Pathologic Staging (pTNM) AJCC 8th Edition

CAP Approved Gastrointestinal • Colon and Rectum 4.0.0.1

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

___ pTis:        Carcinoma in situ, intramucosal carcinoma (involvement of lamina propria with no extension through muscularis mucosae)

___ pT1:        Tumor invades the submucosa (through the muscularis mucosa but not into the muscularis propria)

___ pT2:        Tumor invades the muscularis propria

___ pT3:        Tumor invades through the muscularis propria into pericolorectal tissues

___ pT4:     Tumor invades the visceral peritoneum or invades or adheres to adjacent organ or structure

___ pT4a:        Tumor invades through the visceral peritoneum (including gross perforation of the bowel through tumor and continuous invasion of tumor through areas of inflammation to the surface of the visceral peritoneum)

___ pT4b:        Tumor directly invades or adheres to adjacent organs or structures

Regional Lymph Nodes (pN)

___ pNX:        Regional lymph nodes cannot be assessed

___ pN0:        No regional lymph node metastasis

___ pN1:     One to three regional lymph nodes are positive (tumor in lymph nodes measuring ≥0.2 mm), or any number of tumor deposits are present and all identifiable lymph nodes are negative

___ pN1a:        One regional lymph node is positive

___ pN1b:        Two or three regional lymph nodes are positive

___ pN1c:        No regional lymph nodes are positive, but there are tumor deposits in the subserosa, mesentery, or nonperitonealized pericolic, or perirectal/mesorectal tissues.

___ pN2:        Four or more regional lymph nodes are positive

___ pN2a:        Four to six regional lymph nodes are positive

___ pN2b:        Seven or more regional lymph nodes are positive

Distant Metastasis (pM) (required only if confirmed pathologically in this case)

___ pM1:        Metastasis to one or more distant sites or organs or peritoneal metastasis is identified        

___ pM1a:        Metastasis to one site or organ is identified without peritoneal metastasis

___ pM1b:        Metastasis to two or more sites or organs is identified without peritoneal metastasis

___ pM1c:        Metastasis to the peritoneal surface is identified alone or with other site or organ metastases

       

Specify site(s), if known: ______________________________

Summary of changes AJCC 7th to 8th ed

• M Stage – addition of M1c

Gastrointestinal

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