA: Localized tumor, gross total resection, but with microscopic residual disease">Group IIA: Localized tumor, gross total resection, but with microscopic residual disease</option>
	<option value="Group IIB: Locally extensive tumor (spread to regional lymph nodes), completely resected">Group IIB: Locally extensive tumor (spread to regional lymph nodes), completely resected</option>
	<option value="Group IIC: Locally extensive tumor (spread to regional lymph nodes), gross total resection, but microscopic residual disease">Group IIC: Locally extensive tumor (spread to regional lymph nodes), gross total resection, but microscopic residual disease</option>
	<option value="Group IIIA: Localized or locally extensive tumor, gross residual disease after biopsy only">Group IIIA: Localized or locally extensive tumor, gross residual disease after biopsy only</option>
	<option value="Group IIIB: Localized or locally extensive tumor, gross residual disease after major resection (greater than 50% debulking)">Group IIIB: Localized or locally extensive tumor, gross residual disease after major resection (greater than 50% debulking)</option>
	<option value="Group IV: Any size primary tumor, with or without regional lymph node involvement, with distant metastases, without respect to surgical approach to primary tumor">Group IV: Any size primary tumor, with or without regional lymph node involvement, with distant metastases, without respect to surgical approach to primary tumor</option>
</select>
</p>


<p>
<label class="description">- <a href=".\cap\Cancer-Protocols-2021-06-Update\Pediatric-Protocol-Folder\Rhabdomyosarcoma_4.1.0.0.REL_CAPCP.pdf#page=14" target="_blank">Modified Site, Size, Metastasis Staging for Rhabdomyosarcoma (Coffin 1997)</a>: </label>
<select class="element select medium" ID="A21">
	<option value=""></option>
	<option value="Not applicable">Not applicable</option>
	<option value="Cannot be assessed (explain): ">Cannot be assessed (explain): </option>
	<option value="Stage I: Tumor involves favorable site (ie, bile ducts, orbit, head and neck or genitourinary site [excluding bladder, prostate, and cranial parameningeal]); and, Tumor metastatic to distant site not identified">Stage I: Tumor involves favorable site (ie, bile ducts, orbit, head and neck or genitourinary site [excluding bladder, prostate, and cranial parameningeal]); and, Tumor metastatic to distant site not identified</option>
	<option value="Stage II: Tumor involves unfavorable site (ie, bladder/prostate, extremity, parameningeal or other site not mentioned in stage I); and, Tumor size 5 cm or greater; and,  Tumor involvement of lymph nodes not identified; and, Tumor metastatic to distant site not identified">Stage II: Tumor involves unfavorable site (ie, bladder/prostate, extremity, parameningeal or other site not mentioned in stage I); and, Tumor size 5 cm or greater; and,  Tumor involvement of lymph nodes not identified; and, Tumor metastatic to distant site not identified</option>
	<option value="Stage III: Tumor involves unfavorable site, is 5 cm or less, and involves regional lymph nodes, but distant metastases are not identified; or, Tumor involves unfavorable site and is greater than 5 cm, with or without regional lymph node involvement, but distant metastases are not identified">Stage III: Tumor involves unfavorable site, is 5 cm or less, and involves regional lymph nodes, but distant metastases are not identified; or, Tumor involves unfavorable site and is greater than 5 cm, with or without regional lymph node involvement, but distant metastases are not identified</option>
	<option value="Stage IV: Distant metastases present">Stage IV: Distant metastases present</option>
</select>
</p>
</fieldset>
</p>

<p>
<label class="">+ Additional pathologic findings:</label>
 <textarea ID="A22" 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)"/>
<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>
<br>
<br>

<div id="footer">
Last upated on 23-Jun-2025,<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>
Rhabdomyosarcoma Resection 5.0.0.1 (Jun-2025), <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.
</div>
</div>
<img id="bottom" src="bottom.png" alt="">
</body>
</html>