HL7 Europe Common Cancer Model, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/cancer-common/ and changes regularly. See the Directory of published versions
| Draft as of 2026-05-13 |
JSON representation of the CancerStage logical model.
{
"resourceType" : "StructureDefinition",
"id" : "CancerStage",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition CancerStage</b></p><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage\" title=\"Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage).\">CancerStage</a><a name=\"CancerStage\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;\" href=\"http://hl7.org/fhir/R4/conformance-rules.html#constraints\" title=\"This element has or is affected by constraints ( cs-ev-e1, cs-ev-e2, cs-tnm-1, cs-nontnm-1 )\">C</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/types.html#Base\">Base</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">CancerStage<br/><span style=\"font-weight:bold\">Instances of this logical model can be the target of a Reference</span><br class=\"constraint\"/><span title=\"null\" class=\"constraint\">Constraints: </span><span style=\"font-weight:bold\" title=\"If type is Clinical, imaging evidence must not be provided.\" class=\"constraint\">cs-ev-e1</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"If type is Pathological, surgery evidence must not be provided.\" class=\"constraint\">cs-ev-e2</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"If classificationType is TNM, 3 values is expected.\" class=\"constraint\">cs-tnm-1</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"For non-TNM staging systems, a single value is typically expected.\" class=\"constraint\">cs-nontnm-1</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.cancerConditionAtDiagnosisReference\" title=\"Reference to the cancer condition at first diagnosis for which the stage is reported.\">cancerConditionAtDiagnosisReference</a><a name=\"CancerStage.cancerConditionAtDiagnosisReference\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-CancerConditionAtDiagnosis.html\">CancerConditionAtDiagnosis</a>)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">CancerCondition AtDiagnosis Reference</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.classificationType\" title=\"Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM).\">classificationType</a><a name=\"CancerStage.classificationType\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">ClassificationType</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.stage\" title=\"One or more staging values expressed as (code, value) pairs.\">stage</a><a name=\"CancerStage.stage\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">StageValue<br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.stage.code\" title=\"Identifies which staging element is being reported (e.g. T category, N category, M category, stage group).\">code</a><a name=\"CancerStage.stage.code\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Stage element code</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.stage.value\" title=\"Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value).\">value</a><a name=\"CancerStage.stage.value\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Stage element value</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.type\" title=\"It indicates whether the stage instance is of type Clinical or Pathological.\">type</a><a name=\"CancerStage.type\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Type</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CancerStage-definitions.html#CancerStage.evidenceReference\" title=\"Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage.\">evidenceReference</a><a name=\"CancerStage.evidenceReference\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-Surgery.html\">Surgery</a> | <a href=\"StructureDefinition-Imaging.html\">Imaging</a>)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">EvidenceReference<br/></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics",
"valueCode" : "can-be-target"
}
],
"url" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage",
"version" : "0.1.0",
"name" : "CancerStage",
"title" : "CancerStage",
"status" : "draft",
"date" : "2026-05-13T10:39:20+00:00",
"publisher" : "HL7 Europe",
"contact" : [
{
"name" : "HL7 Europe",
"telecom" : [
{
"system" : "url",
"value" : "http://hl7.eu"
}
]
}
],
"description" : "Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage).",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "150",
"display" : "Europe"
}
]
}
],
"copyright" : "HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.html).",
"fhirVersion" : "4.0.1",
"kind" : "logical",
"abstract" : false,
"type" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Base",
"derivation" : "specialization",
"snapshot" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString" : "4.0.1"
}
],
"element" : [
{
"id" : "CancerStage",
"path" : "CancerStage",
"short" : "CancerStage",
"definition" : "Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage).",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Base",
"min" : 0,
"max" : "*"
},
"constraint" : [
{
"key" : "cs-ev-e1",
"severity" : "error",
"human" : "If type is Clinical, imaging evidence must not be provided.",
"expression" : "type.text = 'Clinical' implies evidenceReference.resolve().ofType(Imaging).empty()",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-ev-e2",
"severity" : "error",
"human" : "If type is Pathological, surgery evidence must not be provided.",
"expression" : "type.text = 'Pathological' implies evidenceReference.resolve().ofType(Surgery).empty()",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-tnm-1",
"severity" : "warning",
"human" : "If classificationType is TNM, 3 values is expected.",
"expression" : "classificationType.text = 'TNM' implies stage.count() >= 3",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-nontnm-1",
"severity" : "warning",
"human" : "For non-TNM staging systems, a single value is typically expected.",
"expression" : "classificationType.text != 'TNM' implies stage.count() = 1",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
}
],
"isModifier" : false
},
{
"id" : "CancerStage.cancerConditionAtDiagnosisReference",
"path" : "CancerStage.cancerConditionAtDiagnosisReference",
"short" : "CancerCondition AtDiagnosis Reference",
"definition" : "Reference to the cancer condition at first diagnosis for which the stage is reported.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CancerStage.cancerConditionAtDiagnosisReference",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"
]
}
]
},
{
"id" : "CancerStage.classificationType",
"path" : "CancerStage.classificationType",
"short" : "ClassificationType",
"definition" : "Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM).",
"comment" : "For TNM, this element should be populated with 'TNM'. For single-value systems, it may be omitted when the system/measure is represented through stageComponent.code.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CancerStage.classificationType",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.stage",
