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: ClinicalCancerProgression - XML Profile

Active as of 2026-06-14

XML representation of the ClinicalCancerProgression logical model.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="ClinicalCancerProgression"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition ClinicalCancerProgression</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression" title="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).">ClinicalCancerProgression</a><a name="ClinicalCancerProgression"> </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 ( ccp-1, ccp-2 )">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">ClinicalCancerProgression<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="LocoRegionalSites must be present if ExtentType is Loco-regional" class="constraint">ccp-1</span><span title="null" class="constraint">, </span><span style="font-weight:bold" title="MetastaticSites must be present if ExtentType is Metastatic" class="constraint">ccp-2</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.cancerConditionAtDiagnosisReference" title="Reference to the original cancer condition at diagnosis to which this progression refers.">cancerConditionAtDiagnosisReference</a><a name="ClinicalCancerProgression.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">CancerConditionReference</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.diseaseStatus" title="Disease status at this time point (e.g. progression, stable disease, remission, recurrence).">diseaseStatus</a><a name="ClinicalCancerProgression.diseaseStatus"> </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">DiseaseStatus</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_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.tumourGradeSystem" title="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.">tumourGradeSystem</a><a name="ClinicalCancerProgression.tumourGradeSystem"> </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..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">TumourGradeSystem</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_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.tumourGradeValue" title="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.">tumourGradeValue</a><a name="ClinicalCancerProgression.tumourGradeValue"> </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#string">string</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">TumourGradeValue</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_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.assertedDate" title="Date when this progression/status was asserted/recorded.">assertedDate</a><a name="ClinicalCancerProgression.assertedDate"> </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#dateTime">dateTime</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">AssertedDate</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-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.extentType" title="Extent of disease at this time point (Local, Loco-regional, Metastatic).">extentType</a><a name="ClinicalCancerProgression.extentType"> </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">ExtentType</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_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.locoRegionalSites" title="Sites involved when ExtentType is Loco-regional.">locoRegionalSites</a><a name="ClinicalCancerProgression.locoRegionalSites"> </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/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">LocoRegionalSites<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_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_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClinicalCancerProgression-definitions.html#ClinicalCancerProgression.metastaticSites" title="Sites involved when ExtentType is Metastatic.">metastaticSites</a><a name="ClinicalCancerProgression.metastaticSites"> </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..*</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">MetastaticSites<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/ClinicalCancerProgression"/>
      <version value="1.0.0-ballot"/>
      <name value="ClinicalCancerProgression"/>
      <title value="ClinicalCancerProgression"/>
      <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 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 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/ClinicalCancerProgression"/>
      <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="ClinicalCancerProgression">
          <path value="ClinicalCancerProgression"/>
          <short value="ClinicalCancerProgression"/>
          <definition
                      value="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)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Base"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="ccp-1"/>
            <severity value="error"/>
            <human
                   value="LocoRegionalSites must be present if ExtentType is Loco-regional"/>
            <expression
                        value="extentType.coding.where(code = 'Loco-regional').exists() implies locoRegionalSites.exists()"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"/>
          </constraint>
          <constraint>
            <key value="ccp-2"/>
            <severity value="error"/>
            <human
                   value="MetastaticSites must be present if ExtentType is Metastatic"/>
            <expression
                        value="extentType.coding.where(code = 'Metastatic').exists() implies metastaticSites.exists()"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"/>
          </constraint>
          <isModifier value="false"/>
        </element>
        <element
                 id="ClinicalCancerProgression.cancerConditionAtDiagnosisReference">
          <path
                value="ClinicalCancerProgression.cancerConditionAtDiagnosisReference"/>
          <short value="CancerConditionReference"/>
          <definition
                      value="Reference to the original cancer condition at diagnosis to which this progression refers."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path
                  value="ClinicalCancerProgression.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="ClinicalCancerProgression.diseaseStatus">
          <path value="ClinicalCancerProgression.diseaseStatus"/>
          <short value="DiseaseStatus"/>
          <definition
                      value="Disease status at this time point (e.g. progression, stable disease, remission, recurrence)."/>
          <comment
                   value="Choice: Progression | Stable Disease | Partial Remission | Complete Remission | Recurrence"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ClinicalCancerProgression.diseaseStatus"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.tumourGradeSystem">
