HL7 Europe Common Cancer Model
0.1.0 - ci-build 150

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

Logical Model: ClinicalCancerProgression - JSON Profile

Draft as of 2026-05-13

JSON representation of the ClinicalCancerProgression logical model.

Raw json | Download

{
  "resourceType" : "StructureDefinition",
  "id" : "ClinicalCancerProgression",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition ClinicalCancerProgression</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 &amp; 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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression\" title=\"Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).\">ClinicalCancerProgression</a><a name=\"ClinicalCancerProgression\"> </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 ( ccp-1, ccp-2 )\">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\">ClinicalCancerProgression<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=\"LocoRegionalSites must be present if ExtentType is Loco-regional\" class=\"constraint\">ccp-1</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"MetastaticSites must be present if ExtentType is Metastatic\" class=\"constraint\">ccp-2</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.cancerConditionAtDiagnosisReference\" title=\"Reference to the original cancer condition at diagnosis to which this progression refers.\">cancerConditionAtDiagnosisReference</a><a name=\"ClinicalCancerProgression.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\">CancerConditionReference</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.diseaseStatus\" title=\"Disease status at this time point (e.g. progression, stable disease, remission, recurrence).\">diseaseStatus</a><a name=\"ClinicalCancerProgression.diseaseStatus\"> </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\">DiseaseStatus</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_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.tumourGradeSystem\" title=\"Classification system used to define tumour grade, describing how abnormal tumour cells and tissue appear under microscopic examination (e.g. Gleason for prostate cancer, FNCLCC for soft tissue sarcomas). The grading system provides an indication of the biological aggressiveness of the tumour.\">tumourGradeSystem</a><a name=\"ClinicalCancerProgression.tumourGradeSystem\"> </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..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\">TumourGradeSystem</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_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.tumourGradeValue\" title=\"Grade value assigned according to the selected TumourGradeSystem. The grade reflects the degree of cellular differentiation and biological aggressiveness of the tumour and may evolve over time.\">tumourGradeValue</a><a name=\"ClinicalCancerProgression.tumourGradeValue\"> </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#string\">string</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\">TumourGradeValue</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_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.assertedDate\" title=\"Date when this progression/status was asserted/recorded.\">assertedDate</a><a name=\"ClinicalCancerProgression.assertedDate\"> </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#dateTime\">dateTime</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\">AssertedDate</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.extentType\" title=\"Extent of disease at this time point (Local, Loco-regional, Metastatic).\">extentType</a><a name=\"ClinicalCancerProgression.extentType\"> </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\">ExtentType</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_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.locoRegionalSites\" title=\"Sites involved when ExtentType is Loco-regional.\">locoRegionalSites</a><a name=\"ClinicalCancerProgression.locoRegionalSites\"> </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/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\">LocoRegionalSites<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_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_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.metastaticSites\" title=\"Sites involved when ExtentType is Metastatic.\">metastaticSites</a><a name=\"ClinicalCancerProgression.metastaticSites\"> </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..*</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\">MetastaticSites<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/ClinicalCancerProgression",
  "version" : "0.1.0",
  "name" : "ClinicalCancerProgression",
  "title" : "ClinicalCancerProgression",
  "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 longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).",
  "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/ClinicalCancerProgression",
  "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" : "ClinicalCancerProgression",
        "path" : "ClinicalCancerProgression",
        "short" : "ClinicalCancerProgression",
        "definition" : "Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Base",
          "min" : 0,
          "max" : "*"
        },
        "constraint" : [
          {
            "key" : "ccp-1",
            "severity" : "error",
            "human" : "LocoRegionalSites must be present if ExtentType is Loco-regional",
            "expression" : "extentType.coding.where(code = 'Loco-regional').exists() implies locoRegionalSites.exists()",
            "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
          },
          {
            "key" : "ccp-2",
            "severity" : "error",
            "human" : "MetastaticSites must be present if ExtentType is Metastatic",
            "expression" : "extentType.coding.where(code = 'Metastatic').exists() implies metastaticSites.exists()",
            "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
          }
        ],
        "isModifier" : false
      },
      {
        "id" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
        "path" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
        "short" : "CancerConditionReference",
        "definition" : "Reference to the original cancer condition at diagnosis to which this progression refers.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"
            ]
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.diseaseStatus",
        "path" : "ClinicalCancerProgression.diseaseStatus",
        "short" : "DiseaseStatus",
        "definition" : "Disease status at this time point (e.g. progression, stable disease, remission, recurrence).",
