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Staging (Ampulla of Vater)
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Staging (Ampulla of Vater)
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Pathologic Staging (pTNM) 4.0.0.0 AJCC 8th Edition
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
___ pT1: Tumor limited to ampulla of Vater or sphincter of Oddi or tumor invades beyond the sphincter of Oddi (perisphincteric invasion) and/or into the duodenal submucosa
___ pT1a: Tumor limited to ampulla of Vater or sphincter of Oddi
___ pT1b: Tumor invades into the duodenal submucosa and/or beyond the sphincter of Oddi (perisphincteric invasion)
___ pT2: Tumor invades into the muscularis propria of the duodenum
___ pT3: Tumor directly invades the pancreas (up to 0.5 cm) or tumor extends more than 0.5 cm into the pancreas, or extends into peripancreatic or periduodenal tissue or duodenal serosa without involvement of the celiac axis or superior mesenteric artery
___ pT3a: Tumor directly invades the pancreas (up to 0.5 cm)
___ pT3b: Tumor extends more than 0.5 cm into the pancreas, or extends into peripancreatic tissue or periduodenal tissue or duodenal serosa without involvement of the celiac axis or superior mesenteric artery
___ pT4: Tumor involves the celiac axis, superior mesenteric artery, and/or common hepatic artery, irrespective of size
Regional Lymph Nodes (pN)
___ pNX: Regional lymph nodes cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1: Metastasis to one to three regional lymph nodes
___ pN2: Metastasis to four or more regional lymph nodes
Distant Metastasis (pM) (required only if confirmed pathologically in this case)
___ pM1: Distant metastasis
Specify site(s), if known: ___________________________
Summary of changes AJCC 7th to 8th edition