<StructureDefinition xmlns="http://hl7.org/fhir">
  <url value="https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Observation-TNMc" />
  <version value="0.0.1" />
  <name value="TNMc" />
  <status value="draft" />
  <description value="Staging of tumor diseases according to the TNM classification (clinical) in accordance with the current AJCC edition" />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="Observation" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" />
  <derivation value="constraint" />
  <differential>
    <element id="Observation.status">
      <path value="Observation.status" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.category.coding.system">
      <path value="Observation.category.coding.system" />
      <min value="1" />
      <fixedUri value="http://hl7.org/fhir/observation-category" />
    </element>
    <element id="Observation.category.coding.code">
      <path value="Observation.category.coding.code" />
      <min value="1" />
      <fixedCode value="laboratory" />
    </element>
    <element id="Observation.code">
      <path value="Observation.code" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.code.coding.system">
      <path value="Observation.code.coding.system" />
      <min value="1" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.code.coding.code">
      <path value="Observation.code.coding.code" />
      <min value="1" />
      <fixedCode value="21908-9" />
    </element>
    <element id="Observation.subject">
      <path value="Observation.subject" />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Patient-Patient" />
        <targetProfile value="https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Patient-Pseudonym" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Observation.focus">
      <path value="Observation.focus" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
        <targetProfile value="https://www.cancercoreeurope.eu/fhir/StructureDefinition/cce-core-Condition-PrimaryDiagnosis" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Observation.effective[x]">
      <path value="Observation.effective[x]" />
      <short value="Date of TNM documentation/Date of findings" />
      <definition value="This is the date on which the TNM data set was created and which is also considered relevant for the evaluation. It is usually identical to the diagnosis date or is close to this date." />
      <type>
        <code value="dateTime" />
      </type>
    </element>
    <element id="Observation.value[x]">
      <path value="Observation.value[x]" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <description value="Indicates the stage of the tumor (according to &quot;Union internationale contre le cancer&quot;)" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/UICCStageVS" />
      </binding>
    </element>
    <element id="Observation.value[x].coding.version">
      <path value="Observation.value[x].coding.version" />
      <short value="TNM-Version" />
      <definition value="Catalog version of the TNM" />
      <min value="1" />
      <binding>
        <strength value="extensible" />
        <description value="Catalog version of the TNM" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMVersionVS" />
      </binding>
    </element>
    <element id="Observation.value[x].coding.code">
      <path value="Observation.value[x].coding.code" />
      <short value="UICC Stadium" />
      <definition value="Indicates the stage of the tumor (according to &quot;Union internationale contre le cancer&quot;)" />
      <min value="1" />
    </element>
    <element id="Observation.component">
      <path value="Observation.component" />
      <slicing id="394">
        <discriminator>
          <type value="value" />
          <path value="code.coding.code" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
    </element>
    <element id="Observation.component:TNM-T">
      <path value="Observation.component" />
      <sliceName value="TNM-T" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-T.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-T.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="21905-5" />
    </element>
    <element id="Observation.component:TNM-T.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-T" />
      <definition value="Indicates the extent (location and size) of the primary tumor" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <description value="TNM-T" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMTVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-N">
      <path value="Observation.component" />
      <sliceName value="TNM-N" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-N.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-N.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <fixedCode value="21906-3" />
    </element>
    <element id="Observation.component:TNM-N.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-N" />
      <definition value="Indicates whether lymph nodes are affected" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <description value="TNM-N" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMNVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-M">
      <path value="Observation.component" />
      <sliceName value="TNM-M" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-M.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-M.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <fixedCode value="21907-1" />
    </element>
    <element id="Observation.component:TNM-M.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-M" />
      <definition value="Indicates whether metastases are present" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <description value="TNM-M" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMMVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-y-Symbol">
      <path value="Observation.component" />
      <sliceName value="TNM-y-Symbol" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-y-Symbol.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-y-Symbol.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="59479-6" />
    </element>
    <element id="Observation.component:TNM-y-Symbol.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-y-Symbol" />
      <definition value="Indicates when, in the case of multimodal therapies with multiple treatment approaches, the classification was made during or after these therapies" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM y-Symbol" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMySymbolVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-y-Symbol.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-r-Symbol">
      <path value="Observation.component" />
      <sliceName value="TNM-r-Symbol" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-r-Symbol.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-r-Symbol.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="21983-2" />
    </element>
    <element id="Observation.component:TNM-r-Symbol.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-r-Symbol" />
      <definition value="Indicates whether the tumor is an assessed recurrence" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM r-Symbol" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMrSymbolVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-r-Symbol.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-m-Symbol">
      <path value="Observation.component" />
      <sliceName value="TNM-m-Symbol" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-m-Symbol.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-m-Symbol.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="42030-7" />
    </element>
    <element id="Observation.component:TNM-m-Symbol.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-m-Symbol" />
      <definition value="Indicates whether multiple primary tumors are present in a region" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM m-Symbol" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMmSymbolVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-m-Symbol.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-L-Category">
      <path value="Observation.component" />
      <sliceName value="TNM-L-Category" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-L-Category.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-L-Category.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="33739-4" />
    </element>
    <element id="Observation.component:TNM-L-Category.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-L-Category" />
      <definition value="Lymphatic vessel invasion" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM-L-Category" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMLCategoryVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-L-Category.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-V-Category">
      <path value="Observation.component" />
      <sliceName value="TNM-V-Category" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-V-Category.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-V-Category.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="33740-2" />
    </element>
    <element id="Observation.component:TNM-V-Category.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-V-Category" />
      <definition value="Vein invasion" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM-V-Category" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMVCategoryVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-V-Category.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-Pn-Category">
      <path value="Observation.component" />
      <sliceName value="TNM-Pn-Category" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-Pn-Category.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-Pn-Category.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="92837-4" />
    </element>
    <element id="Observation.component:TNM-Pn-Category.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-Pn-Category" />
      <definition value="Perineuralinvasion" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM-Pn-Category" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMPnCategoryVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-Pn-Category.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
    <element id="Observation.component:TNM-S-Category">
      <path value="Observation.component" />
      <sliceName value="TNM-S-Category" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Observation.component:TNM-S-Category.code.coding.system">
      <path value="Observation.component.code.coding.system" />
      <fixedUri value="http://loinc.org" />
    </element>
    <element id="Observation.component:TNM-S-Category.code.coding.code">
      <path value="Observation.component.code.coding.code" />
      <min value="1" />
      <fixedCode value="21924-6" />
    </element>
    <element id="Observation.component:TNM-S-Category.value[x]">
      <path value="Observation.component.value[x]" />
      <short value="TNM-S-Category" />
      <definition value="Serumtumormarker" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="TNM-S-Category" />
        <valueSet value="https://www.cancercoreeurope.eu/fhir/core/ValueSet/TNMSCategoryVS" />
      </binding>
    </element>
    <element id="Observation.component:TNM-S-Category.value[x].coding.code">
      <path value="Observation.component.value[x].coding.code" />
      <min value="1" />
    </element>
  </differential>
</StructureDefinition>