Pathologic T

This input is used for staging


**Note 1:** High grade dysplasia and severe dysplasia of the colon are generally not reportable in cancer registries. * Assign pTis if your registry collects these tumors **Note 2:** In situ includes cancer cells confined within the glandular basement membrane (intraepithelial); localized includes confined to lamina propria (intramucosal), the muscular mucosa, and muscularis propria. **Note 3:** 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 4:** Direct invasion in cT4b includes invasion of other organs or segments of the colorectum by way of the serosa, as confirmed on microscopic examination, or for tumors in a retroperitoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria. **Note 5:** Tumor that is adherent to other organs or structures, macroscopically, is classified T4b. However, if no tumor is present in the adhesion, microscopically, the classification should be pT1 - pT3. **Note 6:** Assign T4b for contiguous extension from the site of origin. Discontinuous involvement is coded in M (distant metastasis).


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 or invasion of lamina propria (Adeno)carcinoma, noninvasive, in a polyp or adenoma

Invasive tumor confined to:
Lamina propria, including lamina propria in the stalk of a polyp
Mucosa, NOS, including intramucosal, NOS
Muscularis mucosae (but not through), including muscularis mucosae in the stalk of a polyp

Stated as Tis
p1 pT1 Tumor invades submucosa Confined to:
Head of polyp, NOS
Stalk of polyp, NOS

Invasive tumor in polyp, NOS

Invades submucosa (superficial invasion), including submucosa in the head or stalk of polyp

Confined to rectosigmoid, NOS
Confined to rectum, NOS
Localized, NOS

Stated as T1
p2 pT2 Tumor invades muscularis propria For rectum (C209):
Tumor invading muscularis propria with intraluminal extension to colon and/or anal canal/anus

Stated as T2
p3 pT3 Tumor invades subserosa or into non-peritionalized pericolic or perirectal tissues Extension through wall, NOS
Invasion through muscularis propria or muscularis, NOS
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded
Transmural, NOS

For rectum (C209):
Tumor invading through muscularis propria with intraluminal extension to colon and/or anal canal/anus

Adjacent (connective) tissue:
For all sites:
Perirectal fat
For rectosigmoid:
Mesentery (including mesenteric fat, mesocolon)
Pericolic fat
For rectum:
Rectovaginal septum

Fat, NOS

Stated as T3
p4 pT4 Tumor directly invades other organs or structures and/or perforates visceral peritoneum# Note: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories

Stated as T4 [NOS]
p4A pT4a Tumor perforates visceral peritoneum Invasion of/through serosa (mesothelium) (visceral peritoneum)

Stated as T4a
p4B pT4b Tumor directly invades other organs or structures Tumor found in adhesion(s) if microscopic examination performed

Adherent to other organs or structures, NOS

For both rectum and rectosigmoid sites:
Cul de sac (rectouterine pouch)
Pelvic wall/pelvic plexuses
Skeletal muscle of pelvic floor

For rectosigmoid (C199):
Small intestine
Colon via serosa
Fallopian tube(s)

For rectum (C209):
Anal canal/anus extraluminally
Bone(s) of pelvis
Ductus deferens
Perineum, perianal skin
Rectovesical fascia for males only
Sacral plexus
Seminal vesicle(s)

Further contiguous extension

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 in AJCC 7th edition.