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{
"id" : "clin_t_vulva_52779",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Clin T Vulva",
"title" : "Clinical T",
"notes" : "**Note 1:** FIGO does not include an in situ category for tumors of the vulva, but TNM does. Assign pTis (behavior code /2) for in situ cases. \n\n**Note 2:** When both the Federation Internationale de Gynecologie et d'Obstetrique (FIGO) stage and extension information on the primary tumor are available, use the extension information to assign the T in preference to a statement of FIGO stage - see Registrar notes.\n* If the only information is FIGO III [NOS], IIIA, IIIB, IIIC, or IVA, assign the appropriate stage and leave clinical T, N, and M blank. If the only information is FIGO stage IVB, leave T and N blank and see M\n\n**Note 3:** FIGO Stage I, IA and IB are defined by the following\n* Size of tumor \n* Involvement of vulva OR vulva and perineum\n* Depth of stromal invasion\n\n**Note 4:** The depth of invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion. (1)\n\n**Note 5:** T3 is not used by FIGO. They label it T4. If you have a record which states T4, assign T3. (1)\n\n**Note 6:** FIGO Stage IVA is assigned based on tumor extension and/or regional lymph node involvement.",
"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, pg., 198\n\n\\# T1 [NOS] is not defined in AJCC 7th edition.",
"last_modified" : "2018-02-02T14:54:21.211Z",
"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", "Clinical classification criteria met, evaluation done:\n Physician unable to assess T\n Extension cannot be determined OR\n Physician assigns cTX, no other information available to determine T" ], [ "c0", "cT0", "No evidence of primary tumor", "" ], [ "pIS", "pTis", "Carcinoma in situ (preinvasive carcinoma)\nIntraepithelial neoplasia Grade III (VIN III)", "Noninvasive\nBowen disease" ], [ "c1", "cT1", "Tumor confined to vulva or vulva and perineum#", "Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories\n\nVulva and perineum: Stromal invasion but depth of invasion in millimeters not stated\n\nInvasive carcinoma confined to:\n Musculature\n Submucosa\n Vulva including skin\n\nConfined to the vulva and perineum, size unknown\n\nLocalized, NOS\n\nFIGO Stage I [NOS]\n\nStated as T1 [NOS]" ], [ "c1A", "cT1a", "Tumor 2 cm or less in greatest dimension and with stromal invasion no greater than 1.0 mm", "Vulva and perineum: Stromal invasion less than or equal to 1 mm\n\nFIGO Stage IA\n\nStated as T1a" ], [ "c1B", "cT1b", "Tumor greater than 2 cm or with stromal invasion greater than 1 mm", "Vulva and perineum: Stromal invasion greater than 1 mm\n\nFIGO Stage IB\n\nStated as T1b" ], [ "c2", "cT2", "Tumor of any size with extension to adjacent perineal structures: \n Anus\n Lower third urethra \n Lower third vagina", "Perianal skin\nUrethra, NOS \nVagina NOS\n\nFIGO Stage II\n\nStated as T2" ], [ "c3", "cT3", "Tumor of any size with extension to the following structures:\n Bladder mucosa\n Fixed to pelvic bone\n Rectal mucosa\n Upper 2/3 urethra\n Upper 2/3 vagina", "Bladder wall or bladder, NOS (including mucosa)\nPerineal body\nRectal wall or rectum, NOS (including mucosa)\n\nFurther contiguous extension\n\nStated as T3 or T4" ], [ "88", "88", "Not applicable", "Primary site/histology not TNM defined\nDeath certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Only information is FIGO Stage III [NOS], IIIA, IIIB, IIIC, IVA, or IVB\n\nClinical classification 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" ] ]
}