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{
"id" : "esophagus_t_28679",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Path T Esophagus",
"title" : "Pathologic T",
"notes" : "**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. \n* Assign pTis if your registry collects these tumors\n\n**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.\n\n**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.\n\n**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.",
"last_modified" : "2018-02-02T14:54:24.378Z",
"definition" : [ {
"key" : "path_t",
"name" : "Pathologic T",
"type" : "INPUT"
}, {
"key" : "path_t_display",
"name" : "Pathologic T Display",
"type" : "DESCRIPTION"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "notes",
"name" : "Registrar Notes",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "pX", "pTX", "Primary tumor cannot be assessed", "Pathologic classification criteria met, evaluation done: \n Physician unable to assess T\n Surgical resection of primary tumor, extension not stated \nPhysician assigns pTX, no other information available to determine T" ], [ "p0", "pT0", "No evidence of primary tumor", "" ], [ "pIS", "pTis", "Carcinoma in situ/high-grade dysplasia", "Intraepithelial, noninvasive\n\nStated as Tis" ], [ "p1", "pT1", "Tumor invades: \n Lamina propria\n Muscularis mucosae\n Submucosa", "Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories\n\nInvades lamina propria, muscularis mucosae, or submucosa, exact layer not specified\n\nLocalized, NOS\n\nStated as T1 [NOS]" ], [ "p1A", "pT1a", "Tumor invades lamina propria or muscularis mucosae", "Invasive tumor confined to mucosa, NOS (including intramucosal, NOS)\n\nInvades lamina propria or muscularis mucosae\n\nStated as T1a" ], [ "p1B", "pT1b", "Tumor invades submucosa", "Stated as T1b" ], [ "p2", "pT2", "Tumor invades muscularis propria", "Stated as T2" ], [ "p3", "pT3", "Tumor invades adventitia", "Adventitia and/or soft tissue invaded\nEsophagus is described as \"FIXED\"\n\nStated as T3" ], [ "p4", "pT4", "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\n\nInvades adjacent structures, NOS\n\nStated as T4 [NOS]" ], [ "p4A", "pT4a", "Tumor invades: \n Pleura\n Pericardium\n Diaphragm", "Tumor invades adjacent structures:\n\nAbdominal/lower esophagus:\n Diaphragm fixed\n\nCervical/upper esophagus:\n Hypopharynx\n Jugular vein\n Larynx\n Pleura\n Thyroid gland \n\nIntrathoracic esophagus: \n Lower portion (abdominal):\n Blood vessel(s), major: gastric artery/vein\n Diaphragm, not fixed; diaphragm, NOS\n Pleura\n Stomach, cardia (via serosa)\n\n Upper or middle portion:\n Diaphragm \n Pleura\n\nThoracic/middle esophagus:\n Pericardium\n Pleura \n\nStated as T4a" ], [ "p4B", "pT4b", "Tumor invades other adjacent structures such as:\n Aorta\n Trachea\n Vertebral body", "Tumor invades adjacent structures\n\nCervical esophagus:\n Blood vessel(s): carotid artery, subclavian artery\n Carina \n Cervical vertebra(e) \n Trachea \n\nCervical/upper esophagus:\n Lung\n Main stem bronchus\n\nIntrathoracic esophagus (all portions):\n Adjacent Rib(s) \n Lung via bronchus\n Mediastinal structure(s), NOS \n Thoracic vertebra(e)\n\nIntrathoracic esophagus, upper or middle:\n Azygos vein\n\nIntrathoracic, upper or mid-portion, esophagus:\n Blood vessel(s), major: aorta, pulmonary artery/vein, vena cava \n Carina \n Trachea \n \nIntrathoracic, lower portion (abdominal), esophagus:\n Blood vessel(s): aorta, vena cava \n \nFurther contiguous extension\n\nTumor invades adjacent structures and stated to be unresectable\n\nStated as T4b" ], [ "88", "88", "Not applicable", "Primary site/histology not TNM defined\nDeath certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Pathologic classification criteria not met \nPathologic classification criteria met, evaluation done: \n Results not documented in patient record \n No surgical resection of known primary tumor (not T0) \n Resection insufficient for site-specific pathologic assessment\nNo surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category\nEvidence of metastatic disease (pM1), no other workup\nOnly Pathologic Stage Group documented (no T, N, or M information available)" ] ]
}
