Pathologic T

This input is used for staging

Notes

**Note 1:** Non-invasive carcinomas in the esophagus formerly called in situ are now called high grade dysplasia. High grade dysplasia and severe dysplasia are generally not reportable in cancer registries. * Assign pTis if your registry collects these tumors **Note 2:** Ignore intraluminal extension to adjacent segment(s) of esophagus or to cardia of stomach and code depth of invasion or extra-esophageal spread as indicated. **Note 3:** The three layers of the mucosa (epithelium, lamina propria, and muscularis mucosae) may be called the m1, m2, and m3 layers. The submucosa may be described as having inner, middle, and outer thirds called sm1, sm2, and sm3. **Note 4:** If the diagnosis states linitis plastica and no other information regarding primary tumor is available, assign T1. Linitis plastica is defined as diffuse involvement of the entire stomach wall. **Note 5:** Assign T4a for contiguous extension from the site of origin. Discontinuous involvement is coded in distant metastasis.except for implants within the stomach (T1).

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/high-grade dysplasia Non-invasive

(Adeno)carcinoma, noninvasive, in a polyp

Stated as Tis
p1 pT1 Tumor invades:
Lamina propria
Muscularis mucosae
Submucosa
Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories.

Tumor in polyp, NOS

Implants inside stomach

Localized, NOS

Stated as T1 [NOS]
p1A pT1a Tumor invades lamina propria or muscularis mucosae Invasive tumor confined to mucosa, NOS (including intramucosal, NOS)

Invades lamina propria or muscularis mucosae

Stated as T1a
p1B pT1b Tumor invades submucosa Stated as T1b
p2 pT2 Tumor invades muscularis propria Invades into but not through muscularis propria

Linitis plastica (and no other information regarding extension available)

Stated as T2
p3 pT3 Tumor invades adventitia Extension through wall, NOS
Invasion through muscularis propria or muscularis, NOS
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded

Adventitia and/or soft tissue invaded
Esophagus is described as "FIXED"

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
p4 pT4 Tumor 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]
p4A pT4a Tumor invades:
Pleura
Pericardium
Diaphragm
Invasion of/through serosa (mesothelium) (tunica serosa) (visceral peritoneum), including:
Perforation of visceral peritoneum covering the gastric ligaments or the omentum WITHOUT invasion of adjacent structures

Abdominal wall
Adrenal gland
Kidney
Retroperitoneum
Pericardium
Pleura
Diaphragm

Stated as T4a
p4B pT4b Tumor invades other adjacent structures such as:
Aorta
Trachea
Vertebral body
Tumor invades adjacent structures:
Duodenum via serosa
Duodenum, NOS
Esophagus via serosa
Ileum
Jejunum
Liver
Pancreas
Small intestine, NOS
Spleen
Transverse colon (including flexures)

Stated as unresectable, NOS

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)