Pathologic T
This input is used for staging
Notes
**Note 1:** Carcinoma of the pharyngeal tonsil is staged using the schema for oropharynx. **Note 2:** Tumor size must be known to assign a value of T1 or T2. 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 or T2 categories, but no size or category is specified, assign TX **Note 3:** Assign the appropriate T category (T1, T2) based on the tumor size for the following descriptions Invasive tumor confined to Adenoid Pharyngeal tonsil (nasopharyngeal tonsil) Posterior superior wall (vault) Involvement of inferior wall of nasopharynx (superior surface of soft palate) Nasal cavity Oropharynx Pterygopalatine fossa Soft palate, inferior surface including uvula Any of the above WITH parapharyngeal extension Confined to pharyngeal tonsil Localized, NOS **Note 4:** Parapharyngeal involvement denotes postero-lateral infiltration of tumor beyond the pharyngobasilar fascia. The pharyngobasilar fascia is the fibrous layer of the pharyngeal wall between the mucosa and the muscular layer, attached superiorly to the basilar part of the occipital bone and diminishing in thickness as it descends. **Note 5:** The masticator space primarily consists of the muscles of mastication, the medial and lateral pterygoid, masseter, and temporalis muscles. The space also includes the ramus of the mandible and the third division of cranial nerve V as it passes through the foramen ovale into the suprahyoid neck.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 OR extension to lingual surface of epiglottis | 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 | Tumor invades any of the following: Larynx Deep/extrinsic muscle of tongue, which are: Genioglossus Hypoglossus Palatoglossus Styloglossus Medial pterygoid Hard palate Mandible |
Hypopharynx Paranasal sinus Stated as T4a |
| p4B | pT4b | Tumor invades any of the following: Lateral pterygoid muscle Pterygoid plates Lateral nasopharynx Skull base Encases carotid artery |
Bony structures of skull base Brain Cranial nerve involvement Floor of orbit Hypopharynx Infratemporal fossa/masticator space Orbit Further contiguous extension including: Soft tissues of the neck 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) |