Clinical T

This input is used for staging


**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for NET ampulla tumors. **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/limited to ampulla of Vater or extending to sphincter of Oddi Duodenal wall Confined to ampulla, NOS Localized, NOS


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
Tumor size (TS) unknown for T categories where TS needed to determine T
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor
c1 cT1 Tumor invades lamina propria or submucosa and is no greater than 1 cm in size Stated as T1
c2 cT2 Tumor invades muscularis propria or is greater than 1 cm in size Stated as T2
c3 cT3 Jejunal or ileal tumor invades subserosa
Ampullary or duodenal tumor invades pancreas or retroperitoneum
Peripancreatic soft tissues

Stated as T3
c4 cT4 Tumor perforates visceral peritoneum (serosa) or invades other organs or adjacent structures Common bile duct
Extrahepatic bile ducts other than common bile duct or sphincter of Oddi

Extension to other adjacent organs or tissues:
Blood vessels (major):
Hepatic artery
Portal vein
Hepatic flexure
Lesser omentum
Liver including porta hepatis
Transverse colon

Further contiguous extension

Stated as T4
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)