Pathologic T
This input is used for staging
Notes
**Note 1:** Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to code as bone involvement. (1) **Note 2:** 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 3:** 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 4:** 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 confined to lamina propria (mucoperiosteum) (stroma) Bone, NOS Buccal mucosa (inner cheek) Cartilage of mandible or maxilla Cartilage, NOS Cortical bone of mandible or maxilla Cortical bone, NOS Fascial muscle, NOS Floor of mouth Labial mucosa (inner lip), lower lip Labial mucosa (inner lip), lip, NOS Lateral pharyngeal wall Mandible, NOS Maxilla, NOS Soft palate including uvula Subcutaneous soft tissue of face Tongue mucosa Tonsillar pillars and fossae Tonsils Confined to gum, NOS Localized, NOS **Note 5:** Involvement through cortical bone is required for assignment of T4a.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 Tumor size (TS) unknown for T categories where TS needed to determine T 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 2 cm or less in greatest dimension | Stated as T1 |
| p2 | pT2 | Tumor more than 2 cm but not more than 4 cm in greatest dimension | Stated as T2 |
| p3 | pT3 | Tumor more than 4 cm in greatest dimension | 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 | (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: Genioglossus Hyoglossus Palatoglossus Styloglossus Maxillary sinus Skin of face |
Deep (extrinsic) muscle of tongue: Genioglossus Hyoglossus Palatoglossus Styloglossus Bone of maxilla Maxilla, NOS Skin of face Trabecular bone of mandible Stated as T4a |
| p4B | pT4b | (lip and oral cavity) Tumor invades: Masticator space Pterygoid plates Skull base or Encases internal carotid artery |
Labial mucosa (inner lip), upper lip Mucosa upper lip Specified bone Masticator space Pterygoid plates Further contiguous extension, including: Base of skull Internal carotid artery (encased) Skull 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) |