Pathologic T

This input is used for staging


**Note 1:** Impaired vocal cord mobility, also described as vocal cord paresis, may suggest invasion of intrinsic laryngeal muscle. Fixation of the vocal cord may be described as immobility of the arytenoids noted on endoscopy, vocal cord paralysis, or deviation of larynx to fixed side. **Note 2:** Assign T1 for localized tumor only if no information is available to identify further extension.


Pathologic T Pathologic T Display Description Registrar Notes
pX pTX Primary tumor cannot be assessed Pathologic classification criteria met, evaluation done:
Physician unable to assess T
Surgical resection of primary tumor, extension not stated
Physician assigns pTX, no other information available to determine T
p0 pT0 No evidence of primary tumor
pIS pTis Carcinoma in situ Intraepithelial, noninvasive

Stated as Tis
p1 pT1 Tumor limited to one subsite of supraglottis
WITH normal vocal cord mobility
Invasive tumor confined to anterior surface of epiglottis with normal vocal cord mobility

Localized, NOS

Stated as T1
p2 pT2 Tumor invades:
Mucosa of more than one adjacent subsite of supraglottis OR
Glottis or region outside the supraglottis, e.g.,
Mucosa of base of tongue
Medial wall of pyriform sinus

WITHOUT fixation of the larynx
Larynx, glottic or NOS WITHOUT fixation of larynx
Mucosa of adjacent subsite(s) of oropharynx
Mucosa of vallecula without fixation of larynx

Stated as T2
p3 pT3 Tumor limited to larynx WITH vocal cord fixation and/or
invades any of the following:
Postcricoid area
Pre-epiglottic space
Paraglottic space
Inner cortex of thyroid cartilage
Any structure coded in T1 or T2 WITH vocal cord fixation

Hypopharynx, NOS
Paraglottic space
Pyriform sinus except medial wall

Stated as T3
p4 pT4 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]
p4A pT4a Tumor invades through the thyroid cartilage and/or invades tissues beyond the larynx, e.g.,
Soft tissues of neck including deep/extrinsic muscle of tongue
Strap muscles
Deep tissues of base of tongue
Buccal mucosa (inner cheek)
Floor of mouth
Gum (gingiva)
Pterygoid muscle
Soft palate

Invasion of, through outer cortex of thyroid cartilage
Thyroid cartilage, NOS

Strap muscles:

Stated as T4a
p4B pT4b Tumor invades:
Prevertebral space
Encases carotid artery
Mediastinal structures
Further contiguous extension, including:
Anterior 2/3 of tongue
Hard palate
Parotid gland

Stated as T4b
88 88 Not applicable Primary site/histology not TNM defined
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Pathologic classification criteria not met
Pathologic classification criteria met, evaluation done:
Results not documented in patient record
No surgical resection of known primary tumor (not T0)
Resection insufficient for site-specific pathologic assessment
No surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category
Evidence of metastatic disease (pM1), no other workup
Only Pathologic 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]. \# T4 [NOS] is not defined in AJCC 7th edition.