Clinical T

This input is used for staging


**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for NET rectum tumors. **Note 2:** Ignore intraluminal extension to adjacent segment(s) of colon/rectum or to the ileum from the cecum; code depth of invasion or extracolonic spread as indicated. **Note 3:** Tumor size must be known to assign a value of T1 or T2. You may use a physician’s statement of the T (sub)category if this is the only information in the medical record. * If the tumor appears to be in the T1 or T2 (sub)categories, but no size or category is specified, assign TX **Note 4:** Assign the appropriate T (sub)category (T1, T2) based on the tumor size for the following descriptions Invasive tumor confined to mucosa, NOS including intramucosal, NOS Invades lamina propria, including lamina propria in the stalk of a polyp Invades submucosa (superficial invasion), including submucosa in the stalk of a polyp Confined to and not through the muscularis mucosae, including muscularis mucosae in the stalk of a polyp Confined to colon, NOS Localized, NOS **Note 5:** Assign T4 for tumor with macroscopic adhesions to other organs or structures and for pathologically confirmed tumor in adhesions. * If no tumor is present in adhesions upon microscopic examination, assign the appropriate T category to describe the microscopically confirmed depth of tumor invasion for these cases


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
c1 cT1 Tumor invades lamina propria or submucosa and is no greater than 2 cm in size Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories

Stated as T1 [NOS]
c1A cT1a Tumor less than 1 cm in size Stated as T1a
c1B cT1b Tumor 1-2 cm in size Stated as T1b
c2 cT2 Tumor invades muscularis propria OR

Is greater than 2 cm in size
Muscularis propria invaded

Stated as T2
c3 cT3 Tumor invades subserosa, or non-peritonealized pericolic or perirectal tissues Extension through wall,​ NOS
Invasion through muscularis propria or muscularis,​ NOS
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded
Transmural,​ NOS

For rectum (C209):
Tumor invading through muscularis propria with intraluminal extension to colon and/or anal canal/anus

Adjacent (connective) tissue:
For all sites:
Perirectal fat
For rectosigmoid (C199):
Mesentery (including mesenteric fat,​ mesocolon)
Pericolic fat
For rectum (C209):
Rectovaginal septum

Fat,​ NOS

Stated as T3
c4 cT4 Tumor perforates peritoneum OR

Invades other organs
Invasion of/through serosa (mesothelium) (visceral peritoneum)

Adherent to other organs or structures, NOS

For both rectum and rectosigmoid sites:
Cul de sac (rectouterine pouch)
Pelvic wall/pelvic plexuses
Skeletal muscle of pelvic floor

For rectosigmoid (C199):
Small intestine
Colon via serosa
Fallopian tube(s)

For rectum (C209):
Anal canal/anus extraluminally
Bone(s) of pelvis
Ductus deferens
Perineum,​ perianal skin
Rectovesical fascia for males only
Sacral plexus
Seminal vesicle(s)

Further contiguous extension

Stated as T4
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)