คณะแพทยศาสตร์ มหาวิทยาลัยนเรศวร - โรงเรียนแพทย์ที่ใช้ ...



Lip and Oral Cavity Cancer Staging (AJCC 7th ed. 2010) C00.0 External upper lip C02.2 Ventral surface of tongue C05.0 Hard palate C00.1 External lower lip C02.3 Anterior two-thirds of tongue, part unspecified C05.8 Overlapping lesion of palate C00.2 External lip, unspecified C02.8 Overlapping lesion of tongue C05.9 Palate, unspecified C00.3 Upper lip, inner aspect C02.9 Tongue, unspecified C06.0 Cheek mucosa C00.4 Lower lip, inner aspect C03.0 Upper gum C06.1 Vestibule of mouth C00.5 Lip, unspecified, inner aspect C03.1 Lower gum C06.2 Retromolar area C00.6 Commissure of lip C03.9 Gum, unspecified C06.8 Overlapping lesion of other and C00.8 Overlapping lesion of lip C04.0 Anterior floor of mouthunspecified parts of mouth C00.9 Lip, unspecified C04.1 Lateral floor of mouth C06.9 Mouth, unspecified C02.0 Dorsal surface of tongue C04.8 Overlapping lesion of floor of mouth C02.1 Border of tongue C04.9 Floor of mouth, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ T1 Tumor 2 cm or less in greatest dimension T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension T3 Tumor more than 4 cm in greatest dimension T4a Moderately advanced local disease. (Lip) Tumor invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin of face, i.e., chin or nose (Oral Cavity) Tumor invades adjacent structures only (e.g., through cortical bone, [mandible or maxilla] into deep [extrinsic] muscle of tongue [genioglossus, hyoglossus, palatoglossus, and styloglossus], maxillary sinus, skin of face) T4b Very advanced local disease. Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid arteryRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in lymph node more than 6 cm in greatest dimensionDistant Metastasis (M) M0No distant metastasis M1 Distant metastasisStage Grouping 0TisN0M0 IVAT4aNo-2M0 IT1N0M0T1-3N2M0 IIT2N0M0 IVBAny TN3M0 IIIT3N0M0T4bAny NM0T1-3N1M0 IVCAny TAny NM1 Stage unknownPhysician .......................................Date............../.................../.............Oropharynx Cancer Staging (AJCC 7th ed. 2010) C01.9 Malignant neoplasm of base of tongue C09.8 Overlapping lesion of tonsil C10.8 Overlapping lesion of oropharynx C02.4 Lingual tonsil C09.9 Tonsil, unspecified C10.9 Oropharynx, unspecified C05.1 Soft palate C10.0 Vallecula C14.0 Pharynx, unspecified C05.2 Uvula C10.2 Lateral wall of oropharynx C14.8 Overlapping lesion of lip, C09.0 Tonsillar fossa C10.3 Posterior pharyngeal wall oral cavity and pharynx C09.1 Tonsillar pillar (anterior, posterior) C10.4 Branchial cleftDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor 2 cm or less in greatest dimension T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension T3Tumor more than 4 cm in greatest dimension or extension to lingual surface of epiglottis T4a Moderately advanced local disease. Tumor invades the larynx, deep/extrinsic muscle of tongue, medial pterygoid, hard palate or mandible* T4b Very advanced local disease. Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx or skull base or encases carotid artery * Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of larynxRegional Lymph Nodes (N) N0No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension,or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2bMetastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2cMetastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3Metastasis in lymph node more than 6 cm in greatest dimension*Metastases at Level VII are considered regional lymph node metastases.Distant Metastasis (M) M0No distant metastasis M1Distant metastasisStage Grouping 0TisN0M0 IVAT4a N0-2 M0 IT1N0M0 T1-3 N2 M0 IIT2N0M0 IVBAny T N3 M0 IIIT3N0M0T4b Any N M0T1-3N1M0 IVCAny T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Nasopharynx Cancer Staging (AJCC 7th ed. 2010) C11.0 Superior wall of nasopharynx C11.3 Anterior wall of nasopharynx C14.0 Pharynx, unspecified C11.1 Posterior wall of nasopharynx C11.8 Overlapping lesion of nasopharynx C14.8 Overlapping lesion of lip, oral cavity C11.2 Lateral wall of nasopharynx C11.9 Nasopharynx, unspecified and pharynxDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Undifferentiated carcinoma (M8020/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor confined to the nasopharynx, or extends to oropharynx and/or nasal cavity without parapharyngeal extension* T2Tumor with parapharyngeal extension* T3Tumor involves bony structures of skull base and/or paranasal sinuses T4 Tumor with intracranial extension and/or involvement of involvement of cranial nerves, hypopharynx, orbit, or with extension to the infratemporal fossa/masticator space * Parapharyngeal extension denotes posterolateral infiltration of tumor.Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Unilateral metastasis in lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa, and/or unilateral or bilateral, retropharyngeal lymph nodes, 6 cm or less, in greatest dimension* N2 Bilateral metastasis in lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa* N3 Metastasis in lymph node(s) more than 6 cm and/or extension to supraclavicular fossa N3a Greater than 6 cm in dimension N3b Extension to the supraclavicular fossa*** Midline nodes are considered ipsilateral nodes.**Supraclavicular zone or fossa is relevant to the staging of nasopharyngeal carcinoma and is the triangular region originally described by Ho. It is defined by three points: (1) the superior margin of the sternal end of the clavicle, (2) the superior margin of the lateral end of the clavicle, (3) the point where the neck meets the shoulder. Note that this would include caudal portions of Levels IV and VB. All cases with lymph nodes (whole or part) in the fossa are considered N3b.Distant Metastasis (M) M0No distant metastasis M1Distant metastasisStage Grouping 0 Tis N0 M0 I T1 N0 M0 II T1 N1 M0 T2 N0-1 M0 III T3 N0 M0 T3 N1 M0 T1-3 N2 M0 IVA T4 N0-2 M0 IVB Any T N3 M0 IVC Any T Any N M1 Stage unknownPhysician ....................................... Date............../.................../.............Hypopharynx Cancer Staging (AJCC 7th ed. 2010) C12.9 Malignant neoplasm of pyriform sinus C13.2 Posterior wall of hypopharynx C14.0 Pharynx, unspecified C13.0 Postcricoid region C13.8 Overlapping lesion of hypopharynx C14.8 Overlapping lesion of lip, C13.1 Aryepiglottic fold, hypopharyngeal aspect C13.9 Hypopharynx, unspecified oral cavity and pharynx Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) Tis Carcinoma in situ T1 Tumor limited to one subsite of hypopharynx and/or 2 cm or less in greatest dimension T2 Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures more than 2 cm but not more than 4 cm in greatest dimension without fixation of hemilarynx T3 Tumor more than 4 cm in greatest dimension or with fixation of hemilarynx or extension to esophagus T4a Moderately advanced local disease. Tumor invades cricoids/thyroid cartilage, hyoid bone, thyroid gland, or central compartmentsoft tissue* T4b Very advanced disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures * Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes, non more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in lymph node more than 6 cm in greatest dimension *Metastases at Level VII are considered regional lymph node metastases.Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0Tis N0 M0 IT1 N0 M0IIT2 N0 M0IIIT3 N0 M0T1-3 N1 M0IVAT4a N0-2 M0T1-3 N2 M0IVBAny T N3 M0T4b Any N M0IVCAny T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Larynx Cancer Staging (AJCC 7th ed. 2010) C10.1 Anterior surface of epiglottis C32.1 Supraglottis C32.8 Overlapping lesion of larynx C32.0 Glottis C32.2 Subglottis C32.9 Larynx, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Other ……………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situSupraglottis T Tumor limited to one subsite of supraglottis with normal vocal cord mobility T2 Tumor invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.d., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynx T3 Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre-epiglottic space, paraglottic space, and/or inner cortex of thyroid cartilage T4a Moderately advanced local disease. Tumor invades through the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b Very advanced disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structuresGlottis T1 Tumor limited to the vocal cord(s) (may involve anterior or posterior commissure) with normal mobility T1a Tumor limited to one vocal cord T1b Tumor involves both vocal cord T2Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility T3Tumor limited to larynx with vocal cord fixation and/or invasion of paraglottic space, and/or inner cortex of thyroid cartilage T4a Moderately advanced local disease. Tumor invades through the outer cortex of the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b Very advanced disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structuressubglottis T1 Tumor limited to the subglottis T2 Tumor extends to vocal cord(s) with normal or impaired mobility T3 Tumor limited to larynx with vocal cord fixation T4a Moderately advanced local disease. Tumor invades cricoids or thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b Very advanced disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structuresRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension,or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or in bilateral or contralateral lymph node, none more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2C Metastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in lymph node more than 6 cm in greatest dimension??????????2Distant Metastasis (M) M0No distant metastasis M1Distant metastasisStage Grouping 0TisN0M0 IT1N0M0 IIT2N0M0 IIIT3N0M0T1-3N1M0 IVAT4aN0-1M0T1-3N2M0T4aN2M0 IVBT4bAny NM0Any T N 3M0 IVCAny TAny NM1 Stage unknownPhysician .......................................Date............../.................../.............Nasal Cavity Cancer Staging (AJCC 7th ed. 2010) C30.0 Nasal cavity C31.0 Maxillary sinus C31.1 Ethmoidal sinus Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Schneiderian carcinoma (M8121/3) Other ………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situMaxillary Sinus T1 Tumor limited to maxillary sinus mucosa with no erosion or destruction of bone T2 Tumor causing bone erosion or destruction including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of maxillary sinus and pterygoid plates T3 Tumor invades any of the following: bone of the posterior wall of maxillary sinus, subcutaneous tissues, floor or mesial wall of orbit, pterygoid fossa, ethmoid sinuses T4a Moderately advanced local disease.Tumor invades anterior orbital contents, skin of cheek, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid or frontal sinuses T4b Very advanced disease. Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivusNasal Cavity and Ethmoid Sinus T1 Tumor restricted to any one subsite, with or without bony invasion T2 Tumor invading two subsites in a single region or extending to involve an adjacent region within the nasoethmoidal complex, with or without bony invasion T3 Tumor extends to invade the medial wall or floor of the orbit, masillary sinus, palate, or cribriform plate T4a Moderately advanced local disease.Tumor invades any of the following: anterior orbital contents, skin of nose or cheek, minimal extension to anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses T4b Very advanced disease. Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus 2222Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes, non more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2C Metastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in lymph node more than 6 cm in greatest dimensionDistant Metastasis (M) M0 No distant metastasis M1Distant metastasisStage Grouping 0TisN0M0 IVA T4a N0-2 M0 IT1N0M0 T1-3 N2 M0 IIT2N0M0 IVB Any T N3 M0 IIIT3N0M0 T4b Any N M0T1-3N1M0 IVC Any T Any N M1 Physician ....................................... Stage unknownDate............../.................../.............Major Salivary Glands Cancer Staging (AJCC 7th ed. 2010) C07.9 Malignant neoplasm of parotid gland C08.1 Sublingual gland C08.9 Major salivary gland, unspecified C08.0 Submandibular gland C08.8 Overlapping lesion of major salivary glands Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Basal cell adenocarcinoma (M8147/3) Adinoid cystic carcinoma (M8200/3) Mucoepidermoid carcinoma (M8430/3) Mucinous carcinoma (M8480/3) Acinic cell carcinoma (M8550/3) Papillary cystadenocarcinoma (M8480/3) Other ……………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Tumor 2 cm or less in greatest dimension without extraparenchymal extension T2Tumor more than 2 cm but not more than 4 cm in greatest dimension without extraparenchymal extension T3Tumor more than 4 cm and/or tumor having extraparenchymal extension T4a Moderately advanced disease. Tumor invades skin, mandible, ear canal, and/or facial nerve T4b Very advanced disease. Tumor invades skull base and/or pterygoid plates and/or encases carotid artery Note: Extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissue. Microscopic evidence alone does not constitute extraparenchymal extension for classification purposes.