Pathologic Staging (pTNM AJCC 8th edition)

CAP Approved Genitourinary • Penis 4.0.1.0

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

___ pTis:        Carcinoma in situ (penile intraepithelial neoplasia [PeIN])

___ pTa:        Noninvasive localized squamous cell carcinoma

___ pT1:        Glans: Tumor invades lamina propria

       Foreskin: Tumor invades dermis, lamina propria, or dartos fascia

       Shaft: Tumor invades connective tissue between epidermis and corpora regardless of location

       All sites with or without lymphovascular invasion or perineural invasion and is or is not high grade

___ pT1a:        Tumor is without lymphovascular invasion or perineural invasion and is not high grade (ie, grade 3 or sarcomatoid)

___ pT1b:        Tumor exhibits lymphovascular invasion and/or perineural invasion or is high grade (ie, grade 3 or sarcomatoid)

___ pT2:        Tumor invades into corpus spongiosum (either glans or ventral shaft) with or without urethral invasion

___ pT3:        Tumor invades into corpora cavernosum (including tunica albuginea) with or without urethral invasion

___ pT4:        Tumor invades into adjacent structures (ie, scrotum, prostate, pubic bone)

Regional Lymph Nodes (pN)

___ pNX:        Lymph node metastasis cannot be established

___ pN0:        No lymph node metastasis

___ pN1:        ≤2 unilateral inguinal metastases, no ENE

___ pN2:        ≥3 unilateral inguinal metastases or bilateral metastases, no ENE

___ pN3:        ENE of lymph node metastases or pelvic lymph node metastases

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

___ pM1:        Distant metastasis present#

       Specify site(s), if known: ___________________________

# Including lymph node metastasis outside the true pelvis, lung, liver, cutaneous nodules distant from the primary site, and bone.

Major changes:

1. T stage changes

Previous stage T2 and T3:

CAP 4.0, currently:

___ pT2: Tumor invades into corpus spongiosum (either glans or ventral shaft) with or without urethral invasion

___ pT3: Tumor invades into corpora cavernosum (including tunica albuginea) with or without urethral invasion

2. N has changes related to extra-nodal extension

Genitourinary

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