Clinical T

This input is used for staging

Notes

**Note 1:** The substantia propria is the stromal tissue of the conjunctiva underlying the epithelium. The bulbar conjunctiva covers the eyeball, the palpebral conjunctiva lines the eyelids, and the forniceal conjunctiva covers the junction of the eyelid and eyeball. The caruncle is the fleshy prominence at the inner corner of the eye lined by conjunctival epithelium. **Note 2:** Tumors confined to the epithelium are staged as Tis in TNM 7th Edition. Melanoma in situ (includes the term primary acquired melanosis) with atypia replacing greater than 75% of the normal epithelial thickness, with cytological features of epithelial cells, including abundant cytoplasm, vesicular nuclei, or prominent nucleoli, and/or presence of intraepithelial nests of atypical cells. (1) **Note 3:** Quadrants are defined by clock hour, starting at the limbus (e.g., 6, 9, 12, 3) extending from the central cornea, to and beyond the eyelid margins. This will bisect the carcuncle. Quadrants of involvement are coded in **Site-Specific Factor 2, Quadrants**. (1)

NAACCR Item

NAACCR #940
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
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor
pIS pTis Melanoma confined to the conjunctival epithelium (in situ) In situ, intraepithelial, noninvasive
Melanoma confined to conjunctival epithelium WITH or WITHOUT corneal extension

Stated as Tis
c1 cT1 Melanoma of the bulbar conjunctiva Note: T1 has subcategories of T1a, T1b, T1c and T1d. Assign T1 only when there is no information available to assign one of the subcategories

Tumor(s) of bulbar conjunctiva NOS

Localized, NOS

Stated as T1 [NOS]
c1A cT1a Tumor involves not more than one quadrant Stated as T1a
c1B cT1b Tumor involves more than one but not more than two quadrants Stated as T1b
c1C cT1c Tumor involves more than two but not more than three quadrants Stated as T1c
c1D cT1d Tumor involves more than three quadrants Stated as T1d
c2 cT2 Malignant conjunctival melanoma of the non-bulbar conjunctiva involving:
Palpebral
Forniceal
Caruncular conjunctiva
Note: T2 has subcategories of T2a, T2b, T2c and T2d. Assign T2 only when there is no information available to assign one of the subcategories

Tumor of non-bulbar conjunctiva, NOS
Tumor(s) of bulbar conjunctiva, NOS WITH corneal extension

Tumor involves conjunctival fornix or palpebral conjunctiva WITH extension to cornea
Involvement of caruncle WITH extension to cornea

Stated as T2 [NOS]
c2A cT2a Non-carcuncular tumor involves not more than one quadrant Stated as T2a
c2B cT2b Non-caruncular tumor involves more than one quadrant Stated as T2b
c2C cT2c Caruncular tumor involves not more than one quadrant of conjunctiva Stated as T2c
c2D cT2d Caruncular tumor involves more than one quadrant of conjunctiva Stated as T2d
c3 cT3 Tumor with local invasion Note: T3 has subcategories of T3a, T3b, T3c and T3d. Assign T3 only when there is no information available to assign one of the subcategories

Conjunctival melanoma with local invasion NOS

Stated as T3 [NOS]
c3A cT3a Globe Stated as T3a
c3B cT3b Eyelid Nasolacrimal system

Stated as T3b
c3C cT3c Orbit Stated as T3c
c3D cT3d Sinus Stated as T3d
c4 cT4 Tumor invades central nervous system (CNS) Stated as T4
88 88 Not applicable Primary site/histology not TNM defined
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)
(1) International Union Against Cancer (UICC) *TNM Classification of Malignant Tumors,* 7th ed., Sobin, LH, Gospodarowicz, M, Wittekind, CH, eds. New York: Wiley, 2009, pgs., 280, 281