HL7 Europe Common Cancer Model
1.0.0-ballot - ballot 150

HL7 Europe Common Cancer Model - Local Development build (v1.0.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Logical Model: CancerStage - XML Profile

Active as of 2026-06-14

XML representation of the CancerStage logical model.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="CancerStage"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition CancerStage</b></p><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage" title="Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage).">CancerStage</a><a name="CancerStage"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( cs-ev-e1, cs-ev-e2, cs-tnm-1, cs-nontnm-1 )">C</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/types.html#Base">Base</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">CancerStage<br/><span style="font-weight:bold">Instances of this logical model can be the target of a Reference</span><br class="constraint"/><span title="null" class="constraint">Constraints: </span><span style="font-weight:bold" title="If type is Clinical, imaging evidence must not be provided." class="constraint">cs-ev-e1</span><span title="null" class="constraint">, </span><span style="font-weight:bold" title="If type is Pathological, surgery evidence must not be provided." class="constraint">cs-ev-e2</span><span title="null" class="constraint">, </span><span style="font-weight:bold" title="If classificationType is TNM, 3 values is expected." class="constraint">cs-tnm-1</span><span title="null" class="constraint">, </span><span style="font-weight:bold" title="For non-TNM staging systems, a single value is typically expected." class="constraint">cs-nontnm-1</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.cancerConditionAtDiagnosisReference" title="Reference to the cancer condition at first diagnosis for which the stage is reported.">cancerConditionAtDiagnosisReference</a><a name="CancerStage.cancerConditionAtDiagnosisReference"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-CancerConditionAtDiagnosis.html">CancerConditionAtDiagnosis</a>)</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">CancerCondition AtDiagnosis Reference</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.classificationType" title="Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM).">classificationType</a><a name="CancerStage.classificationType"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">ClassificationType</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.stage" title="One or more staging values expressed as (code, value) pairs.">stage</a><a name="CancerStage.stage"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">StageValue<br/></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.stage.code" title="Identifies which staging element is being reported (e.g. T category, N category, M category, stage group).">code</a><a name="CancerStage.stage.code"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Stage element code</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.stage.value" title="Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value).">value</a><a name="CancerStage.stage.value"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Stage element value</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.type" title="It indicates whether the stage instance is of type Clinical or Pathological.">type</a><a name="CancerStage.type"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Type</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-CancerStage-definitions.html#CancerStage.evidenceReference" title="Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage.">evidenceReference</a><a name="CancerStage.evidenceReference"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="StructureDefinition-Surgery.html">Surgery</a> | <a href="StructureDefinition-Imaging.html">Imaging</a>)</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">EvidenceReference<br/></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics">
        <valueCode value="can-be-target"/>
      </extension>
      <url
           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
      <version value="1.0.0-ballot"/>
      <name value="CancerStage"/>
      <title value="CancerStage"/>
      <status value="active"/>
      <date value="2026-06-14T12:51:40+02:00"/>
      <publisher value="HL7 Europe"/>
      <contact>
        <name value="HL7 Europe"/>
        <telecom>
          <system value="url"/>
          <value value="http://hl7.eu"/>
        </telecom>
      </contact>
      <description
                   value="Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage)."/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="150"/>
          <display value="Europe"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.html)."/>
      <fhirVersion value="4.0.1"/>
      <kind value="logical"/>
      <abstract value="false"/>
      <type
            value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
      <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
      <derivation value="specialization"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="4.0.1"/>
        </extension>
        <element id="CancerStage">
          <path value="CancerStage"/>
          <short value="CancerStage"/>
          <definition
                      value="Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Base"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="cs-ev-e1"/>
            <severity value="error"/>
            <human
                   value="If type is Clinical, imaging evidence must not be provided."/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-ev-e2"/>
            <severity value="error"/>
            <human
                   value="If type is Pathological, surgery evidence must not be provided."/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-tnm-1"/>
            <severity value="warning"/>
            <human value="If classificationType is TNM, 3 values is expected."/>
            <expression
                        value="classificationType.text = 'TNM' implies stage.count() &gt;= 3"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-nontnm-1"/>
            <severity value="warning"/>
            <human
                   value="For non-TNM staging systems, a single value is typically expected."/>
            <expression
                        value="classificationType.text != 'TNM' implies stage.count() = 1"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <isModifier value="false"/>
        </element>
        <element id="CancerStage.cancerConditionAtDiagnosisReference">
          <path value="CancerStage.cancerConditionAtDiagnosisReference"/>
          <short value="CancerCondition AtDiagnosis Reference"/>
          <definition
                      value="Reference to the cancer condition at first diagnosis for which the stage is reported."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="CancerStage.cancerConditionAtDiagnosisReference"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"/>
          </type>
        </element>
        <element id="CancerStage.classificationType">
          <path value="CancerStage.classificationType"/>
          <short value="ClassificationType"/>
          <definition
                      value="Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM)."/>
          <comment
                   value="For TNM, this element should be populated with 'TNM'. For single-value systems, it may be omitted when the system/measure is represented through stageComponent.code."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="CancerStage.classificationType"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.stage">
          <path value="CancerStage.stage"/>
          <short value="StageValue"/>
          <definition
                      value="One or more staging values expressed as (code, value) pairs."/>
          <comment
                   value="Most staging systems are represented by a single component. TNM is represented by three components, one for each of T, N, and M (codes 'T', 'N', 'M')."/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="CancerStage.stage"/>
            <min value="1"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