"path" : "CancerStage.stage",
"short" : "StageValue",
"definition" : "One or more staging values expressed as (code, value) pairs.",
"comment" : "Most staging systems are represented by a single component. TNM is represented by three components, one for each of T, N, and M (codes 'T', 'N', 'M').",
"min" : 1,
"max" : "*",
"base" : {
"path" : "CancerStage.stage",
"min" : 1,
"max" : "*"
},
"type" : [
{
"code" : "BackboneElement"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id" : "CancerStage.stage.id",
"path" : "CancerStage.stage.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "CancerStage.stage.extension",
"path" : "CancerStage.stage.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : false,
"isSummary" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "CancerStage.stage.modifierExtension",
"path" : "CancerStage.stage.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content",
"modifiers"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "CancerStage.stage.code",
"path" : "CancerStage.stage.code",
"short" : "Stage element code",
"definition" : "Identifies which staging element is being reported (e.g. T category, N category, M category, stage group).",
"comment" : "For single-value staging systems, this represents the staging system/measure being used (e.g. 'FIGO stage group'). For TNM, expected codes include 'T', 'N', and 'M'.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CancerStage.stage.code",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.stage.value",
"path" : "CancerStage.stage.value",
"short" : "Stage element value",
"definition" : "Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value).",
"comment" : "For TNM, this carries the component value (e.g. T2, N0, M0). For single-value systems, this carries the stage group/value (e.g. IIIB).",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CancerStage.stage.value",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.type",
"path" : "CancerStage.type",
"short" : "Type",
"definition" : "It indicates whether the stage instance is of type Clinical or Pathological.",
"comment" : "It indicates whether the stage instance is of type Clinical or Pathological. Choice: Clinical | Pathological",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CancerStage.type",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.evidenceReference",
"path" : "CancerStage.evidenceReference",
"short" : "EvidenceReference",
"definition" : "Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage.",
"comment" : "It shall be present. The reference shall be to one or more imaging procedures in case the stage is Clinical, or to one surgery in case the stage is Pathological.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "CancerStage.evidenceReference",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/Surgery"🔗 ,
"http://hl7.eu/fhir/cancer-common/StructureDefinition/Imaging"
]
}
]
}
]
},
"differential" : {
"element" : [
{
"id" : "CancerStage",
"path" : "CancerStage",
"short" : "CancerStage",
"definition" : "Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage).",
"constraint" : [
{
"key" : "cs-ev-e1",
"severity" : "error",
"human" : "If type is Clinical, imaging evidence must not be provided.",
"expression" : "type.text = 'Clinical' implies evidenceReference.resolve().ofType(Imaging).empty()",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-ev-e2",
"severity" : "error",
"human" : "If type is Pathological, surgery evidence must not be provided.",
"expression" : "type.text = 'Pathological' implies evidenceReference.resolve().ofType(Surgery).empty()",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-tnm-1",
"severity" : "warning",
"human" : "If classificationType is TNM, 3 values is expected.",
"expression" : "classificationType.text = 'TNM' implies stage.count() >= 3",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
},
{
"key" : "cs-nontnm-1",
"severity" : "warning",
"human" : "For non-TNM staging systems, a single value is typically expected.",
"expression" : "classificationType.text != 'TNM' implies stage.count() = 1",
"source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"
}
]
},
{
"id" : "CancerStage.cancerConditionAtDiagnosisReference",
"path" : "CancerStage.cancerConditionAtDiagnosisReference",
"short" : "CancerCondition AtDiagnosis Reference",
"definition" : "Reference to the cancer condition at first diagnosis for which the stage is reported.",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"
]
}
]
},
{
"id" : "CancerStage.classificationType",
"path" : "CancerStage.classificationType",
"short" : "ClassificationType",
"definition" : "Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM).",
"comment" : "For TNM, this element should be populated with 'TNM'. For single-value systems, it may be omitted when the system/measure is represented through stageComponent.code.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.stage",
"path" : "CancerStage.stage",
"short" : "StageValue",
"definition" : "One or more staging values expressed as (code, value) pairs.",
"comment" : "Most staging systems are represented by a single component. TNM is represented by three components, one for each of T, N, and M (codes 'T', 'N', 'M').",
"min" : 1,
"max" : "*",
"type" : [
{
"code" : "BackboneElement"
}
]
},
{
"id" : "CancerStage.stage.code",
"path" : "CancerStage.stage.code",
"short" : "Stage element code",
"definition" : "Identifies which staging element is being reported (e.g. T category, N category, M category, stage group).",
"comment" : "For single-value staging systems, this represents the staging system/measure being used (e.g. 'FIGO stage group'). For TNM, expected codes include 'T', 'N', and 'M'.",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.stage.value",
"path" : "CancerStage.stage.value",
"short" : "Stage element value",
"definition" : "Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value).",
"comment" : "For TNM, this carries the component value (e.g. T2, N0, M0). For single-value systems, this carries the stage group/value (e.g. IIIB).",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.type",
"path" : "CancerStage.type",
"short" : "Type",
"definition" : "It indicates whether the stage instance is of type Clinical or Pathological.",
"comment" : "It indicates whether the stage instance is of type Clinical or Pathological. Choice: Clinical | Pathological",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "CodeableConcept"
}
]
},
{
"id" : "CancerStage.evidenceReference",
"path" : "CancerStage.evidenceReference",
"short" : "EvidenceReference",
"definition" : "Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage.",
"comment" : "It shall be present. The reference shall be to one or more imaging procedures in case the stage is Clinical, or to one surgery in case the stage is Pathological.",
"min" : 0,
"max" : "*",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/Surgery"🔗 ,
"http://hl7.eu/fhir/cancer-common/StructureDefinition/Imaging"
]
}
]
}
]
}
}