{
  "resourceType" : "Observation",
  "id" : "mii-exa-onko-modification-verlauf-6months",
  "meta" : {
    "profile" : ["https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-verlauf"]
  },
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xml:lang=\"en\" lang=\"en\"><hr/><p><b>English</b></p><hr/><p class=\"res-header-id\"><b>Generated Narrative: Observation mii-exa-onko-modification-verlauf-6months</b></p><a name=\"mii-exa-onko-modification-verlauf-6months\"> </a><a name=\"hcmii-exa-onko-modification-verlauf-6months\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mii-pr-onko-verlauf.html\">MII PR Onkologie Verlauf</a></p></div><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 396432002}\">Status of regression of tumor (observable entity)</span></p><p><b>subject</b>: <a href=\"Patient-example-modification.html\">Martin Beispiel  Male, DoB: 1958-11-03</a></p><p><b>focus</b>: <a href=\"Condition-mii-exa-onko-ascending-colon-cancer-diagnosis.html\">Condition Bösartige Neubildung: Colon ascendens</a></p><p><b>effective</b>: 2025-03-10</p><p><b>value</b>: <span title=\"Codes:{https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung V}\">Vollremission (complete remission, CR)</span></p><p><b>note</b>: </p><blockquote><div><p>Patient completed modified chemotherapy protocol (6 cycles FOLFOX4 + 6 cycles LV5FU2). Despite early discontinuation of oxaliplatin due to neuropathy, patient achieved complete response. CT scan and colonoscopy show no evidence of recurrence. CEA normal (1.8 ng/mL). Peripheral neuropathy has improved to grade 1 but persists. Patient is disease-free at 6-month follow-up.</p>\n</div></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 445200009}\">Status of residual neoplasm (observable entity)</span></p><p><b>value</b>: <span title=\"Codes:{https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-primaertumor K}\">Kein Tumor nachweisbar</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 399656008}\">Presence of metastatic neoplasm in regional lymph node (observable entity)</span></p><p><b>value</b>: <span title=\"Codes:{https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-lymphknoten K}\">kein Lymphknotenbefall nachweisbar</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 399608002}\">Status of distant metastasis (observable entity)</span></p><p><b>value</b>: <span title=\"Codes:{https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-fernmetastasen K}\">Keine Fernmetastasen nachweisbar</span></p></blockquote></div>"
  },
  "status" : "final",
  "code" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "396432002",
      "display" : "Status of regression of tumor (observable entity)"
    }]
  },
  "subject" : {
    "reference" : "Patient/example-modification"
  },
  "focus" : [{
    "reference" : "Condition/mii-exa-onko-ascending-colon-cancer-diagnosis"
  }],
  "effectiveDateTime" : "2025-03-10",
  "valueCodeableConcept" : {
    "coding" : [{
      "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung",
      "code" : "V",
      "display" : "Vollremission (complete remission, CR)"
    }]
  },
  "note" : [{
    "text" : "Patient completed modified chemotherapy protocol (6 cycles FOLFOX4 + 6 cycles LV5FU2). Despite early discontinuation of oxaliplatin due to neuropathy, patient achieved complete response. CT scan and colonoscopy show no evidence of recurrence. CEA normal (1.8 ng/mL). Peripheral neuropathy has improved to grade 1 but persists. Patient is disease-free at 6-month follow-up."
  }],
  "component" : [{
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "445200009",
        "display" : "Status of residual neoplasm (observable entity)"
      }]
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-primaertumor",
        "code" : "K",
        "display" : "Kein Tumor nachweisbar"
      }]
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "399656008",
        "display" : "Presence of metastatic neoplasm in regional lymph node (observable entity)"
      }]
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-lymphknoten",
        "code" : "K",
        "display" : "kein Lymphknotenbefall nachweisbar"
      }]
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "399608002",
        "display" : "Status of distant metastasis (observable entity)"
      }]
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-fernmetastasen",
        "code" : "K",
        "display" : "Keine Fernmetastasen nachweisbar"
      }]
    }
  }]
}