Clinical T

This input is used for staging


**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.


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
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor
pIS pTis Carcinoma in situ/high-grade dysplasia Intraepithelial, noninvasive

Stated as Tis
c1 cT1 Tumor invades:
Lamina propria
Muscularis mucosae
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]
c1A cT1a 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
c1B cT1b Tumor invades submucosa Stated as T1b
c2 cT2 Tumor invades muscularis propria Stated as T2
c3 cT3 Tumor invades adventitia Adventitia and/or soft tissue invaded
Esophagus is described as "FIXED"

Stated as T3
c4 cT4 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]
c4A cT4a Tumor invades:
Tumor invades adjacent structures:

Abdominal/lower esophagus:
Diaphragm fixed

Cervical/upper esophagus:
Jugular vein
Thyroid gland

Intrathoracic esophagus:
Lower portion (abdominal):
Blood vessel(s), major: gastric artery/vein
Diaphragm, not fixed; diaphragm, NOS
Stomach, cardia (via serosa)

Upper or middle portion:

Thoracic/middle esophagus:

Stated as T4a
c4B cT4b Tumor invades other adjacent structures such as:
Vertebral body
Tumor invades adjacent structures

Cervical esophagus:
Blood vessel(s): carotid artery, subclavian artery
Cervical vertebra(e)

Cervical/upper esophagus:
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

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 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)