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Staging (Appendix)
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Staging (Appendix)
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Pathologic Staging (pTMN) AJCC 8th Edition CAP Approved Endocrine • Neuroendocrine Tumors of the Appendix 4.0.0.0
TNM Descriptors (required only if applicable) (select all that apply)
___ m (multiple primary tumors)
___ r (recurrent)
___ y (posttreatment)
Primary Tumor (pT)
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pT1: Tumor 2 cm or less in greatest dimension
___ pT2: Tumor more than 2 cm but less than or equal to 4 cm
___ pT3 Tumor more than 4 cm or with subserosal invasion or involvement of the mesoappendix
___ pT4 Tumor perforates the peritoneum or directly invades other adjacent organs or structures (excluding direct mural extension to adjacent subserosa of adjacent bowel), eg, abdominal wall and skeletal muscle
Regional Lymph Nodes (pN)
___ pNX: Cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1: Metastasis in regional lymph nodes
Distant Metastasis (pM)
___ Not applicable
___ pM1: Distant metastasis
___ pM1a: Metastasis confined to liver
___ pM1b: Metastasis in at least one extrahepatic site (eg, lung, ovary, nonregional lymph node, peritoneum, bone)
___ pM1c: Both hepatic and extrahepatic metastases (Specify site(s), if known)
Appendix NET – BH- CAP 4.0.0.0 summary of pTNM changes AJCC 7th to 8th edition
- There is no longer subcategorization of pT1 into pT1a and pT1b
- Involvement of the cecum no longer makes the stage a pT2
- Involvement of the mesoappendix now makes the stage pT3 and extension to the ileum is no longer a criterion for a pT3 tumor
- Tumor perforation of the peritoneum is now classified as pT4 along with invasion of other organs or structures
- M1 is subcategorized into 3 categories (M1a is metastasis confined to the liver, M1b is metastasis in at least one extrahepatic site and M1c is defined as both hepatic and extrahepatic metastasis)