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 small intestine tumors. **Note 2:** Ignore intraluminal extension to adjacent segment(s) of colon/rectum or to the ileum from the cecum; code depth of invasion or extracolonic spread as indicated. **Note 3:** The nonperitonealized perimuscular tissue is, for jejunum and ileum, part of the mesentery and, for duodenum in areas where serosa is lacking, part of the retroperitoneum. **Note 4:** 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 5:** Assign the appropriate T category (T1, T2) based on the tumor size for the following descriptions: Invasive tumor confined to mucosa, NOS including intramucosal, NOS Invades lamina propria, including lamina propria in the stalk of a polyp Invades submucosa (superficial invasion), including submucosa in the stalk of a polyp Confined to and not through the muscularis mucosae, including muscularis mucosae in the stalk of a polyp Confined to colon, NOS Localized, NOS **Note 6:** Assign T4 for tumor with macroscopic adhesions to other organs or structures and for pathologically confirmed tumor in adhesions. * If no tumor is present in adhesions upon microscopic examination, use lower codes to describe the microscopically confirmed depth of tumor invasion for these cases


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 No evidence of primary tumor
c1 cT1 Tumor invades lamina propria or submucosa and is no greater than 1 cm in size Confined to:
Mucosa, NOS, including intramucosal, NOS
Muscularis mucosae, including muscularis mucosae in a polyp

Intraluminal spread to other segments of small intestine or cecum

Localized, NOS

Stated as T1
c2 cT2 Tumor invades muscularis propria or is greater than 1 cm in size Muscularis propria invaded

Stated as T2
c3 cT3 Jejunal or ileal tumor invades subserosa
Ampullary or duodenal tumor invades pancreas or retroperitoneum
Adjacent connective tissue
Fat, NOS
Invasion through muscularis propria or muscularis, NOS
Extension through wall, NOS
Nonperitonealized perimuscular tissue
Subserosal tissue/(sub)serosal fat invaded
Transmural, NOS

For duodenum primary only (C170):
Ampulla of Vater
Pancreatic duct

Stated as T3
c4 cT4 Tumor perforates visceral peritoneum (serosa) or invades other organs or adjacent structures Invasion of/through serosa (mesothelium) (tunica serosa) (visceral peritoneum)

For all small intestine sites:
Abdominal wall
Other segments of the small intestine via serosa

For duodenum primary only (C170):
Blood vessel(s), major:
Gastroduodenal artery
Portal vein
Renal vein
Superior mesenteric artery or vein
Vena cava
Extrahepatic bile ducts
Hepatic flexure
Kidney, right or NOS
Transverse colon
Ureter, right

For jejunum or ileum primary only (C171, C172):
Colon, including appendix
Fallopian tube
Retroperitoneum invaded greater than 2 cm in depth

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)