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 tumor's extension is only described by a phrase like "through the muscularis propria", this could mean that the cancer has penetrated the outermost muscle cells but not beyond (T2); but usually "through the muscularis" is used to indicate that the cancer extends beyond the muscle and into adjacent tissue, consistent with a T3 tumor. When the most specific description is a phrase like "through the muscularis" or "through the esophageal wall", then assign T3.

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	Intraepithelial, noninvasive 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 Invades lamina propria, muscularis mucosae, or submucosa, exact layer not specified 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	Stated as T2
p3	pT3	Tumor invades adventitia	Adventitia and/or soft tissue invaded Esophagus is described as "FIXED" 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 Invades adjacent structures, NOS Stated as T4 [NOS]
p4A	pT4a	Tumor invades: Pleura Pericardium Diaphragm	Tumor invades adjacent structures: Abdominal/lower esophagus: Diaphragm fixed Cervical/upper esophagus: Hypopharynx Jugular vein Larynx Pleura Thyroid gland Intrathoracic esophagus: Lower portion (abdominal): Blood vessel(s), major: gastric artery/vein Diaphragm, not fixed; diaphragm, NOS Pleura Stomach, cardia (via serosa) Upper or middle portion: Diaphragm Pleura Thoracic/middle esophagus: Pericardium Pleura Stated as T4a
p4B	pT4b	Tumor invades other adjacent structures such as: Aorta Trachea Vertebral body	Tumor invades adjacent structures Cervical esophagus: Blood vessel(s): carotid artery, subclavian artery Carina Cervical vertebra(e) Trachea Cervical/upper esophagus: Lung Main stem bronchus Intrathoracic esophagus (all portions): Adjacent Rib(s) Lung via bronchus Mediastinal structure(s), NOS Thoracic vertebra(e) Intrathoracic esophagus, upper or middle: Azygos vein Intrathoracic, upper or mid-portion, esophagus: Blood vessel(s), major: aorta, pulmonary artery/vein, vena cava Carina Trachea Intrathoracic, lower portion (abdominal), esophagus: Blood vessel(s): aorta, vena cava Further contiguous extension Tumor invades adjacent structures and stated to be unresectable 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)