Pathologic T

This input is used for staging

Notes

**Note 1:** Impaired vocal cord mobility, also described as vocal cord paresis, may suggest invasion of intrinsic laryngeal muscle. Fixation of the vocal cord may be described as immobility of the arytenoids noted on endoscopy, vocal cord paralysis, or deviation of larynx to fixed side. **Note 2:** Assign T1 for localized tumor only if no information is available to identify further extension.

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 vocal cord(s) (may involve anterior or posterior commissure)
WITH normal mobility
Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories

Invasive tumor with normal vocal cord mobility:
Confined to glottis, NOS:
Intrinsic larynx
Laryngeal commissure(s):
Anterior
Posterior;
Vocal cord(s), NOS:
True vocal cord(s)
True cord(s)

Localized, NOS

Stated as T1 [NOS]
p1A pT1a Tumor limited to one vocal cord One vocal cord with normal vocal cord mobility

Stated as T1a with no other information on extension
p1B pT1b Tumor involves both vocal cords Both vocal cords with normal vocal cord mobility

Stated as T1b with no other information on extension
p2 pT2 Tumor extends to supraglottis and/or subglottis, and/or
WITH impaired vocal cord mobility
Tumor involves adjacent regions(s) of larynx:
Subglottis
Supraglottis:
Aryepiglottic fold
Arytenoid cartilage:
Corniculate tubercle
Cuneiform tubercle
Ventricular bands (false vocal cord(s))

Impaired vocal cord mobility

Stated as T2
p3 pT3 Tumor limited to larynx WITH vocal cord fixation and/or
Invades:
Paraglottic space
Inner cortex of the thyroid cartilage
Tumor limited to larynx WITH vocal cord fixation
Involvement of intrinsic muscle(s) of larynx:
Aryepiglottic
Arytenoid
Cricoarytenoid
Cricothyroid
Thyroarytenoid
Thyroepiglottic
Vocalis

Inner cortex of thyroid cartilage (minor thyroid cartilage erosion)

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 through the outer cortex of the thyroid cartilage, AND/OR
Invades tissues beyond the larynx, e.g.
Trachea
Soft tissues of neck including deep/extrinsic muscle of tongue
Genioglossus
Hyoglossus
Palatoglossus
Styloglossus
Strap muscles
Thyroid
Esophagus
Base of tongue
Hypopharynx, NOS
Pre-epiglottic tissues
Postcricoid area
Pyriform sinus
Vallecula

Extension to/through:
Cricoid cartilage
Outer cortex of thyroid cartilage

Extension to/through tissues beyond larynx:
Strap muscles:
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
Oropharynx
Skin
Soft tissue of neck
Thyroid gland
Trachea

Cervical esophagus

Stated as T4a
p4B pT4b Tumor invades:
Prevertebral space
Encases carotid artery
Mediastinal structures
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.