Clinical T

This input is used for staging

Notes

**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for mucosal melanoma tumors. **Note 2:** Mucosal melanomas are aggressive tumors, therefore, T1 and T2 are omitted, as are Stages I and II. **Note 3:** Assign T3 for localized tumor when no other information is available or for extension involving the mucosa only of adjacent sites. **Note 4:** Assign T4a or T4b for extension involving the deeper tissues of the primary or adjacent sites.

NAACCR Item

NAACCR #940
Clinical T Clinical T Display Description Registrar Notes
cX cTX Primary tumor cannot be assessed# Clinical classification criteria met, evaluation done:
Physician unable to assess T
Extension cannot be determined
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor#
c3 cT3 Tumor limited to the epithelium and/or submucosa (mucosal disease) Tumor confined to mucosa of supraglottis:
Supraglottis (one subsite):
Aryepiglottic fold
Arytenoid cartilage:
Corniculate cartilage
Cuneiform cartilage
Epilarynx, NOS
False cords:
Ventricular bands
Ventricular cavity
Ventricular fold
Infrahyoid epiglottis
Laryngeal cartilage, NOS
Laryngeal (posterior) surface of epiglottis
Suprahyoid epiglottis (including tip, lingual {anterior} and laryngeal surfaces)
WITH normal vocal cord mobility

Extension involving mucosa only of glottic larynx or subglottis WITHOUT impaired vocal cord mobility or fixation of larynx or NOS

Extension involving mucosa only of adjacent regions(s) outside supraglottis including:
Mucosa of base of tongue
Vallecula
Medial wall of pyriform sinus
WITHOUT impaired vocal cord mobility or fixation of larynx or NOS

Stated as T3
c4 cT4 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]
c4A cT4a Tumor invades:
Deep soft tissue
Cartilage
Bone
Overlying skin
Involvement of deep tissues of any structure in T3
Involvement of any structures in T3 WITH impaired vocal cord mobility
Involvement of any structures in supraglottic larynx and subglottic larynx WITH vocal cord fixation

Paraglottic space WITHOUT vocal cord fixation
Minor thyroid cartilage erosion (inner cortex) WITHOUT vocal cord fixation

Tumor involves further regions outside the supraglottis including:
Deep tissues or musculature:
Base of tongue
Medial wall pyriform sinus
Vallecula
Hypopharynx, NOS
Pre-epiglottic tissues
Postcricoid area
Pyriform sinus, NOS
WITH or WITHOUT vocal cord fixation

Extension to/through:
Cricoid cartilage
Deep extrinsic muscles of tongue
Esophagus
Oropharynx
Skin
Soft tissues of neck
Strap muscle(s):
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
Thyroid cartilage
Thyroid gland
Trachea

Stated as T4a
c4B cT4b Tumor invades any of the following:
Brain
Dura
Skull base
Lower cranial nerves (IX, X, XI, XII)
Masticator space
Carotid artery
Prevertebral space
Mediastinal structures
Contiguous extension, including:
Carotid artery (encased)
Mediastinal structures

Stated as T4b
88 88 Not applicable In situ case but no pTis is defined by TNM
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Clinical classification criteria not met
Clinical classification criteria met, evaluation done:
No information about diagnostic workup
Results not documented in record
Clinical evaluation of primary tumor not done or unknown if done
Tumor first detected on surgical resection (no clinical workup)
Evidence of metastatic disease [(cM1) or (pM1)], no other workup
Only Clinical 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]. \# TX, T0 and T4 [NOS] are not defined in AJCC 7th edition.