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contra lateral lymph nodes, none more than 6 cm in greatest dimension N3Metastasis in lymph node more than 6 cm in greatest dimensionDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasisStage Grouping I T1 N0 M0 II T2 N0 M0 III T3 N0 M0 T1-3 N1 M0 IVA T4a N0-1 M0 T1-3 N2 M0 T4a N2 M0 IVB T4b Any N M0 Any T N3 M0 IVC Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Thyroid Cancer Staging (AJCC 7th ed. 2010)C 73 Malignant neoplasm of thyroid glandDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated (anaplastic) carcinoma (M8020/3) Papillary adenocarcinoma (M8260/3) Follicular carcinoma (M8330/3) Medullary carcinoma (M8510/3) Other ……………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1 Tumor 2 cm or less in greatest dimension limited to the thyroid T1a Tumor 1 cm or less, limited to the thyroid T1b Tumor more than 1 cm but not more than 2 cm in greatest dimension, limited to the thyroid T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension, limited to the thyroid T3 Tumor more than 4 cm in greatest dimension limited to the thyroid, or any tumor with minimal extrathyroid extension extension (e.g., extension to sternothyroid muscle or perithyroid soft tissues) T4a Moderately advanced disease. Tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx trachea, esophagus, or recurrent laryngeal nerve T4b Very advanced disease. Tumor invades prevertebral fascia or encases carotid artery of mediastinal vessels All anaplastic carcinomas are considered T4 tumors T4a Intrathyroidal anaplastic carcinoma T4b Anaplastic carcinoma with gross extrathyroid extensionRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis N1a Metastasis to Level VI (pretracheal, paratracheal, and prelaryngea/Delphian lymph nodes) N1b Metastasis to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII)Distant Metastasis (M) M0 No distant metastasis M1Distant metastasisStage Grouping Papillary or Follicular (Differentiated) Under 45 years I Any T Any N M0 II Any T Any N M1Papillary or Follicular (Differentiated) 45 years and older, Medullary Carcinoma I T1 N0 M0 IVA T4a N0 M0 II T2 N0 M0 T4a N1a M0 III T3 N0 M0 T1 N1b M0 T1 N1a M0 T2 N1b M0 T2 N1a M0 T3 N1b M0 T3 N1a M0 T4a N1b M0 IVB T4b Any N M0 IVC Any T Any N M1Anaplastic Carcinoma IVA T4a Any N M0 IVB T4b Any N M1 IVC Any T Any N M1Physician ....................................... Stage unknownDate............../.................../.............Mucosal Melanoma of the Head and Neck Staging (AJCC 7th ed. 2010) C14.0 Pharynx, unspecified C08.1 Sublingual gland C14.2 Waldeyer's ring C08.8 Overlapping lesion of major salivary glands unspecified C38.2 Posterior mediastinum C47.5 Peripheral nerves of pelvis C48.2 Peritoneum, unspecified C14.8 Overlapping lesion of lip, oral cavity and pharynx C08.9 Major salivary gland, unspecified C44.8 Overlapping lesion of skin of upper limb, including shoulder C07.9 Malignant neoplasm of parotid gland C30.1 Middle ear C08.0 Submandibular gland C73. Malignant neoplasm of thyroid gland Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Malignant melanoma, NOS (M8720/3) Nodular melanoma, NOS (M8721/3) Balloon cell melanoma, NOS (M8722/3) Amelanotic melanoma, NOS (M8730/3) Spindle cell melanoma, NOS (M8772/3) Other …….…………………………… Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T3 Mucosal disease T4a Moderately advanced disease. Tumor involving deep soft tissue, cartilage, bone, or overlying skin. T4b Very advanced disease. Tumor involving brain, dura, skull base, lower cranial nerves (IX, X, XI, XII), masticator space, carotid artery, prevertebral space, or mediastinal structrresRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis presentDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasisStage Grouping III T3 N0 M0 IVA T4a N0 M0 T3- T4a N1 M0 IVB T 4b Any N M0 IVC T Any N Any M1 Stage unknownPhysician .......................................Date............../.................../.............Oesophagus and Esophagogastric Junction Cancer Staging (AJCC 7th ed. 2010) C15.0 Cervical part of oesophagus C15.4 Middle third of oesophagus C16.0 Cardia C15.1 Thoracic part of oesophagus C15.5 Lower third of oesophagus C16.1 Fundus of stomach* C15.2 Abdominal part of oesophagus C15.8 Overlapping lesion of oesophagus C16.2 Body of stomach* C15.3 Upper third of oesophagus C15.9 Oesophagus, unspecified *Note: If gastric tumor extends to or above esophagogastric junction.Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Other ………………………………….. Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis High-grade dysplasia T1 Tumor invades lamina propria, muscularis mucosae, or submucosa T1a Tumor invades lamina propria or muscularis mucosae T1b Tumor invades submucosa T2 Tumor invades muscularis propria T3 Tumor invades adventitia T4 Tumor invades adjacent structures T4a Resectable tumor invading pleura, pericardium, or diaphragm T4b Unresectable tumor invading other adjacent structures, such as aorta, vertebral body, trachea, etc. Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph nodes metastasis Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping Group T N M Grade Tumor Location 0 Tis (HGD) N0 M0 1 Any IA T1 N0 M0 1, X Any IB T1 N0 M0 2-3 Any T2-3 N0 M0 1, X Lower, X IIA T2-3 N0 M0 1, X Upper, middle T2-3 N0 M0 2-3 Lower, X IIB T2-3 N0 M0 2-3 Upper, middle T1-2 N1 M0 Any Any IIIA T1-2 N2 M0 Any Any T3 N1 M0 Any Any T4a N0 M0 Any Any IIIB T3 N2 M0 Any Any IIIC T4a N1-2 M0 Any Any T4b Any M0 Any Any Any T N3 M0 Any Any IV Any T Any N M1 Any AnyPhysician ....................................... Stage unknownDate............../.................../.............Stomach Cancer Staging (AJCC 7th ed. 2010) C16.1 Fundus of stomach* C16.5 Lesser curvature of stomach, unspecified C16.2 Body of stomach* C16.6 Greater curvature of stomach, unspecified C16.3 Pyloric antrum C16.8 Overlapping lesion of stomach C16.4 Pylorus C16.9 Stomach, unspecified *Note: See first statement in Summary of Changes.Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Tubular adenocarcinoma (M8211/3) Papillary adenocarcinoma (M8260/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Other ……………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ: intraepithelial tumor without invasion T1Tumor invades lamina propria, muscularis mucosae, or submucosa T1aTumor invades lamina propria or muscularis mucosae T1bTumor invades submucosa T2Tumor invades muscularis propria T3Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures T4Tumor invades serosa (visceral peritoneum) or adjacent structures T4aTumor invades serosa (visceral peritoneum) T4b Tumor invades adjacent structures Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Metastasis in 1 to 2 regional lymph nodes N2Metastasis in 3 to 6 regional lymph nodes N3Metastasis in 7 or more regional lymph nodes N3aMetastasis in 7 to15 regional lymph nodes N3bMetastasis in 16 or more regional lymph nodesDistant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0Tis N0 M0 IIIA T4a N1 M0 IAT1 N0 M0 T3N2 M0 IBT2 N0 M0 T2N3 M0T1 N1 M0 IIIB T4b N0 M0 IIAT3 N0 M0 T4b N1 M0T2 N1 M0 T4a N2 M0 IIBT4a N0 M0 T3N3 M0T3 N1 M0 IIIC T4b N2 M0T2 N2 M0 T4b N3 M0T1 N3 M0 T4a N3 M0 Stage unknown IV Any T Any N M1 Physician ....................................... Date............../.................../............. Small Intestine Cancer Staging (AJCC 7th ed. 2010) C17.0 Duodenum C17.2 Ileum C17.9 Small intestine, unspecified C17.1 Jejunum C17.8 Overlapping lesion of small intestineDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Adenocarcinoma (M8140/3) Carcinoid tumor (M8240/3) Atypical carcinoid tumor (M8249/3) Neuroendocrine carcinoma (M8480/3) Other ……………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ T1a Tumor invades lamina propria T1b Tumor invades submucosa T2 Tumor invades muscularis propria T3 Tumor invades through the muscularis propria into pericolorectal tissues or into the nonperitonealized perimuscular tissue (mesentery or retroperitomeum) with extension 2 cm or less T4 Tumor perforates the visceral peritoneum or directly invades other organs or structures (includes other loops of small intestine, mesentery, or retroperitoneum more than 2 cm, and abdominal wall by way of serosa; for duodenum only, invasion of pancreas or bile duct) Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Metastasis in 1-3 regional lymph nodes N2Metastasis in 4 or more regional lymph nodesDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 T2 N0 M0 IIA T3 N0 M0 IIB T4 N0 M0 IIIA Any T N1 M0 IIIB Any T N2 M0 IV Any T Any N M1 Stage unknown Physician .......................................Date............../.................../.............Appendix Cancer Staging (AJCC 7th ed. 2010) C18.1 AppendixDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Adenocarcinoma (M8140/3) Carcinoma tumor (M8240/3) Mucinous carcinoma (M8480/3) Adenosquamous carcinoma (M8560/3) Medullary carcinoma (M8510/3) Signet ring cell carcinoma (M8490/3) Other …………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T)Carcinoma Carcinoid Tis Carcinoma in situ : intraepithelial or invasion of lamina propria T1 Tumor 2cm or less in greatest dimension T1 Tumor invades submucosa T1a Tumor 1cm or less in greatest dimension T2 Tumor invades muscularis propria T1b Tumor more than 1 cm but not more than 2 cm T3 Tumor invades through the muscularis propria into mesoappendix T2 Tumor more than 2 cm but not more than 4 cm T4 Tumor penetrates visceral peritoneum, including mucinous or with extension to the caecum peritoneal tumor with the right lower quadrant and/or directly T3 Tumor more than 4 cm or with extension to the ileum invades other organs or structures T4 Tumor directly invades other adjacent organs T4a Tumor penetrates visceral peritoneum, including mucinous or structures, e.g., abdominal wall and skeletal muscle peritoneal tumor with the right lower quadrant T4b Tumor directly invades other organs or structures Regional Lymph Nodes (N)Carcinoma Carcinoid N0No regional lymph node metastasis N0 No regional lymph node metastasis N1Metastasis in 1to3 regional lymph nodes N1 Metastasis in 1to3 regional lymph nodes N2Metastasis in 4 or more regional lymph nodes N2aMetastasis in 4-6 regional lymph nodes N2bMetastasis in 7 or more regional lymph nodesDistant Metastasis (M)Carcinoma Carcinoid M0No distant metastasis M0 No distant metastasis M1Distant metastasis M1 Distant metastasis M1aIntraperitoneal metastasis beyond the right lower quadrant, including pseudomyxoma peritonei M1bNon-peritoneal metastasis Stage GroupingCarcinoma CarcinoidGroup T N M Grade Group T N M 0 Tis N0 M0 I T1 N0 M0 I T1-2 N0 M0 II T2, T3 N0 M0 IIA T3 N0 M0 III T4 N0 M0 IIB T4a N0 M0 Any T N1 M0 IIC T4b N0 M0 IV Any T Any N M0 IIIA T1-2 N0 M0 Stage unknown IIIB T3-4 N1 M0 IIIC Any T N2 M0 IVA Any T N0 M1a G1 IVB Any T N0 M1a G2, 3Physician ....................................... Any T N1-2 M1a Any G IVC Any T Any N M1b Any G Date............../.................../.............Colon and Rectum Cancer Staging (AJCC 7th ed. 2010) C18.0 Caecum C18.5 Splenic flexure C18.9 Colon, unspecified C18.2 Ascending colon C18.6 Descending colon C19.9 Rectosigmoid junction C18.3 Hepatic flexure C18.7 Sigmoid colon C20.9 Rectum C18.4 Transverse colon C18.8 Overlapping lesion of colonDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Undifferentiated carcinoma (M8020/3) Adenocarcinoma (M8140/3) Carcinoma tumor (M8240/3) Mucinous carcinoma (M8480/3) Adenosquamous carcinoma (M8560/3) Medullary carcinoma (M8510/3) Signet ring cell carcinoma (M8490/3) Other ……………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ : intraepithelial or invasion of lamina propria T4a Tumor penetrates to the surface of the visceral peritoneum T1 Tumor invades submucosa T4b Tumor directly invades or is adherent to other organs or T2 Tumor invades muscularis propria structures T3 Tumor invades through the muscularis propria into pericolorectal tissuesRegional Lymph Nodes (N) N0 No regional lymph node metastasis N2Metastasis in 4 or more regional lymph nodes N1 Metastasis in 1-3 regional lymph nodes N2a Metastasis in 4-6 regional lymph nodes N1a Metastasis in one regional lymph nodes N2bMetastasis in 7 or more regional lymph nodes N1b Metastasis in 2-3 regional lymph nodes N1c Tumor deposit(s) in the subserosa, mesentery, or perirectal tissues without regional lymph nodes metastasisDistant Metastasis (M) M0 No distant metastasis M1a Metastasis confined to one organ or site (for example, liver, lung, ovary, non reqional node) M1 Distant metastasis M1b Metastases in more than one organ/site or the peritoneum Stage