Clinical T

This input is used for staging

Notes

**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for ciliary body tumors. **Note 2:** Ciliary body and Iris are both included in the ICD-O-3 site code of C694, but they are staged with different criteria by TNM. * The Schema Discriminator is used to select the staging schema appropriate for coding extension for melanoma of the ciliary body **Note 3:** Melanomas of uvea arise most commonly in the choroid, less frequently in the ciliary body, and least often in the iris. Melanomas of the iris tend to be small, and those arising from or extending to the ciliary body typically are large. **Note 4:** UICC 7th Edition assigns a T value to combinations of measurements for basal diameter and thickness of tumor divided into four Tumor Size Categories in a charted format (1). **Note 5:** In clinical practice, the largest tumor basal diameter may be estimated in optic disc diameters (dd, average: 1 dd = 1.5 mm). Tumor thickness may be estimated in diopters (average: 2.5 diopters = 1 mm). However, techniques such as ultrasonography and fundus photography are used to provide more accurate measurements. Ciliary body involvement can be evaluated by the slit-lamp, opthalmoscopy, gonioscopy and transillumination. However, high frequency ultrasonography (ultrasound biomicroscopy) is used for more accurate assessment. Extension through the sclera is evaluated visually before and during surgery, and with ultrasonography, computed tomography or magnetic resonance imaging. (1) **Note 6:** When histopathological measurements are recorded after fixation, tumor diameter and thickness may be underestimated because of tissue shrinkage. (1) **Note 7:** Iris melanomas originate from, and are predominantly located in, this region of the uvea. If less than one-half of the tumor volume is located within the iris, the tumor may have originated in the ciliary body and evaluation should be given to classifying it accordingly. (1)

NAACCR Item

NAACCR #940
Clinical T Clinical T Display Description Registrar Notes
cX cTX Primary tumor cannot be assessed Basal diameter and thickness not known
Tumor size category not known

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
c1 cT1 Tumor size category 1 Note: T1 has subcategories of T1a, T1b, T1c and T1d. Assign T1 only when there is no information available to assign one of the subcategories

Tumor Size Category 1
Localized, NOS

Stated as T1 [NOS]
c1A cT1a WITHOUT ciliary body involvement and extraocular extension Tumor WITHOUT extraocular extension (or extraocular extension not stated)

AND stated as Tumor Size Category 1

Stated as T1a
c1B cT1b WITH ciliary body involvement Stated as T1b
c1C cT1c WITHOUT ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Stated as T1c
c1D cT1d WITH ciliary body involvement AND
Extraocular extension less than or equal to 5 mm in diameter
Tumor WITH extraocular extension less than or equal to 5 mm in diameter

AND stated as Tumor Size Category 1

Stated as T1d
c2 cT2 Tumor size category 2 Note: T2 has subcategories of T2a, T2b, T2c and T2d. Assign T2 only when there is no information available to assign one of the subcategories

Tumor Size Category 2

Stated as T2 [NOS]
c2A cT2a WITHOUT ciliary body involvement and extraocular extension Tumor WITHOUT extraocular extension (or extraocular extension not stated)

AND stated as Tumor Size Category 2

Stated as T2a
c2B cT2b WITH ciliary body involvement Stated as T2b
c2C cT2c WITHOUT ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Stated as T2c
c2D cT2d WITH ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Tumor WITH extraocular extension less than or equal to 5 mm in diameter

AND stated as Tumor Size Category 2

Stated as T2d
c3 cT3 Tumor size category 3 Note: T3 has subcategories of T3a, T3b, T3c and T3d. Assign T3 only when there is no information available to assign one of the subcategories

Tumor Size Category 3

Stated as T3 [NOS]
c3A cT3a WITHOUT ciliary body involvement and extraocular extension Tumor WITHOUT extraocular extension (or extraocular extension not stated)

AND stated as Tumor Size Category 3

Stated as T3a
c3B cT3b WITH ciliary body involvement Stated as T3b
c3C cT3c WITHOUT ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Stated as T3c
c3D cT3d WITH ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Tumor WITH extraocular extension less than or equal to 5 mm in diameter

AND stated as Tumor Size Category 3

Stated as T3d
c4 cT4 Tumor size category 4 Note: T4 has subcategories of T4a, T4b, T4c, T4d and T4e. Assign T4 only when there is no information available to assign one of the subcategories

Stated as Tumor Size Category 4

Further contiguous extension

Stated as T4 [NOS]
c4A cT4a WITHOUT ciliary body involvement and extraocular extension Tumor WITHOUT extraocular extension (or extraocular extension not stated)

AND stated as Tumor Size Category 4

Stated as T4a
c4B cT4b WITH ciliary body involvement Stated as T4b
c4C cT4c WITHOUT ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Stated as T4c
c4D cT4d WITH ciliary body involvement but
WITH extraocular extension less than or equal to 5 mm in diameter
Tumor WITH extraocular extension less than or equal to 5 mm in diameter

AND stated as Tumor Size Category 4

Stated as T4d
c4E cT4e Any tumor size category with extraocular extension more than 5 mm in diameter Tumor WITH extraocular extension greater than 5 mm in diameter

Stated as T4e
88 88 Not applicable In situ case but no pTis is defined by TNM
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)
(1) International Union Against Cancer (UICC) *TNM Classification of Malignant Tumors,* 7th ed., Sobin, LH, Gospodarowicz, M, Wittekind, CH, eds. New York: Wiley, 2009, pgs., 285, 286, 288