Pathologic T

This input is used for staging

Notes

**Note 1:** The bones of the lateral wall of the nasal cavity include the maxilla, the perpendicular plate of the palatine bone, the medial pterygoid plate, the labyrinth and inferior concha of the ethmoid. The roof of the nasal cavity is formed by the nasal bone. The floor of the nasal cavity, which forms the roof of the mouth, is composed of the bones of the hard palate: the horizontal plate of the palatine bone posteriorly and the palatine process of the maxilla anteriorly. **Note 2:** "Bony invasion" does not include extension to palate, cribriform plate, or pterygoid plates. Extension to these structures is coded separately. **Note 3:** Assign T3 for Base of Skull, NOS when there is no information available for more specific bony structures in the skull. **Note 4:** Minimal extension to anterior cranial fossa implies tumor pushing through the cribriform plate, but without invasion of the dura or brain.

NAACCR Item

NAACCR #880
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 the mucosa with no erosion or destruction of bone Invasive tumor confined to ethmoid sinus (left, right or NOS)
WITH (involvement of perpendicular plate of ethmoid bone or ethmoid air cells) or WITHOUT bony involvement

Localized, NOS

Stated as T1
p2 pT2 Tumor causing bone erosion or destruction, including extension into:
Hard palate
Middle nasal meatus

EXCEPT extension to posterior wall of maxillary sinus and pterygoid plates
Confined to both ethmoid sinuses WITH or WITHOUT bony involvement

Extension to nasal cavity with or without bony invasion (Involvement of perpendicular plate of ethmoid bone or ethmoid air cells):
Floor
Lateral wall
Nasal vestibule
Nasal cavity, NOS
Septum
Turbinates

Stated as T2
p3 pT3 Tumor invades any of the following:
Bone of posterior wall of maxillary sinus
Subcutaneous tissues
Floor or medial wall of orbit
Pterygoid fossa
Frontal sinuses
Base of skull, NOS
Cribriform plate
Hard palate
Maxillary sinus
Medial wall or floor of orbit
Orbital plate

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 any of the following:
Anterior orbital contents
Skin of cheek
Pterygoid plates
Infratemporal fossa
Cribriform plate
Sphenoid or frontal sinuses
Anterior cranial fossa (minimal extension)
Skin of nose

Stated as T4a
p4B pT4b Tumor invades any of the following:
Orbital apex
Dura
Brain
Middle cranial fossa
Cranial nerves other than maxillary division of trigeminal nerve (V2)
Nasopharynx
Clivus
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 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.