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{
"id" : "clin_t_melanoma_ciliary_body_68734",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Clin T Melanoma Ciliary Body",
"title" : "Clinical T",
"notes" : "**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for ciliary body tumors.\n\n**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. \n* The Schema Discriminator is used to select the staging schema appropriate for coding extension for melanoma of the ciliary body\n\n**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.\n\n**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). \n\n**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)\n\n**Note 6:** When histopathological measurements are recorded after fixation, tumor diameter and thickness may be underestimated because of tissue shrinkage. (1)\n\n**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)",
"footnotes" : "(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",
"last_modified" : "2018-02-02T14:54:22.485Z",
"definition" : [ {
"key" : "clin_t",
"name" : "Clinical T",
"type" : "INPUT"
}, {
"key" : "clin_t_display",
"name" : "Clinical T Display",
"type" : "DESCRIPTION"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "notes",
"name" : "Registrar Notes",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "cX", "cTX", "Primary tumor cannot be assessed", "Basal diameter and thickness not known\nTumor size category not known\n\nClinical classification criteria met, evaluation done: \n Physician unable to assess T \n Extension cannot be determined\nPhysician 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\n\nTumor Size Category 1\nLocalized, NOS\n\nStated as T1 [NOS]" ], [ "c1A", "cT1a", "WITHOUT ciliary body involvement and extraocular extension", "Tumor WITHOUT extraocular extension (or extraocular extension not stated)\n\nAND stated as Tumor Size Category 1\n\nStated as T1a" ], [ "c1B", "cT1b", "WITH ciliary body involvement", "Stated as T1b" ], [ "c1C", "cT1c", "WITHOUT ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Stated as T1c" ], [ "c1D", "cT1d", "WITH ciliary body involvement AND\nExtraocular extension less than or equal to 5 mm in diameter", "Tumor WITH extraocular extension less than or equal to 5 mm in diameter\n\nAND stated as Tumor Size Category 1\n\nStated 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\n\nTumor Size Category 2\n\nStated as T2 [NOS]" ], [ "c2A", "cT2a", "WITHOUT ciliary body involvement and extraocular extension", "Tumor WITHOUT extraocular extension (or extraocular extension not stated)\n\nAND stated as Tumor Size Category 2\n\nStated as T2a" ], [ "c2B", "cT2b", "WITH ciliary body involvement", "Stated as T2b" ], [ "c2C", "cT2c", "WITHOUT ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Stated as T2c" ], [ "c2D", "cT2d", "WITH ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Tumor WITH extraocular extension less than or equal to 5 mm in diameter\n\nAND stated as Tumor Size Category 2\n\nStated 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\n\nTumor Size Category 3\n\nStated as T3 [NOS]" ], [ "c3A", "cT3a", "WITHOUT ciliary body involvement and extraocular extension", "Tumor WITHOUT extraocular extension (or extraocular extension not stated)\n\nAND stated as Tumor Size Category 3\n\nStated as T3a" ], [ "c3B", "cT3b", "WITH ciliary body involvement", "Stated as T3b" ], [ "c3C", "cT3c", "WITHOUT ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Stated as T3c" ], [ "c3D", "cT3d", "WITH ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Tumor WITH extraocular extension less than or equal to 5 mm in diameter\n\nAND stated as Tumor Size Category 3\n\nStated 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\n\nStated as Tumor Size Category 4\n\nFurther contiguous extension\n\nStated as T4 [NOS]" ], [ "c4A", "cT4a", "WITHOUT ciliary body involvement and extraocular extension", "Tumor WITHOUT extraocular extension (or extraocular extension not stated)\n\nAND stated as Tumor Size Category 4\n\nStated as T4a" ], [ "c4B", "cT4b", "WITH ciliary body involvement", "Stated as T4b" ], [ "c4C", "cT4c", "WITHOUT ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Stated as T4c" ], [ "c4D", "cT4d", "WITH ciliary body involvement but \nWITH extraocular extension less than or equal to 5 mm in diameter", "Tumor WITH extraocular extension less than or equal to 5 mm in diameter\n\nAND stated as Tumor Size Category 4\n\nStated 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\n\nStated as T4e" ], [ "88", "88", "Not applicable", "In situ case but no pTis is defined by TNM\nDeath certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Clinical classification criteria not met \nClinical classification criteria met, evaluation done:\n No information about diagnostic workup\n Results not documented in record\nClinical evaluation of primary tumor not done or unknown if done\nTumor first detected on surgical resection (no clinical workup)\nEvidence of metastatic disease [(cM1) or (pM1)], no other workup\nOnly Clinical Stage Group documented (no T, N, or M information available)" ] ]
}