Clinical T

This input is used for staging

Notes

**Note 1:** Intraluminal or intramural extension to esophagus and duodenum is classified by the depth of greatest invasion in any of these sites, including stomach. * For extension to esophagus or duodenum via serosa, assign T4b **Note 2:** Assign T2 If the diagnosis states linitis plastica and no other information regarding extension is available. * Linitis plastica is defined as diffuse involvement of the entire thickness of the stomach wall **Note 3:** Assign T4b for contiguous extension from the site of origin. Discontinuous involvement is coded in M (distant metastasis). * *Exception*: Assign T1 for implants within the stomach

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 Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria

High grade dysplasia
Noninvasive
(Adeno)carcinoma, noninvasive, in a polyp

Stated as Tis
c1 cT1 Tumor invades lamina propria, muscularis mucosae, or submucosa Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories

Confined to:
Head of polyp, NOS
Stalk of polyp, NOS

Invasive tumor in polyp, NOS

Implants inside stomach

Localized, NOS

Stated as T1 [NOS]
c1A cT1a Tumor invades lamina propria or muscularis mucosae Invasive tumor confined to mucosa, NOS, including intramucosal, NOS

Mucosal tumor with intraluminal extension to esophagus or duodenum

Stated as T1a
c1B cT1b Tumor invades submucosa Superficial invasion of submucosa

Submucosal tumor with intraluminal extension to esophagus or duodenum

Stated as T1b
c2 cT2 Tumor invades muscularis propria Invades into but not through muscularis propria

Linitis plastica and no other information regarding extension available

Invasion of muscularis propria with intraluminal extension to esophagus or duodenum

Stated as T2
c3 cT3 Tumor invades subserosa Extension through wall, NOS
Invasion through muscularis propria or muscularis, NOS
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded

Invasion through muscularis propria with intraluminal extension to esophagus or duodenum

Extension to adjacent (connective) tissue WITHOUT perforation of visceral peritoneum covering these structures:
Gastric artery
Ligaments:
Gastrocolic
Gastrohepatic
Gastrosplenic
Omentum, NOS :
Greater
Lesser
Perigastric fat

Stated as T3
c4 cT4 Tumor perforates serosa OR

Invades adjacent structures
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]
c4A cT4a Tumor perforates serosa Invasion of/through serosa (mesothelium) (tunica serosa) (visceral peritoneum), including perforation of visceral peritoneum covering the gastric ligaments or the omentum

Stated as T4a
c4B cT4b Tumor invades adjacent structures Adjacent structures include:
Abdominal wall
Adrenal (suprarenal) gland
Aorta
Celiac axis
Diaphragm
Duodenum via serosa
Duodenum, NOS
Esophagus via serosa
Ileum
Jejunum
Kidney
Liver
Pancreas
Retroperitoneum
Small intestine, NOS
Spleen
Transverse colon/mesocolon (including flexures)

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 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)