Bladder dictation template 1.1.docx
SPR*/
ICCR¡
Macroscopic reporting dictation template
Data element
Response
Fresh tissue received
No
Text
As stated by the clinician
__x__x__mm
Right __mm
Left __mm
__mm
E.g. prostate, uterus __x__mm
Absent
Present
Neoadjuvant specimens may appear normal.
Absent
Present
If present, record the number of tumours.
Number
S2.03
Procedure
Bladder measurements
Length of each ureter
Length of urethra
Measurements of each other organ
Tumour
Tumour multifocality
Number of tumours
For each tumour: (if >1 designate accordingly)
Tumour site(s) in bladder
S20.4
Largest dimension (largest tumour)
Trigone
Right lateral wall
__mm
S20.4
Other dimension (largest tumour)
__mm
G2.01
Gross appearance of tumour(s)
Choose all that apply & record for each Polypoid
tumour identified.
Fungating
S2.05
Macroscopic evidence of tumour invasion in the bladder
S2.06
Macroscopic evidence of involvement of adjacent organs
S2.07
Distance of tumour to closest surgical margin
Macroscopic evidence of margin involvement
G2.02
S2.08
Peritoneal surface involvement description (if applicable)
Appearance of uninvolved bladder
Lymph nodes
G2.03
Other relevant macroscopic information
Absent
Present
If present, describe tissues invaded (choose all that apply)
Bladder wall
Perivesical tissue
Ureter(s), specify
Urethra
Absent
Present
If present, record organs involved by tumour (choose all that apply)
Prostate
Rectum
Ovaries
Vagina
Seminal vesicles
Uterus/cervix
Fallopian tube(s), specify
Other, specify
__mm
Specify margin.
Absent
Present
If present, record margins involved (choose all that apply)
Perivesical fat
Peritoneal surface
Ureteric
Urethral
Maximum dimension__mm
Location, specify
Normal
Ulcerated
Erythematous
Other
If other, specify
Not
Submitted
If submitted, for each site, record the number of nodes.
submitted
Record number per cassette.
Text
E.g. any additional orientation; specimen integrity (if disrupted)
Describe nature and site of blocks
Text
S2.01
S2.01
S2.01
S2.01
S2.02
Yes
If yes, describe any additional tests/ frozen sections/biobanking performed
Left lateral wall
Anterior wall
Posterior wall
Dome
Papillary
Other, specify
Ulcerated
Solid & indurated
SPR*Structured Reporting of Cancer and ICCR¡ International Collaboration On Cancer Reporting Standards (S) & Guidelines (G)
Bladder dictation template
Date: 21 October 2015
Version: 1.1