Demographics | Age (Yrs) Sex (M/F) Comorbidities (PMHx/PSHx) Smoking (Y/N) Alcohol (Y/N) |
Presentation | Date Onset of symptoms (mm-yyyy) Date seen first by any doctor for index symptoms (dd-mm-yyyy) Date referral made to OTL-HNS (dd-mm-yyyy) Date first seen by OTL-HNS (dd-mm-yyyy) Was the first encounter with OTL-HNS by telemedicine or in-person? (Y/N) If the first encounter was by telemedicine, when was the first in-person visit? (dd-mm-yyyy) |
Workup | Date first biopsy made (dd-mm-yyyy) Date first histopathologic/cytopathologic diagnosis made (dd-mm-yyyy) Date presented at HNC tumor board (dd-mm-yyyy) Date first imaging—CT, MRI, PET/CT (dd-mm-yyyy) |
Tumor Characteristics | Cancer site/subsite Cancer type AJCC stage TNM |
Treatment | Tumor board recommendation of treatment Date Start of treatment: Chemo and/or radiotherapy start date, or surgery date if primary surgery (dd-mm-yyyy) Date Adjuvant CTX and/or RTX started, if had surgery first (dd-mm-yyyy) Date surgical pathology reported (dd-mm-yyyy) Did the treatment have curative intent or palliative only? (Y/N) Date CTX and/or RTX completed (dd-mm-yyyy) |
Post-Treatment | Postoperative complications Length of postoperative hospital stay Chemo/radiotherapy complications |