{
  "description": "Staging of tumor diseases according to the TNM classification (clinical) in accordance with the current AJCC edition",
  "_filename": "StructureDefinition-cce-core-Observation-TNMc.json",
  "package_name": "cce.fhir.minimal",
  "date": null,
  "derivation": "constraint",
  "publisher": null,
  "fhirVersion": "4.0.1",
  "name": "TNMc",
  "abstract": false,
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "0.3.0",
  "status": "draft",
  "id": "dc7e6dd0-1358-4a3d-be51-6107db304a52",
  "kind": "resource",
  "url": "https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Observation-TNMc",
  "version": "0.0.1",
  "differential": {
    "element": [ {
      "id": "Observation.status",
      "path": "Observation.status",
      "mustSupport": true
    }, {
      "id": "Observation.category.coding.system",
      "min": 1,
      "path": "Observation.category.coding.system",
      "fixedUri": "http://hl7.org/fhir/observation-category"
    }, {
      "id": "Observation.category.coding.code",
      "min": 1,
      "path": "Observation.category.coding.code",
      "fixedCode": "laboratory"
    }, {
      "id": "Observation.code",
      "path": "Observation.code",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding.system",
      "min": 1,
      "path": "Observation.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.code.coding.code",
      "min": 1,
      "path": "Observation.code.coding.code",
      "fixedCode": "21908-9"
    }, {
      "id": "Observation.subject",
      "min": 1,
      "path": "Observation.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Patient-Patient", "https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Patient-Pseudonym" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Observation.focus",
      "path": "Observation.focus",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource", "https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Condition-Primarydiagnosis" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Observation.effective[x]",
      "path": "Observation.effective[x]",
      "type": [ {
        "code": "dateTime"
      } ],
      "short": "Date of TNM documentation/Date of findings",
      "mapping": [ {
        "map": "TNM:TNM_Date",
        "comment": "TNM:TNM_Date",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:2:3",
        "comment": "urn:dktk:dataelement:2:3",
        "identity": "ISO-11179"
      } ],
      "definition": "This is the date on which the TNM data set was created and which is also considered relevant for the evaluation. It is usually identical to the diagnosis date or is close to this date."
    }, {
      "id": "Observation.value[x]",
      "path": "Observation.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/UiccstageVS",
        "description": "Indicates the stage of the tumor (according to \"Union internationale contre le cancer\")"
      },
      "mustSupport": true
    }, {
      "id": "Observation.value[x].coding.version",
      "min": 1,
      "path": "Observation.value[x].coding.version",
      "short": "TNM-Version",
      "binding": {
        "strength": "extensible",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMVersionVS",
        "description": "Catalog version of the TNM"
      },
      "mapping": [ {
        "map": "TNM:TNM_Version",
        "comment": "TNM:TNM_Version",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:18:2",
        "comment": "urn:dktk:dataelement:18:2",
        "identity": "ISO-11179"
      } ],
      "definition": "Catalog version of the TNM"
    }, {
      "id": "Observation.value[x].coding.code",
      "min": 1,
      "path": "Observation.value[x].coding.code",
      "short": "UICC Stadium",
      "mapping": [ {
        "map": "TNM.TNM_T, TNM.TNM_N,  TNM.TNM_M",
        "comment": "Calculated from 3 TNM elements",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:89:1",
        "comment": "urn:dktk:dataelement:89:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates the stage of the tumor (according to \"Union internationale contre le cancer\")"
    }, {
      "id": "Observation.component",
      "path": "Observation.component",
      "slicing": {
        "id": "394",
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "code.coding.code",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.component:TNM-T",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-T",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-T.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-T.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "21905-5"
    }, {
      "id": "Observation.component:TNM-T.value[x]",
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-T",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMTVS",
        "description": "TNM-T"
      },
      "mapping": [ {
        "map": "TNM:TNM_T",
        "comment": "TNM:TNM_T",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:100:1",
        "comment": "urn:dktk:dataelement:100:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates the extent (location and size) of the primary tumor",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-N",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-N",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-N.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-N.code.coding.code",
      "path": "Observation.component.code.coding.code",
      "fixedCode": "21906-3"
    }, {
      "id": "Observation.component:TNM-N.value[x]",
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-N",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMNVS",
        "description": "TNM-N"
      },
      "mapping": [ {
        "map": "TNM:TNM_N",
        "comment": "TNM:TNM_N",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:101:1",
        "comment": "urn:dktk:dataelement:101:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates whether lymph nodes are affected",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-M",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-M",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-M.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-M.code.coding.code",
      "path": "Observation.component.code.coding.code",
      "fixedCode": "21907-1"
    }, {
      "id": "Observation.component:TNM-M.value[x]",
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-M",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMMVS",
        "description": "TNM-M"
      },
      "mapping": [ {
        "map": "TNM:TNM_M",
        "comment": "TNM:TNM_M",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:99:1",
