Pathologic T
This input is used for staging
Notes
**Note 1:** High-grade dysplasia of the appendix is not always collected by cancer registries. * Assign pTis if your registry collects these tumors **Note 2:** pTis includes cancer cells confined within the glandular basement membrane (intraepithelial) or lamina propria (intramucosal) with no extension through muscularis mucosa into submucosa. **Note 3:** Ignore intraluminal extension to adjacent segment(s) of colon; code depth of invasion or extracolonic spread as indicated. **Note 4:** Mucinous tumors are identified by morphology codes 8480, 8481, and 8490. **Note 5:** One or more malignant satellite peritumoral nodules or tumor deposits (TD) in the periappendiceal adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule may represent discontinuous spread, venous invasion with extravascular spread, or a totally replaced lymph node. Replaced nodes are counted as positive nodes and coded in Regional lymph nodes. TD representing discontinuous spread or venous invasion are are assigned T3, and the number of TD representing discontinuous spread or venous invasion is coded in Site-Specific Factor 4. **Note 6:** Direct invasion in T4 includes invasion of other intestinal segments by way of the serosa, e.g., invasion of ileum. **Note 7:** Assign cT4b for tumor that is adherent to other organs or structures macroscopically. However, if no tumor is present in the adhesion, microscopically, the classification should be pT1, pT2 or pT3. **Note 8:** Assign T4b for contiguous extension from the site of origin. * *Exception:* Intraperitoneal metastases limited to the right lower quadrant (RLQ) of the abdomen for mucinous tumors, discontinuous involvement is coded in M (distant metastasis)NAACCR Item
NAACCR #880| Pathologic T | Pathologic T Display | Description | Registrar Notes |
|---|---|---|---|
| pX | pTX | Primary tumor cannot be assessed | Pathologic classification criteria met, evaluation done: Physician unable to assess T Surgical resection of primary tumor, extension not stated Physician assigns pTX, no other information available to determine T |
| p0 | pT0 | No evidence of primary tumor | |
| pIS | pTis | Carcinoma in situ: intraepithelial or invasion of lamina propria | Intraepithelial, noninvasive (Adeno)carcinoma, noninvasive, in a polyp or adenoma Invasive tumor confined to: Lamina propria, including lamina propria in the stalk of a polyp Mucosa, NOS, including intramucosal, NOS Muscularis mucosae (but not through), including muscularis mucosae in the stalk of a polyp Stated as Tis |
| p1 | pT1 | Tumor invades submucosa | Confined to: Head of polyp, NOS Stalk of polyp, NOS Invasive tumor in polyp, NOS Invades submucosa (superficial invasion), including submucosa in stalk of polyp Confined to appendix, NOS Localized, NOS Stated as T1 |
| p2 | pT2 | Tumor invades muscularis propria | Stated as T2 |
| p3 | pT3 | Tumor invades subserosa or mesoappendix | Extension through wall, NOS Invasion through muscularis propria or muscularis, NOS Non-peritonealized pericolic tissues invaded Perimuscular tissue invaded Transmural, NOS Wall, NOS Extension to: Adjacent tissue(s), NOS Connective tissue Mesenteric fat Mesentery Pericolic fat Stated as T3 |
| p4 | pT4 | Tumor perforates visceral peritoneum, including mucinous peritoneal tumor within the right lower quadrant and/or directly invades other organs or structures | Note: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories. Stated as T4 [NOS] |
| p4A | pT4a | Tumor perforates visceral peritoneum, including mucinous peritoneal tumor within the right lower quadrant | Invasion of/through serosa (mesothelium) (visceral peritoneum) Tumor penetrates to surface of visceral peritoneum For mucinous tumors only: Peritoneal involvement confined within right lower quadrant ONLY Peritoneal involvement confined within right lower quadrant plus local extension equivalent to T1, T2, T3 or T4 Stated as T4a |
| p4B | pT4b | Tumor directly invades other organs or structures | Adherent to other organs or structures clinically with no microscopic examination Tumor found in adhesion(s) if microscopic examination performed Adherent to other organs or structures: Abdominal wall Adrenal (suprarenal) gland Bladder Diaphragm Fallopian tube Fistula to skin Gallbladder Greater omentum Kidney Liver Ovary Other segment(s) of colon/rectum via serosa Pelvic peritoneum Retroperitoneum (excluding fat) Small intestine Ureter Uterus Other contiguous extension For mucinous tumors only: Regional extension characterized as T4b plus peritoneal involvement confined within right lower quadrant Stated as T4b |
| 88 | 88 | Not applicable | Primary site/histology not TNM defined Death certificate only (DCO) case |
| <BLANK> | BLANK | See Registrar Notes | Pathologic classification criteria not met Pathologic classification criteria met, evaluation done: Results not documented in patient record No surgical resection of known primary tumor (not T0) Resection insufficient for site-specific pathologic assessment No surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category Evidence of metastatic disease (pM1), no other workup Only Pathologic Stage Group documented (no T, N, or M information available) |