Pathologic T
This input is used for staging
Notes
**Note 1:** Perihilar bile duct tumors arise at the confluence of the right and left hepatic ducts in the hilar area of the liver. **Note 2:** The biliary radicals are the ducts or tubes that drain bile into the intestine as part of the digestive process. The second-order biliary radicals are the next largest branches or ducts of the biliary system which join to form or empty into the main hepatic bile duct. **Note 3:** T3 and T4 are defined strictly in terms of invasion into specific large blood vessels and the biliary radicals within the liver. Assign T4 when the specified vessels and/or the biliary radical within the liver plus other named organs are involved. **Note 4:** Involvement within the porta hepatis is coded according to the structures involved: portal vein, common hepatic artery, and common hepatic duct.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 confined to the bile duct, with extension up to the muscle layer or fibrous tissue | Invasive tumor of perihilar (proximal) bile duct(s) confined to: Fibromuscular layer (tunic muscularis) Lamina propria Mucosa, NOS Muscularis propria Submucosa (superficial invasion) Subepithelial connective tissue (tunica mucosa) 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. Invasion beyond wall of the bile duct or invasion of hepatic parenchyma Stated as T2[NOS] |
| p2A | pT2a | Tumor invades beyond the wall of the bile duct to surrounding adipose tissue | Beyond wall of bile duct Periductal/fibromuscular connective tissue Stated as T2a |
| p2B | pT2b | Tumor invades adjacent hepatic parenchyma | Adjacent hepatic parenchyma Liver extension, NOS Liver, NOS Stated as T2b |
| p3 | pT3 | Tumor invades unilateral branches of the portal vein or hepatic artery | Unilateral branches of portal vein (right or left) Unilateral branches of hepatic artery (right or left) Stated as T3 |
| p4 | pT4 | Tumor invades the main portal vein or it's branches bilaterally OR The common hepatic artery OR The second-order biliary radicals bilaterally OR Unilateral second-order biliary radicals with contralateral portal vein or hepatic artery involvement |
Main portal vein or its branches bilaterally Common hepatic artery Hepatic artery, NOS Portal vein, NOS 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) |