          <path value="ClinicalCancerProgression.tumourGradeSystem"/>
          <short value="TumourGradeSystem"/>
          <definition
                      value="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 value="0"/>
          <max value="1"/>
          <base>
            <path value="ClinicalCancerProgression.tumourGradeSystem"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.tumourGradeValue">
          <path value="ClinicalCancerProgression.tumourGradeValue"/>
          <short value="TumourGradeValue"/>
          <definition
                      value="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 value="0"/>
          <max value="1"/>
          <base>
            <path value="ClinicalCancerProgression.tumourGradeValue"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.assertedDate">
          <path value="ClinicalCancerProgression.assertedDate"/>
          <short value="AssertedDate"/>
          <definition
                      value="Date when this progression/status was asserted/recorded."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ClinicalCancerProgression.assertedDate"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="dateTime"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.extentType">
          <path value="ClinicalCancerProgression.extentType"/>
          <short value="ExtentType"/>
          <definition
                      value="Extent of disease at this time point (Local, Loco-regional, Metastatic)."/>
          <comment value="Choice: Local | Loco-regional | Metastatic"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ClinicalCancerProgression.extentType"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.locoRegionalSites">
          <path value="ClinicalCancerProgression.locoRegionalSites"/>
          <short value="LocoRegionalSites"/>
          <definition value="Sites involved when ExtentType is Loco-regional."/>
          <comment value="It must be present if the ExtentType is Loco-regional"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ClinicalCancerProgression.locoRegionalSites"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.metastaticSites">
          <path value="ClinicalCancerProgression.metastaticSites"/>
          <short value="MetastaticSites"/>
          <definition value="Sites involved when ExtentType is Metastatic."/>
          <comment value="It must be present if the ExtentType is Metastatic"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ClinicalCancerProgression.metastaticSites"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
      </snapshot>
      <differential>
        <element id="ClinicalCancerProgression">
          <path value="ClinicalCancerProgression"/>
          <short value="ClinicalCancerProgression"/>
          <definition
                      value="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 value="ccp-1"/>
            <severity value="error"/>
            <human
                   value="LocoRegionalSites must be present if ExtentType is Loco-regional"/>
            <expression
                        value="extentType.coding.where(code = 'Loco-regional').exists() implies locoRegionalSites.exists()"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"/>
          </constraint>
          <constraint>
            <key value="ccp-2"/>
            <severity value="error"/>
            <human
                   value="MetastaticSites must be present if ExtentType is Metastatic"/>
            <expression
                        value="extentType.coding.where(code = 'Metastatic').exists() implies metastaticSites.exists()"/>
            <source
                    value="http://hl7.eu/fhir/cancer-common/StructureDefinition/ClinicalCancerProgression"/>
          </constraint>
        </element>
        <element
                 id="ClinicalCancerProgression.cancerConditionAtDiagnosisReference">
          <path
                value="ClinicalCancerProgression.cancerConditionAtDiagnosisReference"/>
          <short value="CancerConditionReference"/>
          <definition
                      value="Reference to the original cancer condition at diagnosis to which this progression refers."/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/cancer-common/StructureDefinition/CancerConditionAtDiagnosis"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.diseaseStatus">
          <path value="ClinicalCancerProgression.diseaseStatus"/>
          <short value="DiseaseStatus"/>
          <definition
                      value="Disease status at this time point (e.g. progression, stable disease, remission, recurrence)."/>
          <comment
                   value="Choice: Progression | Stable Disease | Partial Remission | Complete Remission | Recurrence"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.tumourGradeSystem">
          <path value="ClinicalCancerProgression.tumourGradeSystem"/>
          <short value="TumourGradeSystem"/>
          <definition
                      value="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 value="0"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.tumourGradeValue">
          <path value="ClinicalCancerProgression.tumourGradeValue"/>
          <short value="TumourGradeValue"/>
          <definition
                      value="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 value="0"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.assertedDate">
          <path value="ClinicalCancerProgression.assertedDate"/>
          <short value="AssertedDate"/>
          <definition
                      value="Date when this progression/status was asserted/recorded."/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="dateTime"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.extentType">
          <path value="ClinicalCancerProgression.extentType"/>
          <short value="ExtentType"/>
          <definition
                      value="Extent of disease at this time point (Local, Loco-regional, Metastatic)."/>
          <comment value="Choice: Local | Loco-regional | Metastatic"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.locoRegionalSites">
          <path value="ClinicalCancerProgression.locoRegionalSites"/>
          <short value="LocoRegionalSites"/>
          <definition value="Sites involved when ExtentType is Loco-regional."/>
          <comment value="It must be present if the ExtentType is Loco-regional"/>
          <min value="0"/>
          <max value="*"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="ClinicalCancerProgression.metastaticSites">
          <path value="ClinicalCancerProgression.metastaticSites"/>
          <short value="MetastaticSites"/>
          <definition value="Sites involved when ExtentType is Metastatic."/>
          <comment value="It must be present if the ExtentType is Metastatic"/>
          <min value="0"/>
          <max value="*"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>