<?xml version="1.0" encoding="UTF-8"?>

<Observation xmlns="http://hl7.org/fhir">
  <id value="mii-exa-onko-modification-verlauf-6months"/>
  <meta>
    <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-verlauf"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="generated"/><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>
</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>
  </text>
  <status value="final"/>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="396432002"/>
      <display value="Status of regression of tumor (observable entity)"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/example-modification"/>
  </subject>
  <focus>
    <reference value="Condition/mii-exa-onko-ascending-colon-cancer-diagnosis"/>
  </focus>
  <effectiveDateTime value="2025-03-10"/>
  <valueCodeableConcept>
    <coding>
      <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung"/>
      <code value="V"/>
      <display value="Vollremission (complete remission, CR)"/>
    </coding>
  </valueCodeableConcept>
  <note>
    <text value="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."/>
  </note>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="445200009"/>
        <display value="Status of residual neoplasm (observable entity)"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-primaertumor"/>
        <code value="K"/>
        <display value="Kein Tumor nachweisbar"/>
      </coding>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="399656008"/>
        <display value="Presence of metastatic neoplasm in regional lymph node (observable entity)"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-lymphknoten"/>
        <code value="K"/>
        <display value="kein Lymphknotenbefall nachweisbar"/>
      </coding>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="399608002"/>
        <display value="Status of distant metastasis (observable entity)"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-fernmetastasen"/>
        <code value="K"/>
        <display value="Keine Fernmetastasen nachweisbar"/>
      </coding>
    </valueCodeableConcept>
  </component>
</Observation>