Table 2.

Selected UNC GOLD forms with variables

Preoperative - Bladder Ureter and Renal Pelvis	Operative – Kidney	Pathology - Prostate
When was bladder cancer initially diagnosed? Referring physician last name Referring physician first name Prior Pelvic Radiation? Prior Abdominal/Pelvic Surgery? Has patient had a TURBTa or biopsy? Date of TURBT/biopsy leading to current treatment Number of prior TURBTs or Biopsies Histology Specify benign histology Specify histology other Specify other benign histology TURBT biopsy grade TURBT Stage Clinical N Stage Clinical M Stage TURBT muscle present? TURBT multifocal? Lymphovascular invasion on pathology Did patient have a restaging TURBT (within 3 months)? Did pathology change? What is new pathology? High or low grade? Was muscle present? N Stage M Stage Lymphovascular invasion on pathology Prognostic Factors Risk Factors Intravesical chemotherapy use Intravesical chemotherapy type How many induction courses has patient had? Preop METSb Preoperative comments Date of data entry: Data entry person:	Was surgery performed? Date of surgery Attending surgeon Laterality Procedure on right Procedure on left Surgical approach Was surgery retroperitoneal? ASAc score Crystalloid Colloids Packed red blood cells Fresh Frozen Plasma Platelets Estimated blood loss Was the surgery cytoreductive? Tumor thrombus present? What is the level of thrombus? Was cardiac bypass used? Was lymph node dissection performed? Was clamping used on the right? Was ischemia warm or cold? What was the right side clamp time? Was early unclamping performed? Was only the artery clamped? Was clamping used on the left? Was ischemia warm or cold? What was the left side clamp time? Was early unclamping performed? Was only the artery clamped? What was the total clamp time? Was fluorescence with ICGd used? What was the time of incision? What was the time of closure? Operative comments Were there any operative complications? (List of complications) Specify complication grade Specify other operative complications Data entry date: Data entry person:	Was tumor tissue sent to pathology? Histology Specify other histology Percent tumor Prostate volume Calculated tumor volume Gleason primary postop Gleason secondary postop Gleason sum postop Gleason tertiary postop Margin status Margin location Specify other margin location Side of margin Aggregate length of margin Pathologic tumor stage Pathologic tumor stage Extracapsular extension Extracapsular extension location Extracapsular extension location, specify Seminal vesicle invasion Seminal vesicle invasion location Perineural invasion? Lymph nodes sampled Lymph tissue in specimen Sampled as a group? Total number positive Total number sampled Right lymph nodes positive? Left lymph nodes positive? Pathology comments Data entry date: Data entry person:

^a.TURBT: Transurethral resection of bladder tumor

^b.MET: Metabolic equivalent of task

^c.ASA score: American Society of Anesthesiologists physical status classification system

^d.ICG: Indocyanine green