        "comment": "urn:dktk:dataelement:99:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates whether metastases are present",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-y-Symbol",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-y-Symbol",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-y-Symbol.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-y-Symbol.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "59479-6"
    }, {
      "id": "Observation.component:TNM-y-Symbol.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-y-Symbol",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMySymbolVS",
        "description": "TNM y-Symbol"
      },
      "mapping": [ {
        "map": "TNM:TNM_y_Symbol",
        "comment": "TNM:TNM_y_Symbol",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:82:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates when, in the case of multimodal therapies with multiple treatment approaches, the classification was made during or after these therapies"
    }, {
      "id": "Observation.component:TNM-y-Symbol.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-r-Symbol",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-r-Symbol",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-r-Symbol.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-r-Symbol.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "21983-2"
    }, {
      "id": "Observation.component:TNM-r-Symbol.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-r-Symbol",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMrSymbolVS",
        "description": "TNM r-Symbol"
      },
      "mapping": [ {
        "map": "TNM:TNM_r_Symbol",
        "comment": "TNM:TNM_r_Symbol",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:81:1",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates whether the tumor is an assessed recurrence"
    }, {
      "id": "Observation.component:TNM-r-Symbol.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-m-Symbol",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-m-Symbol",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-m-Symbol.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-m-Symbol.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "42030-7"
    }, {
      "id": "Observation.component:TNM-m-Symbol.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-m-Symbol",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMmSymbolVS",
        "description": "TNM m-Symbol"
      },
      "mapping": [ {
        "map": "TNM:TNM_m_Symbol",
        "comment": "TNM:TNM_m_Symbol",
        "identity": "ADT-GEKID"
      }, {
        "map": "urn:dktk:dataelement:10:2",
        "identity": "ISO-11179"
      } ],
      "definition": "Indicates whether multiple primary tumors are present in a region"
    }, {
      "id": "Observation.component:TNM-m-Symbol.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-L-Category",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-L-Category",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-L-Category.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-L-Category.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "33739-4"
    }, {
      "id": "Observation.component:TNM-L-Category.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-L-Category",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMLCategoryVS",
        "description": "TNM-L-Category"
      },
      "mapping": [ {
        "map": "TNM:TNM-L-Category",
        "comment": "TNM:TNM-L-Category",
        "identity": "ADT-GEKID"
      } ],
      "definition": "Lymphatic vessel invasion"
    }, {
      "id": "Observation.component:TNM-L-Category.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-V-Category",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-V-Category",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-V-Category.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-V-Category.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "33740-2"
    }, {
      "id": "Observation.component:TNM-V-Category.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-V-Category",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMVCategoryVS",
        "description": "TNM-V-Category"
      },
      "mapping": [ {
        "map": "TNM:TNM-V-Category",
        "comment": "TNM:TNM-V-Category",
        "identity": "ADT-GEKID"
      } ],
      "definition": "Vein invasion"
    }, {
      "id": "Observation.component:TNM-V-Category.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-Pn-Category",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-Pn-Category",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-Pn-Category.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-Pn-Category.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "92837-4"
    }, {
      "id": "Observation.component:TNM-Pn-Category.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-Pn-Category",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMPnCategoryVS",
        "description": "TNM-Pn-Category"
      },
      "mapping": [ {
        "map": "TNM:TNM-Pn-Category",
        "comment": "TNM:TNM-Pn-Category",
        "identity": "ADT-GEKID"
      } ],
      "definition": "Perineuralinvasion"
    }, {
      "id": "Observation.component:TNM-Pn-Category.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    }, {
      "id": "Observation.component:TNM-S-Category",
      "max": "1",
      "path": "Observation.component",
      "sliceName": "TNM-S-Category",
      "mustSupport": true
    }, {
      "id": "Observation.component:TNM-S-Category.code.coding.system",
      "path": "Observation.component.code.coding.system",
      "fixedUri": "http://loinc.org"
    }, {
      "id": "Observation.component:TNM-S-Category.code.coding.code",
      "min": 1,
      "path": "Observation.component.code.coding.code",
      "fixedCode": "21924-6"
    }, {
      "id": "Observation.component:TNM-S-Category.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "TNM-S-Category",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMSCategoryVS",
        "description": "TNM-S-Category"
      },
      "mapping": [ {
        "map": "TNM:TNM-S-Category",
        "comment": "TNM:TNM-S-Category",
        "identity": "ADT-GEKID"
      } ],
      "definition": "Serumtumormarker"
    }, {
      "id": "Observation.component:TNM-S-Category.value[x].coding.code",
      "min": 1,
      "path": "Observation.component.value[x].coding.code"
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}