Pathologic T

This input is used for staging

Notes

**Note 1:** "Multiple (satellite) nodules/tumors" include satellitosis, multifocal tumors, and intrahepatic metastases. **Note 2:** Major vascular invasion is defined as invasion of the branches of the main portal vein (right or left portal vein, not including sectoral or segmental branches) or as invasion of one or more of the three hepatic veins (right, middle, or left). Invasion of the hepatic artery or vena cava is assigned T3. **Note 3:** Cholangiocarcinoma may be classified by growth pattern. The tumor growth patterns of intrahepatic cholangiocarcinoma include the mass forming type, the periductal infiltrating type, and a mixed type. The periductal infiltrating type of cholangiocarcinoma demonstrates a diffuse longitudinal growth pattern along the bile duct. Limited analyses suggest that the diffuse periductal infiltrating type is associated with a poor prognosis. The presence of periductal invasion is assigned T4.

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 (intraductal tumor) Intraepithelial, noninvasive

Stated as Tis
p1 pT1 Solitary tumor without vascular invasion Single lesion in one lobe of liver WITHOUT intrahepatic vascular invasion OR vascular invasion not stated

Single lesion in more than one lobe of liver (contiguous growth) WITHOUT vascular invasion OR vascular invasion not stated

Extension to gallbladder WITH or WITHOUT single lesion in one or more lobes of liver (contiguous growth) WITHOUT vascular invasion OR vascular invasion not stated

Confined to liver, NOS
Localized, NOS

Stated as T1
p2 pT2 Not defined by UICC*# Note: T2 has subcategories of T2a and T2b. Assign T2 only when there is no information available to assign one of the subcategories.

Multiple tumors or single tumor with vascular invasion

Stated as T2[NOS]
p2A pT2a Solitary tumor with vascular invasion Single lesion in one lobe of liver WITH intrahepatic vascular invasion

Single lesion in more than one lobe of liver (contiguous growth) WITH vascular invasion WITH or WITHOUT vascular invasion plus extension to gallbladder

Single tumor WITH major vascular invasion: major branch(es) of portal or hepatic vein(s) WITH or WITHOUT extension to gallbladder

Stated as T2a
p2B pT2b Multiple tumors, with or without vascular invasion Multiple (satellite) nodules/tumors in one lobe of liver:
WITH or WITHOUT intrahepatic vascular invasion plus extension to gallbladder OR
WITH major vascular invasion: major branch(es) of portal or hepatic vein(s) OR
WITH major vascular invasion and extension to gallbladder

Multiple (satellite) nodules/tumors in more than one lobe of liver
Satellite nodules, NOS

Stated as T2b
p3 pT3 Tumor perforates the visceral peritoneum OR

Directly invades adjacent extrahepatic structures
Diaphragm
Direct extension/perforation of visceral peritoneum
Extension to hepatic artery or vena cava
Extrahepatic bile ducts WITH or WITHOUT satellite nodules in more than one lobe or multiple tumors with major vascular invasion

Multiple (satellite) nodules on surface of liver parenchyma

Lesser omentum Ligament(s):
Coronary
Falciform
Hepatoduodenal
Hepatogastric
Round (of liver)
Triangular
Parietal peritoneum

Further contiguous extension:
Pancreas
Pleura
Stomach
Other contiguous extension

Stated as T3
p4 pT4 Tumor with periductal invasion (periductal growth pattern) Stated as T4
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)
\* T2 [NOS] is not defined by UICC in the 7th edition. Approval has been provided by UICC to use "Multiple tumors or single tumor with vascular invasion" as T2 [NOS]. \# T2 [NOS] is not defined in AJCC 7th edition