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The identification of patients with genitourinary tumors who suffer from the infection by the Serious Acute Respiratory Syndrome Corona-Virus 2 (SARS-CoV-2) virus can represent multiple benefits both for themselves and for health professionals and the health system itself. We would be able to know more precisely the clinical evolution of these type of patient, to know their prognosis and being capable to select the most appropriate treatment modality for future pandemics.
SOGUG-COVID is an observational prospective-retrospective trial purely epidemiological, that aims to describe the population with genitourinary tumors (urothelial cancer, prostate cancer, testicular cancer and kidney cancer) infected by COrona VIrus Disease 19 (COVID-19) treated in Spanish hospitals, learn about the clinical presentation, therapeutic evolution and prognosis of said intercurrent infectious process, as well as its possible relationship with different clinical and therapeutic factors.
The study will be carried out in Spanish hospitals, with principal investigators belonging to the medical oncology services of the SOGUG group (Spanish Group of Genitourinary Oncology), who will act as promoter. Once the patients have been selected, the variables of interest will be collected and studied. The main variables to record will be:
Patient characteristics
Hospital center where the patient is recruited
Pathological history:
Concomitant pathology Usual drug treatment
Tumor pathology:
Tumor type, histology, and stage (initial and at diagnosis of infection) Cancer diagnosis date Active cancer treatment or follow-up Participation in clinical trial Type of treatment most recently received for the infection (Surgery; Radiotherapy; Chemotherapy, Immunotherapy ...) Treatment lines, initiation and last dose received of the most recent most recent cancer treatment
COVID-19 infection:
Confirmation date of COVID-19 infection PCR (Polymerase Chain Reaction) diagnostic test Immunoglobulin G (IgG) or Immunoglobulin M (IgM) serological diagnostic test Present symptoms, analytical alterations, thrombosis associated with COVID-19 infection, complications of infection Date of onset and disappearance of symptoms Days of fever and cough Radiological examination at the time of greatest severity Treatments received for COVID-19 Status upon discharge Date of discharge / exitus Negative presence of virus by PCR and PCR date
For patients who are receiving or have received immunotherapy treatments, additional information will be collected:
Immunotherapy treatment line and type Start / end date and last dose previous infection of the treatment with immunotherapy Adverse effects
Prospective follow-up data (6 months from patient inclusion):
Date of start or restart of cancer treatment after infection Change / suspension of cancer treatment after COVID-19 Date of surgery in neoadjuvant patients Recurrence of COVID-19 Best response obtained Date of progression to cancer treatment Current status and date of last contact The study will use the data obtained from the patient's medical history, with no plans to use other sources.
The assignment of a patient to a specific therapeutic strategy has already been decided in advance by the usual clinical practice of medicine; The decision to prescribe a specific treatment is clearly dissociated from the decision to include a patient in the study. No intervention will be applied to patients, whether diagnostic or follow-up, that is not the usual clinical practice. Epidemiological methods will be used to analyze the collected data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Genitourinary cancer patients that suffered COVID-19 | Patients diagnosed with genitourinary cancer (urothelial, kidney, prostate and germ) that suffered from COVID-19 infection prior to cancer treatment, during treatment, or after treatment. |
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| Measure | Description | Time Frame |
|---|---|---|
| Age at Baseline | Describe the population infected by COVID-19 with genitourinary tumors (urothelial cancer, prostate cancer, testicular cancer and kidney cancer) treated in Spanish hospitals, know the clinical presentation: Spcifically here we reported the Age | Baseline, at the time of inclusion |
| Frequency of Complications of COVID-19 Intercurrent Infection | Percentage of patients with complications associated to COVID-19 infection (classified by type and severity) | Through study completion, average 1 year |
| Frequency of Complications of COVID-19 Infection (Pneumonia) Stratified by Treatment | To assess the possible relationship of the different oncological treatments administered to these patients with the clinical evolution of the COVID-19 infection. Complications will be classified by type and severity in groups of patients stratified by the oncological treatment received. | Through study completion, average 1 year |
