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)