# ClinicalCancerProgression - HL7 Europe Common Cancer Model v1.0.0-ballot

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **ClinicalCancerProgression**

## Logical Model: ClinicalCancerProgression 

| | |
| :--- | :--- |
| *Official URL*:http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression | *Version*:1.0.0-ballot |
| Active as of 2026-06-14 | *Computable Name*:ClinicalCancerProgression |
| **Copyright/Legal**: HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.md). | |

 
Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet ClinicalCancerProgression). 

**Usages:**

* Refer to this Logical Model: [OverallCancerTreatmentResponse](StructureDefinition-OverallCancerTreatmentResponse.md), [Radiotherapy](StructureDefinition-Radiotherapy.md), [Surgery](StructureDefinition-Surgery.md) and [SystemicTreatment](StructureDefinition-SystemicTreatment.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/hl7.fhir.eu.cancer-common|current/StructureDefinition/StructureDefinition-ClinicalCancerProgression.json)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-ClinicalCancerProgression.csv), [Excel](StructureDefinition-ClinicalCancerProgression.xlsx) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "ClinicalCancerProgression",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics",
    "valueCode" : "can-be-target"
  }],
  "url" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression",
  "version" : "1.0.0-ballot",
  "name" : "ClinicalCancerProgression",
  "title" : "ClinicalCancerProgression",
  "status" : "active",
  "date" : "2026-06-14T12:51:40+02:00",
  "publisher" : "HL7 Europe",
  "contact" : [{
    "name" : "HL7 Europe",
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.eu"
    }]
  }],
  "description" : "Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "150",
      "display" : "Europe"
    }]
  }],
  "copyright" : "HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.html).",
  "fhirVersion" : "4.0.1",
  "kind" : "logical",
  "abstract" : false,
  "type" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Base",
  "derivation" : "specialization",
  "differential" : {
    "element" : [{
      "id" : "ClinicalCancerProgression",
      "path" : "ClinicalCancerProgression",
      "short" : "ClinicalCancerProgression",
      "definition" : "Logical model representing the longitudinal evolution of the cancer disease, documenting disease status and extent at a specific point in time. Derived from Cancer_Common_Logical_Model_20260521.xlsx  (sheet ClinicalCancerProgression).",
      "constraint" : [{
        "key" : "ccp-1",
        "severity" : "error",
        "human" : "LocoRegionalSites must be present if ExtentType is Loco-regional",
        "expression" : "extentType.coding.where(code = 'Loco-regional').exists() implies locoRegionalSites.exists()",
        "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
      },
      {
        "key" : "ccp-2",
        "severity" : "error",
        "human" : "MetastaticSites must be present if ExtentType is Metastatic",
        "expression" : "extentType.coding.where(code = 'Metastatic').exists() implies metastaticSites.exists()",
        "source" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
      "path" : "ClinicalCancerProgression.cancerConditionAtDiagnosisReference",
      "short" : "CancerConditionReference",
      "definition" : "Reference to the original cancer condition at diagnosis to which this progression refers.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"]
      }]
    },
    {
      "id" : "ClinicalCancerProgression.diseaseStatus",
      "path" : "ClinicalCancerProgression.diseaseStatus",
      "short" : "DiseaseStatus",
      "definition" : "Disease status at this time point (e.g. progression, stable disease, remission, recurrence).",
      "comment" : "Choice: Progression | Stable Disease | Partial Remission | Complete Remission | Recurrence",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.tumourGradeSystem",
      "path" : "ClinicalCancerProgression.tumourGradeSystem",
      "short" : "TumourGradeSystem",
      "definition" : "Classification system used to define tumour grade, describing how abnormal tumour cells and tissue appear under microscopic examination (e.g. Gleason for prostate cancer, FNCLCC for soft tissue sarcomas). The grading system provides an indication of the biological aggressiveness of the tumour.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.tumourGradeValue",
      "path" : "ClinicalCancerProgression.tumourGradeValue",
      "short" : "TumourGradeValue",
      "definition" : "Grade value assigned according to the selected TumourGradeSystem. The grade reflects the degree of cellular differentiation and biological aggressiveness of the tumour and may evolve over time.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.assertedDate",
      "path" : "ClinicalCancerProgression.assertedDate",
      "short" : "AssertedDate",
      "definition" : "Date when this progression/status was asserted/recorded.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.extentType",
      "path" : "ClinicalCancerProgression.extentType",
      "short" : "ExtentType",
      "definition" : "Extent of disease at this time point (Local, Loco-regional, Metastatic).",
      "comment" : "Choice: Local | Loco-regional | Metastatic",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.locoRegionalSites",
      "path" : "ClinicalCancerProgression.locoRegionalSites",
      "short" : "LocoRegionalSites",
      "definition" : "Sites involved when ExtentType is Loco-regional.",
      "comment" : "It must be present if the ExtentType is Loco-regional",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    },
    {
      "id" : "ClinicalCancerProgression.metastaticSites",
      "path" : "ClinicalCancerProgression.metastaticSites",
      "short" : "MetastaticSites",
      "definition" : "Sites involved when ExtentType is Metastatic.",
      "comment" : "It must be present if the ExtentType is Metastatic",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    }]
  }
}

```