| Frequency of Complications of COVID-19 Infection in Patients With Genitourinary Cancer Stratified by Anti-androgenic Oncological Treatment | To evaluate in patients with Genitourinary Cancer the impact of androgen deprivation therapy (ADT) and new antiandrogenic agents (NAH) with or without corticosteroids on the infection COVID-19 as mean of frequency in complications of COVID-19 infection classified by type and severity | Through study completion, average 1 year |
| Frequency of Complications of COVID-19 Infection Stratified by Treatment (Immunotherapy vs no Immunotherapy) | To assess the possible relationship of the different oncological treatments administered to these patients with the clinical evolution of the COVID-19 infection. Complications will be classified by type and severity in groups of patients stratified by the oncological treatment received. |
| Measure | Description | Time Frame |
|---|---|---|
| COVID-19 Mortality Rate in Patients With Genitourinary Cancer | To assess the mortality associated with COVID-19 infection in the population with genitourinary tumors. Percentage of patients alive / dead at discharge. | Through study completion, average 1 year |
| COVID-19 Complication Rate in Patients With Genitourinary Cancer |
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Inclusion Criteria:
Exclusion Criteria:
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Patients diagnosed with genitourinary cancer (urothelial, kidney, prostate and germ) that suffered COVID-19 infection prior to cancer treatment, during treatment, or after treatment.
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| Name | Affiliation | Role |
|---|---|---|
| Miguel Ángel Climent, M.D., Ph.D. | Instituto Valenciano de Oncología | Study Chair |
| Javier Puente, M.D., Ph.D. | Hospital Clínico San Carlos de Madrid | Study Chair |
| Aránzazu González del Alba, M.D., Ph.D. | Hospital Universitario Puerta de Hierro Majadahonda | Study Chair |
| Sergio Vázquez Estevez, M.D., Ph.D. | Hospital Universitario Lucus Augusti | Study Chair |
| Natalia Vidal, M.D., Ph.D. | Hospital Clínico San Carlos de Madrid | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Català d'Oncologia L'Hospitalet | L'Hospitalet de Llobregat | Barcelona | Spain | |||
| Althaia |
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| ID | Title | Description |
|---|---|---|
| FG000 | Genitourinary Cancer Patients That Suffered COVID-19 | Patients diagnosed with genitourinary cancer (urothelial, kidney, prostate and germ) that suffered from COVID-19 infection prior to cancer treatment, during treatment, or after treatment. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 10, 2020 |
Not provided
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| Through study completion, average 1 year |
| Frequency of Adverse Events Related to Immunotherapy Targeted to Cancer (Classified by Type and Severity) | To specifically assess the impact of COVID-19 infection on the toxicity of immunotherapy treatment (mainly pneumonitis) and the impact of immunotherapy on the evolution of the infectious picture in patients with tumors of genitourinary origin. three different scenarios: during treatment, after treatment and in patients who receive treatment after the infection has passed. | Through study completion, average 1 year. Measured at 3 scenarios (during treatment, after treatment and therapies indicated after infection has passed) |
Evaluate the rate (percentage) of complications that have required hospital admission and / or ICU treatment. Complications will be classified by type and severity and represented as percentage of patients presenting them. |
| Through study completion, average 1 year |
| Asymptomatic Rate | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Through study completion, average 1 year |
| Asymptomatic Rate in Renal Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Through study completion, average 1 year |
| Asymptomatic Rate in Urothelial Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Through study completion, average 1 year |
| Asymptomatic Rate in Prostate Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections | Through study completion, average 1 year |
| Asymptomatic Rate in Testicular Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections | Through study completion, average 1 year |
| Frequency of Delays/Modifications on Cancer Treatment Schedule | delays / modifications in cancer follow-up or treatment regimens. | Through study completion, average 1 year |
