Pathologic T

This input is used for staging

Notes

**Note 1:** Periosteum is a fibrous membrane that wraps the outer surface of bones. Cortical bone is the dense compact outer layer of the bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, decreasing weight and allowing room for blood vessels and marrow. **Note 2:** Tumor size must be known to assign a value of T1, T2 or T3. You may use a physician’s statement of the T category if this is the only information in the medical record. * If the tumor appears to be in the T1, T2 or T3 categories, but no size or category is specified, assign TX **Note 3:** For the following descriptions, assign the appropriate T category (T1, T2 or T3) based on the tumor size when involvement is limited to the cortical bone. Invasive tumor confined to Lamina propria Submucosa (superficial invasion) Extension to Bone, NOS Buccal mucosa (inner cheek) Cartilage, NOS Commissure (from lower lip only) Cortical bone, NOS Cortical bone of mandible Cortical bone of maxilla Gingiva Hard palate including cortical palantine bone Lateral pharyngeal wall Lip(s) including commissure Mandible, NOS Maxilla, NOS Musculature (buccinator) Opposite lip (both lips) Soft palate Subcutaneous soft tissue of cheek Tonsillar pillars and fossae Tonsils Confined to buccal mucosa Localized, NOS **Note 4:** Involvement through cortical bone is required for assignment of T4a.

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
Tumor size (TS) unknown for T categories where TS needed to determine T
Physician assigns pTX, no other information available to determine T
p0 pT0 No evidence of primary tumor
pIS pTis Carcinoma in situ Intraepithelial, noninvasive

Stated as Tis
p1 pT1 Tumor 2 cm or less in greatest dimension Stated as T1
p2 pT2 Tumor more than 2 cm but not more than 4 cm in greatest dimension Stated as T2
p3 pT3 Tumor more than 4 cm in greatest dimension Stated as T3
p4 pT4 Not defined by UICC*# Note: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories

Tumor invades bone, nerve or extrinsic deep muscles

Stated as T4[NOS]
p4A pT4a (lip) Tumor invades through:
Cortical bone
Floor of mouth
Inferior alveolar nerve
Skin (chin or nose)

(oral cavity) Tumor invades through:
Cortical bone
Into deep/extrinsic muscle of tongue:
Genioglossus
Hyoglossus
Palatoglossus
Styloglossus
Maxillary sinus
Skin of face
Skin of cheek with or without ulceration

Trabecular bone:
Mandible
Maxilla
Palatine bone

Maxillary sinus (antrum) Nasal cavity

Tongue

Stated as T4a
p4B pT4b (lip and oral cavity) Tumor invades:
Masticator space
Pterygoid plates
Skull base

or Encases internal carotid artery
Masticator space
Pterygoid plates

Other specified bone(s)
(Other than maxilla, mandible, palatine, masticator space, pterygoid plates)

Further contiguous extension including:
Base of skull
Internal carotid artery (encased)
Skull

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)
\* T4 [NOS] is not defined by UICC in the 7th edition. Approval has been provided by UICC to use "Tumor invades bone, nerve or extrinsic deep muscles" as T4 [NOS]. \# T4 [NOS] is not defined in AJCC 7th edition.