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 the following subsites:
Anterior wall:
Lingual (anterior surface of epiglottis)
Vallecula
One lateral wall
Posterior wall

Involvement of mucosa only:
Anterior two-thirds of tongue
Base of tongue
Buccal mucosa (inner cheek)
Floor of mouth
Gum (gingiva)
Hard palate
Hypopharynx, NOS
Larynx
Nasopharynx
Posterior surface of epiglottis
Pyriform sinus
Soft palate, inferior surface, including uvula
Soft palate, superior (nasopharyngeal) surface
Soft palate, NOS

Localized, 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 soft tissue or musculature of any structure in T3 WITH or WITHOUT fixation
Mucosal involvement of hard palate
Involvement of deep soft tissue or musculature of both lateral walls, soft palate, or base of tongue
with contiguous involvement through all four sites

Bone, NOS
Bone excluding base of skull
Cartilage, NOS
Deep tissue or periosteum of hard palate
Deep soft tissue or musculature of anterior tongue
Lateral pterygoid muscle
Maxilla
Maxillary sinus (antrum)
Nasal cavity
Medial pterygoid muscle
Overlying skin
Palatine bone
Parotid Gland
Pterygoid plates
Pterygoid muscle, NOS
Soft tissue of neck, NOS

Deep extrinsic muscles of tongue:
Genioglossus
Geniohyoid
Hyoglossus
Mylohyoid
Palatoglossus
Styloglossus

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
Prevertebral fascia/muscle WITH or WITHOUT involvement of both lateral walls through soft palate or base of tongue and WITH or WITHOUT involvement of anterior tongue or hard palate

Bone of skull
Carotid artery (encased)

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.