| Progression Free Survival in Patients With Genitourinary Tumors That Suffered COVID-19, Patients With a First Line Treatment Ongoing at the Moment of COVID Infection | It is expected to obtain data on time to progression and overall survival of cancer patients, which can be compared with the reference values for each type of tumor pathology. PROGRESSION FREE SURVIVAL (FIRST LINE IN METASTATIC OR ADVANCED SETTING) The date of treatment start (treatment ongoing at the moment of COVID infection) is taken as the start date of follow-up. Only patients with a first line treatment ongoing at the moment of COVID infection were analyzed. | From start of treatment until progression or death, up to 130 months |
| Overall Survival in Patients With Genitourinary Tumors That Suffered COVID-19 | It is expected to obtain data on time to progression and overall survival of cancer patients, which can be compared with the reference values for each type of tumor pathology. For the calculation of overall survival, it is taken from the date of cancer diagnosis to the date of death (at any time, not only in a prospective part). | From start of treatment until progression or death, up to 130 months |
| Manresa |
| Barcelona |
| Spain |
| Hospital Universitari Parc Taulí | Sabadell | Barcelona | Spain |
| Hospital Universitario Puerta de Hierro-Majadahonda | Majadahonda | Madrid | Spain |
| Hospital Universitario de Badajoz | Badajoz | Spain |
| Hospital del Mar | Barcelona | Spain |
| Hospital Santa Creu i Sant Pau | Barcelona | Spain |
| Hospital Universitario Vall d Hebron | Barcelona | Spain |
| Hospital Universitario de Burgos | Burgos | Spain |
| Hospital de Ciudad Real | Ciudad Real | Spain |
| Hospital Universitario Reina Sofía | Córdoba | Spain |
| Instituto Catalán de Oncología- Girona | Girona | Spain |
| Hospital Universitario Lucus Augusti | Lugo | Spain |
| Fundación Jiménez Díaz | Madrid | Spain |
| Hospital 12 de Octubre | Madrid | Spain |
| Hospital Clínico San Carlos de Madrid | Madrid | Spain |
| Hospital Infanta Leonor, | Madrid | Spain |
| Hospital Universitario Gregorio Marañón | Madrid | Spain |
| Hospital Universitario HM Sanchinarro | Madrid | Spain |
| Hospital Universitario La Paz | Madrid | Spain |
| Hospital Universitario La Princesa | Madrid | Spain |
| Hospital Universitario Quironsalud | Madrid | Spain |
| Hospital Universitario Ramón y Cajal | Madrid | Spain |
| Complejo Hospitalario Universitario Ourense | Ourense | Spain |
| Clinica Universidad de Navarra | Pamplona | Spain |
| Hospital Universitario Virgen Macarena | Seville | Spain |
| Hospital Nuestra Señora del Prado | Talavera de la Reina | Spain |
| Hospital Virgen de la Salud | Toledo | Spain |
| Hospital Universitario Dr. Peset | Valencia | Spain |
| Instituto Valenciano de Oncología | Valencia | Spain |
| Hospital Txagorritxu | Vitoria-Gasteiz | Spain |
| Hospital Miguel Servet | Zaragoza | Spain |
| COMPLETED |
|
| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Genitourinary Cancer Patients That Suffered COVID-19 | Patients diagnosed with genitourinary cancer (urothelial, kidney, prostate and germ) that suffered from COVID-19 infection prior to cancer treatment, during treatment, or after treatment. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| |||||||||||||||||||||||
| Smoking status | Count of Participants | Participants |
| |||||||||||||||||||||||
| Comorbities | Count of Participants | Participants |
| |||||||||||||||||||||||
| Cancer type | Count of Participants | Participants |
| |||||||||||||||||||||||
| Clinical cancer stage at cancer diagnosis; | Cancer staging measures the extent of spread of the disease. This scale is established by the American Joint Committee in Cancer (AJCC). The categories range from localized / regional tumours (Stage I-II) to locally advanced (Stage III) or metastatic (Stage IV) | Count of Participants | Participants |
| ||||||||||||||||||||||
| Time from cancer diagnosis to SARS-CoV-2 infection | Median | Full Range | months |
| ||||||||||||||||||||||
| Clinical cancer stage at SARS-CoV-2 infection | Cancer staging measures the extent of spread of the disease. This scale is established by the American Joint Committee in Cancer (AJCC). The categories range from localized / regional tumours (Stage I-II) to locally advanced (Stage III) or metastatic (Stage IV) | Count of Participants | Participants |
| ||||||||||||||||||||||
| Histopathological grade at SARS-CoV-2 infection | Count of Participants | Participants |
| |||||||||||||||||||||||
| Anticancer treatment status at SARS-CoV-2 infection | Count of Participants | Participants |
| |||||||||||||||||||||||
| Anticancer treatment type at SARS-CoV-2 infection | Count of Participants | Participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Age at Baseline | Describe the population infected by COVID-19 with genitourinary tumors (urothelial cancer, prostate cancer, testicular cancer and kidney cancer) treated in Spanish hospitals, know the clinical presentation: Spcifically here we reported the Age | Describe the population infected by COVID-19 with genitourinary tumors (urothelial cancer, prostate cancer, testicular cancer and kidney cancer) treated in Spanish hospitals | Posted | Median | Full Range | years | Baseline, at the time of inclusion |
