Clinical T

This input is used for staging


**Note 1:** Carcinoma of the pharyngeal tonsil is staged using the schema for oropharynx. **Note 2:** Tumor size must be known to assign a value of T1 or T2. 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 or T2 categories, but no size or category is specified, assign TX **Note 3:** Assign the appropriate T category (T1, T2) based on the tumor size for the following descriptions Invasive tumor confined to Adenoid Pharyngeal tonsil (nasopharyngeal tonsil) Posterior superior wall (vault) Involvement of inferior wall of nasopharynx (superior surface of soft palate) Nasal cavity Oropharynx Pterygopalatine fossa Soft palate, inferior surface including uvula Any of the above WITH parapharyngeal extension Confined to pharyngeal tonsil Localized, NOS **Note 4:** Parapharyngeal involvement denotes postero-lateral infiltration of tumor beyond the pharyngobasilar fascia. The pharyngobasilar fascia is the fibrous layer of the pharyngeal wall between the mucosa and the muscular layer, attached superiorly to the basilar part of the occipital bone and diminishing in thickness as it descends. **Note 5:** The masticator space primarily consists of the muscles of mastication, the medial and lateral pterygoid, masseter, and temporalis muscles. The space also includes the ramus of the mandible and the third division of cranial nerve V as it passes through the foramen ovale into the suprahyoid neck.


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 OR extension to lingual surface of epiglottis 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 Tumor invades any of the following:
Deep/extrinsic muscle of tongue, which are:
Medial pterygoid
Hard palate
Paranasal sinus

Stated as T4a
c4B cT4b Tumor invades any of the following:
Lateral pterygoid muscle
Pterygoid plates
Lateral nasopharynx
Skull base
Encases carotid artery
Bony structures of skull base
Cranial nerve involvement
Floor of orbit
Infratemporal fossa/masticator space

Further contiguous extension including:
Soft tissues of the neck

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.