Pathologic Staging (pTNM, AJCC 8th Edition)

CAP Approved Gynecologic • Vagina 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

___ pT1: Tumor confined to the vagina

___ pT1a: Tumor confined to the vagina, measuring ≤2.0 cm

___ pT1b: Tumor confined to the vagina, measuring >2.0 cm

___ pT2: Tumor invading paravaginal tissues but not to pelvic sidewall

___ pT2a: Tumor invading paravaginal tissues but not to pelvic wall, measuring ≤2.0 cm

___ pT2b: Tumor invading paravaginal tissues but not to pelvic wall, measuring >2.0 cm

___ pT3: Tumor extending to the pelvic sidewall# and/or involving the lower third of the vagina and/or causing hydronephrosis or nonfunctioning kidney

___ pT4: Tumor invading the mucosa of the bladder or rectum and/or extending beyond the true pelvis (bullous edema is not sufficient evidence to classify a tumor as T4)

# Pelvic sidewall is defined as the muscle, fascia, neurovascular structures, or skeletal portions of the bony pelvis. On rectal examination, there should be no cancer-free space between the tumor and pelvic sidewall.

Regional Lymph Nodes (pN)

___ pNX:        Cannot be assessed

___ pN0:        No regional lymph node metastasis

___ pN0(i+):        Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm

___ pN1:        Pelvic or inguinal lymph node metastasis

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

___ pM1: Distant metastasis (specify site(s):)

Vagina CAP 4.0.0.1 summary of pTNM changes AJCC 7th to 8th edition

1. No pTis category
2. pT1 and pT2 subdivided based on tumor size
3. pT3 includes involvement of lower third of vagina and/or hydronephrosis
4. New pN0(i+) category for isolated tumor cells

Gynecologic

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