|
|
| |||||||||||||||||||||||||
| Primary | Frequency of Complications of COVID-19 Intercurrent Infection | Percentage of patients with complications associated to COVID-19 infection (classified by type and severity) | Describe the population infected by COVID-19 with genitourinary tumors (urothelial cancer, prostate cancer, testicular cancer and kidney cancer) treated in Spanish hospitals | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| |||||||||||||||||||||||||||
| Primary | Frequency of Complications of COVID-19 Infection (Pneumonia) Stratified by Treatment | To assess the possible relationship of the different oncological treatments administered to these patients with the clinical evolution of the COVID-19 infection. Complications will be classified by type and severity in groups of patients stratified by the oncological treatment received. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Primary | Frequency of Complications of COVID-19 Infection in Patients With Genitourinary Cancer Stratified by Anti-androgenic Oncological Treatment | To evaluate in patients with Genitourinary Cancer the impact of androgen deprivation therapy (ADT) and new antiandrogenic agents (NAH) with or without corticosteroids on the infection COVID-19 as mean of frequency in complications of COVID-19 infection classified by type and severity | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Primary | Frequency of Complications of COVID-19 Infection Stratified by Treatment (Immunotherapy vs no Immunotherapy) | To assess the possible relationship of the different oncological treatments administered to these patients with the clinical evolution of the COVID-19 infection. Complications will be classified by type and severity in groups of patients stratified by the oncological treatment received. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Primary | Frequency of Adverse Events Related to Immunotherapy Targeted to Cancer (Classified by Type and Severity) | To specifically assess the impact of COVID-19 infection on the toxicity of immunotherapy treatment (mainly pneumonitis) and the impact of immunotherapy on the evolution of the infectious picture in patients with tumors of genitourinary origin. three different scenarios: during treatment, after treatment and in patients who receive treatment after the infection has passed. | Posted | Count of Participants | Participants | Through study completion, average 1 year. Measured at 3 scenarios (during treatment, after treatment and therapies indicated after infection has passed) |
|
| ||||||||||||||||||||||||||||
| Secondary | COVID-19 Mortality Rate in Patients With Genitourinary Cancer | To assess the mortality associated with COVID-19 infection in the population with genitourinary tumors. Percentage of patients alive / dead at discharge. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | COVID-19 Complication Rate in Patients With Genitourinary Cancer | Evaluate the rate (percentage) of complications that have required hospital admission and / or ICU treatment. Complications will be classified by type and severity and represented as percentage of patients presenting them. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Asymptomatic Rate | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Asymptomatic Rate in Renal Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Asymptomatic Rate in Urothelial Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections. | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Asymptomatic Rate in Prostate Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Asymptomatic Rate in Testicular Cancer | Describe the frequency of asymptomatic or minimally symptomatic COVID-19 infections | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| ||||||||||||||||||||||||||||
| Secondary | Frequency of Delays/Modifications on Cancer Treatment Schedule | delays / modifications in cancer follow-up or treatment regimens. | Patients with genitourinary tumor presenting Covid-19 infection with prospective part who start/restart treatment | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| |||||||||||||||||||||||||||
| Secondary | Frequency of Delays/Modifications on Cancer Treatment Schedule | delays / modifications in cancer follow-up or treatment regimens. | Patients with genitourinary tumor presenting Covid-19 infection with prospective part witn treatment modifications | Posted | Count of Participants | Participants | Through study completion, average 1 year |
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| |||||||||||||||||||||||||||
| Secondary | Frequency of Delays/Modifications on Cancer Treatment Schedule | delays / modifications in cancer follow-up or treatment regimens. | Patients with genitourinary tumor presenting Covid-19 infection with prospective part | Posted | Count of Participants | Participants | Through study completion, average 1 year |
