Clinical T

This input is used for staging


**Note 1:** The cystic duct extends from the neck of the gallbladder to its junction with the common hepatic duct, to form the common bile duct. **Note 2:** Involvement of one of the stated extrahepatic organs or structures is classified as T3, and involvement of more than one extrahepatic structure is classified as T4. **Note 3:** 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 invades lamina propria or muscular layer Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories

Confined to cystic duct, NOS
Localized, NOS

Stated as T1
c1A cT1a Tumor invades lamina propria Invasive tumor confined to:
Mucosa, NOS
Submucosa (superficial invasion)

Extension to any of the tissue listed above plus involvement of the gallbladder

Stated as T1a
c1B cT1b Tumor invades muscular layer Muscularis propria

Extension to muscularis propria plus any involvement of the gallbladder

Stated as T1b
c2 cT2 Tumor invades perimuscular connective tissue; no extension beyond serosa or into liver Beyond wall of cystic duct
Periductal/fibromuscular connective tissue

Extension to structures listed above plus involvement of the gallbladder

Stated as T2
c3 cT3 Tumor perforates the serosa (visceral peritoneum) and/or directly involves the liver and/or one other adjacent organ or structure, such as:
Extrahepatic bile ducts
Extension to:
Extrahepatic bile ducts (including common hepatic duct) (beyond cystic duct) WITH or WITHOUT extension beyond wall of cystic duct

Liver WITH or WITHOUT extension to extrahepatic bile ducts (including common hepatic duct) (beyond cystic duct)

Serosa (visceral peritoneum) perforated

Extension to ONE of the following WITH or WITHOUT extension to liver:
Unilateral branches of hepatic artery (right or left)
Unilateral branches of portal vein (right or left)

Stated as T3
c4 cT4 Tumor invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structures Abdominal wall
Common hepatic artery

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)