Clinical T

This input is used for staging


**Note 1:** Distal bile duct tumors arise between the junction of the cystic duct-bile duct and the ampulla of Vater. The classification includes tumors developing in congenital choledochal cysts and tumors arising in the intrapancreatic portion of the common bile duct. **Note 2:** Involvement within the porta hepatis is coded according to the structures involved: portal vein, common hepatic artery, and common hepatic duct.


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
pIS pTis Carcinoma in situ Intraepithelial, noninvasive

Stated as Tis
c1 cT1 Tumor confined to the bile duct Tumor confined to:
Lamina propria
Mucosa, NOS
Submucosa (superficial invasion)

Muscularis propria

Localized, NOS

Stated as T1
c2 cT2 Tumor invades beyond the wall of the bile duct Periductal/fibromuscular connective tissue

Stated as T2
c3 cT3 Tumor invades:
Other adjacent organs
Common hepatic duct

Unilateral branches of portal vein (right or left)
Unilateral branches of hepatic artery (right or left)

Stated as T3
c4 cT4 Tumor involves the celiac axis or the superior mesenteric artery Abdominal wall
Celiac axis
Colon, NOS
Transverse including flexure
Greater omentum
Omentum, NOS
Stomach, distal
Stomach, proximal
Superior mesenteric artery

Main portal vein or its branches bilaterally
Common hepatic artery
Hepatic artery, NOS
Portal vein, NOS

Further contiguous extension

Stated as T4
88 88 Not applicable Primary site/histology not TNM defined
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)