|
| |||||||||||||||||||||||||||
| Secondary | Progression Free Survival in Patients With Genitourinary Tumors That Suffered COVID-19, Patients With a First Line Treatment Ongoing at the Moment of COVID Infection | It is expected to obtain data on time to progression and overall survival of cancer patients, which can be compared with the reference values for each type of tumor pathology. PROGRESSION FREE SURVIVAL (FIRST LINE IN METASTATIC OR ADVANCED SETTING) The date of treatment start (treatment ongoing at the moment of COVID infection) is taken as the start date of follow-up. Only patients with a first line treatment ongoing at the moment of COVID infection were analyzed. | Patients with genitourinary tumors that suffered COVID-19. Only patients with a first line treatment ongoing at the moment of COVID infection were analyzed. | Posted | Mean | 95% Confidence Interval | months | From start of treatment until progression or death, up to 130 months |
|
| ||||||||||||||||||||||||||
| Secondary | Overall Survival in Patients With Genitourinary Tumors That Suffered COVID-19 | It is expected to obtain data on time to progression and overall survival of cancer patients, which can be compared with the reference values for each type of tumor pathology. For the calculation of overall survival, it is taken from the date of cancer diagnosis to the date of death (at any time, not only in a prospective part). | Patients with genitourinary tumor presenting Covid-19 infection with prospective part | Posted | Mean | 95% Confidence Interval | years | From start of treatment until progression or death, up to 130 months |
|
|
2 year Note: Adverse events were only collected and reported by those patients on active immunotherapy by the time of SARS-CoV-2 infection (n=87)
Adverse events were only collected and reported in the subgroup of patients treated with immunotherapy (n=87) All cause mortality reported in the overall population
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Adverse Events | Adverse events reported by those patients on active immunotherapy by the time of SARS-CoV-2 infection. The main scope of this trial was not safety. Therefore, the study did not record adverse events in patients treated with other therapies. The study did not record serious adverse events sistematically. This partial information about safety was the only information of adverse events collected during this observational study. | 152 | 408 | 0 | 87 | 22 | 87 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hepatitis | Hepatobiliary disorders | CTCAE (5.0) | Non-systematic Assessment |
| |
| Nephritis | General disorders | CTCAE (5.0) | Systematic Assessment |
| |
| Thyroiditis | Endocrine disorders | CTCAE (5.0) | Systematic Assessment |
| |
| Colitis | Infections and infestations | CTCAE (5.0) | Systematic Assessment |
| |
| Arthritis | General disorders | CTCAE (5.0) | Systematic Assessment |
| |
| Pneumonitis | Infections and infestations | CTCAE (5.0) | Systematic Assessment |
| |
| Hypophysitis | Endocrine disorders | CTCAE (5.0) | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| A person designated by the Sponsor | An organization designated by the Sponsor | +34934344412 | investigacion@mfar.net |
| Mar 28, 2025 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D014565 | Urogenital Neoplasms |
| D011471 | Prostatic Neoplasms |
| D007680 | Kidney Neoplasms |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D005834 | Genital Neoplasms, Male |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D011469 | Prostatic Diseases |
| D014571 | Urologic Neoplasms |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| UK |
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| Cardiopathy |
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| COPD / Asma |
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| Hepatopathy |
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| Nephropathy |
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| None |
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| Kidney |
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| Testicular |
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| Penile |
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| II |
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| III |
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| IV |
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| UK |
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| II |
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| III |
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| IV |
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| UK |
|
| Poorly differentiated |
|
| UK |
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| Metastatic / palliative |
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| UK |
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