        "comment" : "Choice: Progression | Stable Disease | Partial Remission | Complete Remission | Recurrence",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.diseaseStatus",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.tumourGradeSystem",
        "path" : "ClinicalCancerProgression.tumourGradeSystem",
        "short" : "TumourGradeSystem",
        "definition" : "Classification system used to define tumour grade, describing how abnormal tumour cells and tissue appear under microscopic examination (e.g. Gleason for prostate cancer, FNCLCC for soft tissue sarcomas). The grading system provides an indication of the biological aggressiveness of the tumour.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.tumourGradeSystem",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.tumourGradeValue",
        "path" : "ClinicalCancerProgression.tumourGradeValue",
        "short" : "TumourGradeValue",
        "definition" : "Grade value assigned according to the selected TumourGradeSystem. The grade reflects the degree of cellular differentiation and biological aggressiveness of the tumour and may evolve over time.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.tumourGradeValue",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.assertedDate",
        "path" : "ClinicalCancerProgression.assertedDate",
        "short" : "AssertedDate",
        "definition" : "Date when this progression/status was asserted/recorded.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.assertedDate",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.extentType",
        "path" : "ClinicalCancerProgression.extentType",
        "short" : "ExtentType",
        "definition" : "Extent of disease at this time point (Local, Loco-regional, Metastatic).",
        "comment" : "Choice: Local | Loco-regional | Metastatic",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ClinicalCancerProgression.extentType",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.locoRegionalSites",
        "path" : "ClinicalCancerProgression.locoRegionalSites",
        "short" : "LocoRegionalSites",
        "definition" : "Sites involved when ExtentType is Loco-regional.",
        "comment" : "It must be present if the ExtentType is Loco-regional",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ClinicalCancerProgression.locoRegionalSites",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.metastaticSites",
        "path" : "ClinicalCancerProgression.metastaticSites",
        "short" : "MetastaticSites",
        "definition" : "Sites involved when ExtentType is Metastatic.",
        "comment" : "It must be present if the ExtentType is Metastatic",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ClinicalCancerProgression.metastaticSites",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "ClinicalCancerProgression",
        "path" : "ClinicalCancerProgression",
        "short" : "ClinicalCancerProgression",
        "definition" : "Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).",
        "constraint" : [
          {
            "key" : "ccp-1",
            "severity" : "error",
            "human" : "LocoRegionalSites must be present if ExtentType is Loco-regional",
            "expression" : "extentType.coding.where(code = 'Loco-regional').exists() implies locoRegionalSites.exists()",
            "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
          },
          {
            "key" : "ccp-2",
            "severity" : "error",
            "human" : "MetastaticSites must be present if ExtentType is Metastatic",
            "expression" : "extentType.coding.where(code = 'Metastatic').exists() implies metastaticSites.exists()",
            "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
        "path" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
        "short" : "CancerConditionReference",
        "definition" : "Reference to the original cancer condition at diagnosis to which this progression refers.",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              🔗 "http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"
            ]
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.diseaseStatus",
        "path" : "ClinicalCancerProgression.diseaseStatus",
        "short" : "DiseaseStatus",
        "definition" : "Disease status at this time point (e.g. progression, stable disease, remission, recurrence).",
        "comment" : "Choice: Progression | Stable Disease | Partial Remission | Complete Remission | Recurrence",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.tumourGradeSystem",
        "path" : "ClinicalCancerProgression.tumourGradeSystem",
        "short" : "TumourGradeSystem",
        "definition" : "Classification system used to define tumour grade, describing how abnormal tumour cells and tissue appear under microscopic examination (e.g. Gleason for prostate cancer, FNCLCC for soft tissue sarcomas). The grading system provides an indication of the biological aggressiveness of the tumour.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.tumourGradeValue",
        "path" : "ClinicalCancerProgression.tumourGradeValue",
        "short" : "TumourGradeValue",
        "definition" : "Grade value assigned according to the selected TumourGradeSystem. The grade reflects the degree of cellular differentiation and biological aggressiveness of the tumour and may evolve over time.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "string"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.assertedDate",
        "path" : "ClinicalCancerProgression.assertedDate",
        "short" : "AssertedDate",
        "definition" : "Date when this progression/status was asserted/recorded.",
        "min" : 1,
        "max" : "1",
        "type" : [
          {
            "code" : "dateTime"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.extentType",
        "path" : "ClinicalCancerProgression.extentType",
        "short" : "ExtentType",
        "definition" : "Extent of disease at this time point (Local, Loco-regional, Metastatic).",
        "comment" : "Choice: Local | Loco-regional | Metastatic",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.locoRegionalSites",
        "path" : "ClinicalCancerProgression.locoRegionalSites",
        "short" : "LocoRegionalSites",
        "definition" : "Sites involved when ExtentType is Loco-regional.",
        "comment" : "It must be present if the ExtentType is Loco-regional",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      },
      {
        "id" : "ClinicalCancerProgression.metastaticSites",
        "path" : "ClinicalCancerProgression.metastaticSites",
        "short" : "MetastaticSites",
        "definition" : "Sites involved when ExtentType is Metastatic.",
        "comment" : "It must be present if the ExtentType is Metastatic",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ]
      }
    ]
  }
}