GroupingGroupTNMDukesMAC 0TisN0M0-- IT1N0M0AA?T2N0M0AB1 IIAT3N0M0BB2 IIBT4aN0M0BB2 IICT4bN0M0BB3 IIIAT1-T2N1/N1cM0CC1?T1N2aM0CC1 IIIBT3-T4aN1/N1cM0CC2?T2-T3N2aM0CC1/C2?T1-T2N2bM0CC1Physician…………………………..Date………/…………/…………… IIICT4aN2aM0CC2?T3-T4aN2bM0CC2?T4bN1-N2M0CC3 IVAAnyTAny NM1a-- IVBAnyTAny NM1b-- Stage unknownGastrointestinal Stromal Staging (AJCC 7th ed. 2010) C15 Malignant neoplasm of oesophagus C19 Malignant neoplasm of rectosigmoid junction C16 Malignant neoplasm of stomach C20 Malignant neoplasm of rectum C17 Malignant neoplasm of small intestine C48 Malignant neoplasm of retroperitoneum and peritoneum C18 Malignant neoplasm of colonDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Gastrointestinal stromal Tumor (GIST) (M8936/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Tumor 2 cm or less T2Tumor more than 2 cm but not more than 5 cm T3Tumor more than 5 cm but not more than 10 cm T4Tumor more than 10 cm in greatest dimensionRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph node metastasis Distant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasis Stage GroupingGroup T N M Mitotic Rate IA T1or 2 N0 M0 Low IB T3 N0 M0 Low II T1 N0 M0 High T2 N0 M0 High T4 N0 M0 Low IIIA T3 N0 M0 High IIIB T4 N0 M0 High IV Any T N1 M0 Any rate Any T Any N M1 Any ratePhysician…………………………..Date………/…………/…………… Stage unknownRectosigmoid Junction Cancer Staging (AJCC 7th ed. 2010)C19 Malignant neoplasm of rectosigmoid junctionDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Undifferentiated carcinoma (M8020/3) Adenocarcinoma (M8140/3) Carcinoma tumor (M8240/3) Mucinous carcinoma (M8480/3) Adenosquamous carcinoma (M8560/3) Medullary carcinoma (M8510/3) Signet ring cell carcinoma (M8490/3) Other ………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Tumor 2 cm or less T2Tumor more than 2 cm but not more than 5 cm T3Tumor more than 5 cm but not more than 10 cm T4Tumor more than 10 cm in greatest dimensionRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph node metastasis Distant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasis Stage GroupingGroup T N M Mitotic Rate IA T1or 2 N0 M0 Low IB T3 N0 M0 Low II T1 N0 M0 High T2 N0 M0 High T4 N0 M0 Low IIIA T3 N0 M0 High IIIB T4 N0 M0 HighPhysician…………………………..Date………/…………/…………… IV Any T N1 M0 Any rate Any T Any N M1 Any rate Stage unknownAnus Cancer Staging (AJCC 7th ed. 2010) C21.0 Anus, unspecified C21.2 Cloacogenic zone C21.1 Anal canal C21.8 Overlapping lesion of rectum, anus and anal canalDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Adenocarcinoma of anal glands (M8215/3) Mucinous carcinoma (M8480/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ (Bowen’s disease, High-grade Squamous Intraepithelial Lesion (HLIL), Anal Intraepithelial Neoplasia II-III (AIN II-III) T1Tumor 2 cm or less in greatest dimension T2Tumor more than 2 cm but not more than 5 cm in greatest dimension T3Tumor more than 5 cm in greatest dimension T4Tumor of any size invades adjacent organ(s), e.g., vagina, urethra, bladderRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Metastasis in perirectal lymph node(s) N2Metastasis in unilateral internal iliac and/or inguinal lymph nodes N2Metastasis in perirectal and inguinal lymph nodes and/or bilateral internal iliac and/or inguinal lymph nodesDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 T3 N0 M0 IIIA T1-3 N1 M0 T4 N0 M0 IIIB T4 N1 M0 Any T N2 M0 Any T N3 M0 IV Any T Any N M1Physician…………………………..Date………/…………/…………… Stage unknownLiver Cancer Staging (AJCC 7th ed. 2010)C22.0 Liver cell carcinomaHepatocellular carcinomaHepatomaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Hepatocellular carcinoma (M8170/3) Hepatocellular carcinoma, scirrhous (M8172/3) Hepatocellular carcinoma, spindle cell variant (M8173/3) Hepatocellular carcinoma, clear cell type (M8174/3) Hepatocellular carcinoma, pleomorphic type (M8175/3) Combined hepatocellular carcinoma & CHCA (M8180/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Solitary tumor without vascular invasion T2Solitary tumor without vascular invasion or multiple tumors none more than 5 cm T3aMultiple tumors more than 5 cm T3bSingle tumors or multiple tumors of any size involving a major branch of the portal vein or hepatic vein T4Tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneumRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping I T1 N0 M0 II T2 N0 M0 IIIA T3a N0 M0 IIIB T3b N0 M0 IIIC T4 N0 M0 IVA Any T N1 M0 IVB Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Intrahepatic Bile Ducts Cancer Staging (AJCC 7th ed. 2010)C22.1 Intrahepatic bile duct carcinomaCholangiocarcinomaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Cholangiocarcinoma (M8160/3) Klatskin tumor (M8162/3) Bile duct cystadenocarcinoma (M8161/3) Mixed hepatocellular and bile duct carcinoma (M8180/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Solitary tumor without vascular invasion T2aSolitary tumor with vascular invasion T2bMultiple tumors, with or without vascular invasion T3Tumor perforating the visceral peritoneum or involving the local extra hepatic structures by direct invasion T4Tumor with periductal invasionRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 III T3 N0 M0 IVA T4 N0 M0 Any T N1 M0 IVB Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Gallbladder Cancer Staging (AJCC 7th ed. 2010) C23 Malignant neoplasm of gallbladder C24.0 Extrahepatic bile ductDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Papillary carcinoma (M8050/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Adenocarcinoma, intestinal type (M8144/3) Clear cell adenocarcinoma (M8310/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Adenosquamous carcinoma (M8560/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor invades lamina propria or muscular layer T1aTumor invades lamina propria T1bTumor invades muscular layer T2Tumor invades perimuscular connective tissue; no extension beyond serosa or into liver T3Tumor perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one ther adjacent organ or structure, such as the stomach, duodenum, colon, pancreas, omentum, or extrahepaic bile ducts T4Tumor invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structuresRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Metastasis to nodes along the cystic duct, common bile duct, hepatic artery, and/or portal vein N2Metastasis to periaortic, pericaval, superior mesentery artery and/or celiac artery lymph nodesDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 