        </element>
        <element id="CancerStage.stage.id">
          <path value="CancerStage.stage.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="CancerStage.stage.extension">
          <path value="CancerStage.stage.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="CancerStage.stage.modifierExtension">
          <path value="CancerStage.stage.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="CancerStage.stage.code">
          <path value="CancerStage.stage.code"/>
          <short value="Stage element code"/>
          <definition
                      value="Identifies which staging element is being reported (e.g. T category, N category, M category, stage group)."/>
          <comment
                   value="For single-value staging systems, this represents the staging system/measure being used (e.g. 'FIGO stage group'). For TNM, expected codes include 'T', 'N', and 'M'."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="CancerStage.stage.code"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.stage.value">
          <path value="CancerStage.stage.value"/>
          <short value="Stage element value"/>
          <definition
                      value="Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value)."/>
          <comment
                   value="For TNM, this carries the component value (e.g. T2, N0, M0). For single-value systems, this carries the stage group/value (e.g. IIIB)."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="CancerStage.stage.value"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.type">
          <path value="CancerStage.type"/>
          <short value="Type"/>
          <definition
                      value="It indicates whether the stage instance is of type Clinical or Pathological."/>
          <comment
                   value="It indicates whether the stage instance is of type Clinical or Pathological. Choice: Clinical | Pathological"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="CancerStage.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.evidenceReference">
          <path value="CancerStage.evidenceReference"/>
          <short value="EvidenceReference"/>
          <definition
                      value="Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage."/>
          <comment
                   value="It shall be present. The reference shall be to one or more imaging procedures in case the stage is Clinical, or to one surgery in case the stage is Pathological."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="CancerStage.evidenceReference"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/Surgery"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/Imaging"/>
          </type>
        </element>
      </snapshot>
      <differential>
        <element id="CancerStage">
          <path value="CancerStage"/>
          <short value="CancerStage"/>
          <definition
                      value="Logical model representing the cancer stage at the time of first diagnosis. The stage may be clinical or pathological: the clinical stage is derived from imaging evidence, while the pathological stage, when available, is derived from surgical evidence. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet CancerStage)."/>
          <constraint>
            <key value="cs-ev-e1"/>
            <severity value="error"/>
            <human
                   value="If type is Clinical, imaging evidence must not be provided."/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-ev-e2"/>
            <severity value="error"/>
            <human
                   value="If type is Pathological, surgery evidence must not be provided."/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-tnm-1"/>
            <severity value="warning"/>
            <human value="If classificationType is TNM, 3 values is expected."/>
            <expression
                        value="classificationType.text = 'TNM' implies stage.count() &gt;= 3"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
          <constraint>
            <key value="cs-nontnm-1"/>
            <severity value="warning"/>
            <human
                   value="For non-TNM staging systems, a single value is typically expected."/>
            <expression
                        value="classificationType.text != 'TNM' implies stage.count() = 1"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerStage"/>
          </constraint>
        </element>
        <element id="CancerStage.cancerConditionAtDiagnosisReference">
          <path value="CancerStage.cancerConditionAtDiagnosisReference"/>
          <short value="CancerCondition AtDiagnosis Reference"/>
          <definition
                      value="Reference to the cancer condition at first diagnosis for which the stage is reported."/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"/>
          </type>
        </element>
        <element id="CancerStage.classificationType">
          <path value="CancerStage.classificationType"/>
          <short value="ClassificationType"/>
          <definition
                      value="Staging classification system used when the staging system needs to be explicitly identified (e.g. TNM)."/>
          <comment
                   value="For TNM, this element should be populated with 'TNM'. For single-value systems, it may be omitted when the system/measure is represented through stageComponent.code."/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.stage">
          <path value="CancerStage.stage"/>
          <short value="StageValue"/>
          <definition
                      value="One or more staging values expressed as (code, value) pairs."/>
          <comment
                   value="Most staging systems are represented by a single component. TNM is represented by three components, one for each of T, N, and M (codes 'T', 'N', 'M')."/>
          <min value="1"/>
          <max value="*"/>
          <type>
            <code value="BackboneElement"/>
          </type>
        </element>
        <element id="CancerStage.stage.code">
          <path value="CancerStage.stage.code"/>
          <short value="Stage element code"/>
          <definition
                      value="Identifies which staging element is being reported (e.g. T category, N category, M category, stage group)."/>
          <comment
                   value="For single-value staging systems, this represents the staging system/measure being used (e.g. 'FIGO stage group'). For TNM, expected codes include 'T', 'N', and 'M'."/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.stage.value">
          <path value="CancerStage.stage.value"/>
          <short value="Stage element value"/>
          <definition
                      value="Value associated with the reported staging element (e.g. T2, N1, M0; or a stage group value)."/>
          <comment
                   value="For TNM, this carries the component value (e.g. T2, N0, M0). For single-value systems, this carries the stage group/value (e.g. IIIB)."/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.type">
          <path value="CancerStage.type"/>
          <short value="Type"/>
          <definition
                      value="It indicates whether the stage instance is of type Clinical or Pathological."/>
          <comment
                   value="It indicates whether the stage instance is of type Clinical or Pathological. Choice: Clinical | Pathological"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="CancerStage.evidenceReference">
          <path value="CancerStage.evidenceReference"/>
          <short value="EvidenceReference"/>
          <definition
                      value="Reference(s) to the evidence used to define the stage: imaging in case of a Clinical stage, or surgery in case of a Pathological stage."/>
          <comment
                   value="It shall be present. The reference shall be to one or more imaging procedures in case the stage is Clinical, or to one surgery in case the stage is Pathological."/>
          <min value="0"/>
          <max value="*"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/Surgery"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/Imaging"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>