Clinical T

This input is used for staging


**Note 1:** Periosteum is a fibrous membrane that wraps the outer surface of bones. Cortical bone is the dense compact outer layer of the bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, decreasing weight and allowing room for blood vessels and marrow. **Note 2:** Tumor size must be known to assign a value of T1, T2 or T3. You may use a physician’s statement of the T category if this is the only information in the medical record. * If the tumor appears to be in the T1, T2 or T3 categories, but no size or category is specified, assign TX **Note 3:** Assign the appropriate T category (T1-T3) based on the tumor size when the tumor involvement is limited to the cortical bone for the following descriptions Invasive tumor on one side confined to Lamina propria Submucosa Tumor crosses midline Anterior 2/3 of tongue Base of tongue Bone, NOS Cartilage, NOS Cortical bone of mandible Cortical bone of maxilla Cortical bone, NOS Epiglottis Gingiva (alveolar ridge), lower Glossoepiglottic fold Glossopharyngeal sulcus Lateral pharyngeal wall Mandible, NOS Maxilla, NOS Periosteum of mandible Pharyngeal (lingual) surface Pharyngoepiglottic fold Subcutaneous soft tissue of chin/neck Sublingual gland, including ducts Submandibular (submaxillary) glands, including ducts Tonsillar pillars and fossae Tonsils Vallecula Confined to floor of mouth Localized, NOS **Note 4:** Involvement through cortical bone is required for assignment of T4a.


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
Tumor size (TS) unknown for T categories where TS needed to determine T
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor
pIS pTis Carcinoma in situ Intraepithelial, noninvasive

Stated as Tis
c1 cT1 Tumor 2 cm or less in greatest dimension Stated as T1
c2 cT2 Tumor more than 2 cm but not more than 4 cm in greatest dimension Stated as T2
c3 cT3 Tumor more than 4 cm in greatest dimension Stated as T3
c4 cT4 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]
c4A cT4a (lip) Tumor invades through:
Cortical bone
Floor of mouth
Inferior alveolar nerve
Skin (chin or nose)

(oral cavity) Tumor invades through:
Cortical bone
Into deep/extrinsic muscle of tongue:
Maxillary sinus
Skin of face
Deep (extrinsic) muscle of tongue:

Maxillary sinus (antrum)
Skin of undersurface of chin/neck
Trabecular bone of mandible
Trabecular bone of maxilla

Stated as T4a
c4B cT4b (lip and oral cavity) Tumor invades:
Masticator space
Pterygoid plates
Skull base

or Encases internal carotid artery
Specified bone

Masticator space
Pterygoid plates

Further contiguous extension:
Base of skull
Internal carotid artery (encased)

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)
\* 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.