|
Staging (Major Salivary Glands)
|   |
|
Staging (Major Salivary Glands)
| |
Pathologic Staging (pTNM)
CAP Approved Head and Neck • Salivary Glands 4.0.0.0
TNM Descriptors (required only if applicable) (select all that apply)
___ m (multiple primary tumors)
___ r (recurrent)
___ y (posttreatment)
Note: The phrases in italics include clinical findings required for AJCC staging. This clinical information may not be available to the pathologist. However, if known, these findings should be incorporated into the pathologic staging.
Primary Tumor (pT)
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pTis: Carcinoma in situ
___ pT1: Tumor 2 cm or smaller in greatest dimension without extraparenchymal extension#
___ pT2: Tumor larger than 2 cm but not larger than 4 cm in greatest dimension without extraparenchymal extension#
___ pT3: Tumor larger than 4 cm and/or tumor having extraparenchymal extension#
___ pT4: Moderately advanced or very advanced disease
___ pT4a: Moderately advanced disease. Tumor invades skin, mandible, ear canal, and/or facial nerve.
___ pT4b: Very advanced disease. Tumor invades skull base and/or pterygoid plates and/or encases carotid artery
# Extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues. Microscopic evidence alone does not constitute extraparenchymal extension for classification purposes.
Regional Lymph Nodes (pN)#
___ pNX: Regional lymph nodes cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1: Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(-)
___ pN2: Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(−)
___ pN2a: Metastasis in single ipsilateral node 3 cm or smaller in greatest dimension and
ENE(+); or a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
___ pN2b: Metastasis in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and
ENE(−)
___ pN2c: Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
___ pN3: Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−);or in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or multiple ipsilateral, contralateral, or bilateral nodes any with ENE(+) ; or a single contralateral node 3 cm or smaller and ENE(+)
___ pN3a: Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
___ pN3b: Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+);
or multiple ipsilateral, contralateral or bilateral nodes any with ENE(+)
# Midline nodes are considered ipsilateral nodes.
Note: Pathological ENE should be recorded as ENE(−) or ENE(+).
Note: Measurement of the metastatic focus in the lymph nodes is based on the largest metastatic deposit size, which may include matted or fused lymph nodes.
Distant Metastasis (pM)
___ Not applicable
___ pM1: Distant metastasis (specify sites if known)
Summary of changes AJCC 7th to 8th edition