IIIA T3 N0 M0 IIIB T1-3 N1 M0 IVA T4 N0-1 M0 IVB Any T N2 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../............. Perihilar Bile Ducts Staging (AJCC 7th ed. 2010)C24.0 Extrahepatic bile ductDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Papillary carcinoma (M8050/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Adenocarcinoma, intestinal type (M8144/3) Clear cell adenocarcinoma (M8310/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Adenosquamous carcinoma (M8560/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor confined to the bile duct, with extension up to the muscle layer or fibrous tissue T2aTumor invades beyond the wall of the bile duct to surrounding adipose tissue T2bTumor invades adjacent hepatic parenchyma T3Tumor invades unilateral branches of the portal vein or hepatic artery T4Tumor invades main portal vein or its branches bilaterally; or the common hepatic artery; or the second-order biliary radicals bilaterally; or unilateral second-order biliary radicals with contralateral portal vein or hepatic artery involvement Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis (including nodes along the cystic duct, common bile duct, hepatic artery, and portal vein) N2Metastasis to periaortic, pericaval, superior mesentery artery, and/or celiac artery lymph nodes artery lymph nodesDistant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2a-b N0 M0 IIIA T3 N0 M0 IIIB T1-3 N1 M0 IVA T4 N0-1 M0 IVB Any T N2 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Distal Bile Ducts Staging (AJCC 7th ed. 2010)C24.0 Distal Bile bile ductDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Papillary carcinoma (M8050/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Adenocarcinoma, intestinal type (M8144/3) Clear cell adenocarcinoma (M8310/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Adenosquamous carcinoma (M8560/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor confined to the bile duct histologically T2Tumor invades beyond the wall of the bile duct T3Tumor invades the gallbladder, pancreas, duodenum or other adjacent organs without involvement of the celiac axis, or the superior mesenteric artery T4Tumor involves the celiac axis, or the superior mesenteric artery Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 IA T1 N0 M0 IB T2 N0 M0 IIA T3 N0 M0 IIB T1 N1 M0 T2 N1 M0 T3 N1 M0 III T4 Any N M0 IVB Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Ampulla of Vater Cancer Staging (AJCC 7th ed. 2010)C24.1 Ampulla of VaterDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Papillary carcinoma (M8050/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Adenocarcinoma, intestinal type (M8144/3) Clear cell adenocarcinoma (M8310/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Adenosquamous carcinoma (M8560/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor limited to ampulla of Vater or sphincter of Oddi T2Tumor invades duodenal wall T3Tumor invades pancreas T4Tumor invades peripancreatic soft tissues or other adjacent organs or structures other than pancreasRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 IA T1 N0 M0 IB T2 N0 M0 IIA T3 N0 M0 IIB T1 N1 M0 T2 N1 M0 T3 N1 M0 III T4 Any N M0 IV Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Pancreas Cancer Staging (AJCC 7th ed. 2010) C25.0 Head of pancreas C25.3 pancreatic duct C25.8 Overlapping lesion of pancreas C25.1 Body of pancreas C25.7 Other parts of pancreas C25.9 pancreas, unspecified C25.2 Tail of pancreas Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Papillary carcinoma (M8050/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Islet cell carcinoma (M8150/3) Serous cystadenocarcinoma (M8441/3) Mucinous cystadenocarcinoma (M8470/3) Mucinous carcinoma (M8480/3) Signet ring cell carcinoma (M8490/3) Acinar cell carcinoma (M8550/3) Adenosquamous carcinoma (M8560/3) Intraductal papillary-mucinous carcinoma invasive (M8453/3) Pancreatoblastoma (M8971/3) Other …………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor limited to the pancreas, 2 cm or less in greatest dimension T2Tumor limited to the pancreas, more than 2 cm in greatest dimension T3Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery T4Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor)Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 IA T1 N0 M0 IB T2 N0 M0 IIA T3 N0 M0 IIB T1 N1 M0 T2 N1 M0 T3 N1 M0 III T4 Any N M0 IV Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Lung Cancer Staging (AJCC 7th ed. 2010) C34.0 Main bronchus C34.3 Lower lobe, bronchus or lung C34.1 Upper lobe, bronchus or lung C34.8 Overlapping lesion of bronchus and lung C34.2 Middle lobe, bronchus or lung C34.9 Bronchus or lung, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary ly Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Large cell carcinoma (M8012/3) Small cell carcinoma (M8041/3) Adenocarcinoma (M8140/3) Sarcomatoid carcinoma (M8033/3) Adenoid cystic carcinoma (M8200/3) Carcinoid tumor (M8240/3) Mucoepidermoid carcinoma (M8430/3) Adenosquamous carcinoma (M8560/3) Other ………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ T1Tumor 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (for example, not in the main bronchus) T2Tumor limited to the pancreas, more than 2 cm in greatest dimension T3Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery T4Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor)Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping 0 Tis N0 M0 IA T1 N0 M0 IB T2 N0 M0 IIA T3 N0 M0 IIB T1 N1 M0 T2 N1 M0 T3 N1 M0 III T4 Any N M0 IV Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Pleural Mesothelioma Staging (AJCC 7th ed. 2010)C38.4 PleuraDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Mesothelioma, malignant (M9050/3) Fibrous mesothelioma, malignant (M9051/3) Epithelioid mesothelioma, malignant (M9052/3) Mesothelioma, biphasic, malignant (M9050/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff Undifferentiated Primary Tumor (T) T1 Tumor limited to the ipsilateral parietal pleura with or without mediastinal pleura and with or without diaphragmatic pleural involvement T1a No involvement of the visceral pleura T1b Tumor also involving the visceral pleura T2 Tumor involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features: · involvement of diaphragmatic muscle · extension of tumor from visceral pleura into the underlying pulmonary parenchyma T3 Locally advanced but potentially resectable tumor. Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features: · involvement of the endothoracic fascia · extension into the mediastinal fat · solitary, completely resectable focus of tumor extending into the soft tissues of the chest wall · non-transmural involvement of the pericardium T4 Locally advanced technically unresectable tumor. Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features: · diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction · direct transdiaphragmatic extension of tumor to the peritoneum · direct extension of tumor to the contralateral pleura · direct extension of tumor to mediastinal organs · direct extension of tumor into the spine · tumor extending through to the internal surface of the pericardium with or without a pericardial effusion; or tumor involving the myocardiumRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastases in the ipsilateral bronchopulmonary or hilar lymph nodes N2 Metastases in the subcarinal or the ipsilateral mediastinal lymph nodes including the ipsilateral internal mammary and peridiaphragmatic nodes N3 Metastases in the contralateral mediastinal, contralateral internal mammary, ipsilateral or contralateral supraclavicular lymph nodesDistant Metastasis (M) M0No distant metastasis M1 Distant metastasis Stage Grouping I T1 N0 M0 IV T4 Any N M0 IA T1a N0 M0 Any T N3 M0 IB T1b N0 M0 Any T Any N M II T2 N0 M0 Stage unknown III T1,T2 N1-2 M0 T3 N0-2 M0Physician .......................................Date............../.................../.............Bone Cancer Staging (AJCC 7th ed. 2010) C40.0 Scapula and long bones of upper limb C40.9 Bone and articular cartilage C41.4 Pelvic bones, sacrum and coccyx C40.1 Short bones of upper limb of limb, unspecified C41.8 Overlapping lesion of bone and articular C40.2 Long bones of lower limb C41.0 Bones of skull and face cartilage C40.3 Short bones of lower limb C41.1 Mandible C41.9 Bone and articular cartilage, unspecifie C40.8 Overlapping lesion of bone and C41.2 Vertebral column articular cartilage of limbs C41.3 Ribs, sternum and clavicle Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Fibrosarcoma (M8810/3) Malignant fibrous histiocytoma (M8830/3) Angiosarcoma (M9120/3) Osteosarcoma (M9180/3) Chondrosarcoma (M9220/3) Ewing’s sarcoma (M9260/3) Primitive neuroectodermal tumor PNET (M9473/3) Other ……………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumor 8 cm or less in greatest dimension T2 Tumor more than 8 cm in greatest dimension T3 Discontinuous tumor in the primary bone siteRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasisDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasis M1a Lung M1b Other distant sitesStage Grouping IA T1 N0 M0 G1,2 Low grade GX IB T2-3 N0 M0 G1,2 Low grade GX IIA T1 N0 M0 G1,2 High grade GX IIB T2 N0 M0 G3,4 High grade III T3 N0 M0 G3,4 High grade IVA Any T N0 M1a Any G IVB Any T N1 Any M Any G Any T Any N M1b Any G Stage unknownPhysician .......................................Date............../.................../.............Soft Tissue Sarcoma Staging (AJCC 7th ed. 2010) C38.0 Heart C47.6 Peripheral nerves of trunk, C49.1 Connective and soft tissue of C38.1 Anterior mediastinum unspecified upper limb, including shoulder C38.2 Posterior mediastinum C47.5 Peripheral nerves of pelvis C48.2 Peritoneum, unspecified C38.3 Mediastinum, part unspecified C47.8 Overlapping lesion of peripheral C49.2 Connective and soft tissue of of upper limb, including shoulder C38.8 Overlapping lesion of heart, nerves and autonomic nervous system lower limb, including hip of head, face and neck mediastinum and pleura C47.9 Peripheral nerves and autonomic C49.3 Connective and soft tissue of thorax of lower limb, including hip C47.0 Peripheral nerves of head, nervous system, unspecified C49.4 Connective and soft tissue of abdomenface and neck C48.0 Retroperitoneum C49.5 Connective and soft tissue of pelvis C47.1 Peripheral nerves of upper- C48.1 Specified parts of peritoneum C49.6 Connective and soft tissue of trunk, limb, including shoulder C48.2 Peritoneum, unspecified unspecified C47.2 Peripheral nerves of lower C48.8 Overlapping lesion of C49.8 Overlapping lesion of connective limb, including hip retroperitoneum and peritoneum and soft tissue C47.3 Peripheral nerves of thorax C49.0 Connective and soft tissue of head, C49.9 Connective and soft tissue, C47.4 Peripheral nerves of abdomen face and neck unspecifiedDiagnosis: Clinical by Histology & Phys ical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Myxofibrosarcoma (M8811/3) Dedifferentiated (M8851/3) Myxoid liposarcoma (M8852/3) Round cell liposarcoma (M8853/3) Pleomorphic liposarcoma (M8854/3) Rhabdomyosarcoma (M8900/3) Leiomyosarcoma (M9260/3) Synovial sarcoma (M9040/3) Malignant peripheral nerve sheath tumor (M9540/3) Other ……………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumor 5 cm or less in greatest dimension T1a Superficial tumor T1b Deep tumor T2 Tumor more than 5 cm in greatest dimension T2a Superficial tumor T2b Deep tumorNote: Superficial tumor is located exclusively above the superficial fascia without invasion of the fascia; deep tumor is located either exclusively beneath the superficial fascia, superficial to the fascia with invasion of or through the fascia, or both superficial yet beneath the fascia.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasisNote: Presence of positive nodes (N1) in M0 tumors is considered Stage IIIDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasisStage Grouping IA T1a-1b N0 M0 G1, GX IB T2a-2b N0 M0 G1, GX IIA T1a-1b N0 M0 G2, G3 IIB T2a-2b N0 M0 G2 III T2a-2b N0 M0 G3 Any T N1 M0 Any G IV Any T Any N M1 Any G Physician ....................................... Stage unknownDate............../.................../.............Skin Cancer Staging (AJCC 7th ed. 2010) C44.0 Skin of lip C44.6 Skin of upper limb, including shoulder C44.2 Skin of ear and external auricular canal C44.7 Skin of lower limb, including hip unspecified C38.2 Posterior mediastinum C47.5 Peripheral nerves of pelvis C48.2 Peritoneum, unspecified C44.3 Skin of other and unspecified parts of face C44.8 Overlapping lesion of skin of upper limb, including shoulder C44.4 Skin of scalp and neck C44.9 Malignant neoplasm of skin, unspecified lower limb, including hip of head, face and neck C44.5 Skin of trunk C63.2 Scrotum Diagnosis: Clinical by Histology & Phys ical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Basal cell carcinoma (M8090/3) Adenocarcinoma (M8140/3) Other ……………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) Tis Carcinoma in situ T1 Tumor 2 cm or less in greatest dimension with less than two high risk features T2 Tumor greater than 2 cm in greatest dimension or tumor any size with two or more high risk features T3 Tumor with invasion of maxilla, orbit, or temporal bone T4 Tumor with invasion of skeleton (axial or appendicular) or perineural invasion of skull baseRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph node, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in a lymph node, more than 6 cm in greatest dimensionDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasisStage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 III T3 N0 M0 T1-3 N1 M0 IV T1-3 N2 M0 T Any N3 M0 T4 N Any M0 T Any N Any M1 Stage unknownPhysician .......................................Date............../.................../.............Merkel Cell Carcinoma Staging (AJCC 7th ed. 2010) C44.0 Skin of lip C44.8 Overlapping lesion of skin C60.0 Prepuce C44.2 Skin of ear and external auricular canal C44.9 Malignant neoplasm of skin, unspecified C60.1 Glans penis C44.3 Skin of other and unspecified parts of face C51.0 Labium majus C60.2 Body of penis C44.4 Skin of scalp and neck C51.1 Labium minus C60.8 Overlapping lesion of penis C44.5 Skin of trunk C51.2 Clitoris C60.9 Penis, unspecified C44.6 Skin of upper limb, including shoulder C51.8 Overlapping lesion of vulva C63.2 Scrotum C44.7 Skin of lower limb, including hip C51.9 Vulva, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Merkel cell carcinoma (M8247/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) TisIn situ primary tumor T1 Less than or equal to 2 cm maximum tumor dimension T2Greater than 2 cm but not more than 5 cm maximum tumor dimension T3Over 5 cm maximum tumor dimension T4 Primary tumor invades bone, muscle, fascia, or cartilageRegional Lymph Nodes (N) N0 No regional lymph node metastasis Nodes negative by clinical exam* (no pathologic node exam performed) Nodes cN0 Nodes negative by clinical exam* (no pathologic node exam performed) Nodes negative by pathologic exam N1 Metastasis in regional lymph node(s): Micrometastasis**, Macrometastasis*** N2 In transit metastasis *****Clinical detection of nodal disease may be via inspection, palpation and/or imaging **Isolated tumor cells in a lymph node are classified as micrometastases (N1a) and the presence of isolated tumor cells recorded using the prognostic factor. Micrometastases are diagnosed after sentinel or elective lymphadenectomy***Macrometastases are defined as clinically detectable nodal metastases confirmed by therapeutic lymphadenectomy or needle biopsy****In transit metastasis: a tumor distinct from the primary lesion and located either 1) between the primary lesion and the draining regional lymph nodes or 2) distal to the primary lesionDistant Metastasis (M) M0No distant metastasis M1b Metastasis to lung M1Metastasis beyond regional lymph nodes M1c Metastasis to all other visceral sites M1a Metastasis to skin, subcutaneous tissues or distant lymph nodesStage Grouping Clinical Stage Grouping Pathologic 0 TisN0 M0 0 Tis N0 M0 IB T1N0 M0 IAT1 pN0 M0 IIB T2/T3 N0 M0 IIAT2/T3 pN0 M0 IIC T4 N0 M0 IICT4 N0 M0 IIIB Any T cN1/N1b/N2 M 0 IIIAAny T N1a M0 IV Any T Any N M1 IIIBAny T N1b/N2 M0 Stage unknown IVAny T Any N M1Physician .......................................Date............../.................../.............Melanoma of the Skin Staging (AJCC 7th ed. 2010) C43.0 Malignant melanoma of lip C43.5 Malignant melanoma of trunk C43.1 Malignant melanoma of eyelid, including canthus C43.6 Malignant melanoma of upper limb, including shoulder C43.2 Malignant melanoma of ear and external auricular canal C43.7 Malignant melanoma of lower limb, including hip C43.3 Malignant melanoma of other and unspecified parts of face C43.8 Overlapping malignant of skin C43.4 Malignant melanoma of scalp and neck C43.9 Malignant melanoma of skin, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Malignant melanoma (M8720/3) Nodular melanoma (M8721/3) Balloon cell melanoma (M8722/3) Malignant melanoma, regressing (M8723/3) Amelanotic melanoma (M8730/3) Malignant melanoma (M8720/3) Epithelioid cell melanoma (M8771/3) Spindle cell melanoma (M8720/3) Other …………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) Tis Melanoma in situ T3 Melanomas 2.01 – 4.0 mm T1 Melanomas ≤ 1.0 mm in thickness T3a without ulceration T1a without ulceration and mitosis < 1/mm2 T3b with ulceration T1b with ulceration or mitoses ≥ 1/mm2 T4 Melanomas > 4.0 mm T2 Melanomas 1.01 – 2.0 mm T4a without ulceration T2a without ulceration T4b with ulceration T2b with ulcerationRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 1 node, 2-3 nodes Micrometastasis (are diagnosed after sentinel lymph node biopsy and completion lymphadenectomy (if performed)) Macrometastasis (are defined as clinically detectable nodal metastases confirmed by therapeutic lymphadenectomy or when nodal metastasis exhibits gross extracapsular extension) N2c In transit met(s)/satellite(s) without metastatic nodes N3 Clinical: ≥ 1 node with in transit met(s)/ satellite(s); pathologic: 4 or more metastatic nodes, or matted nodes, or in transit met(s)/ satellite(s) with metastatic node(s)Distant Metastasis (M) M0 No distant metastasis M1b Metastases to lung M1a Metastases to skin, subcutaneous tissues, M1c Metastases to all other visceral sites or distant metastases to any site or distant lymph nodes combined with an elevated serum LDHStage Grouping0TisN0M0 IIBT3b N0 M0IAT1aN0M0T4a N0 M0IBT1bN0M0 IICT4b N0 M0T2aN0M0 IIIAny T ≥N1 M0IIAT2bN0M0 IVAny T Any N M1 T3aN0M0 Stage unknownPhysician .......................................Date............../.................../.............Breast Cancer Staging (AJCC 7th ed. 2010) C50.0 Nipple and areola C50.5 Lower-outer quadrant of breast C50.1 Central portion of breast C50.6 Axillary tail of breast C50.2 Upper-inner quadrant of breast C50.8 Overlapping lesion of breast C50.3 Lower-inner quadrant of breast C50.9 Breast, unspecified C50.4 Upper-outer quadrant of breastDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Adenoid cystic carcinoma (M8200/3) Tubular carcinoma (M8211/3) Mucinous carcinoma (M8480/3) Ductal carcinoma (M8500/3) Medullary carcinoma (M8510/3) Lobular carcinoma (M8520/3) Paget disease and infiltrating duct carcinoma of breast (M8520/3) Other ……………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ T2 Tumor > 20 mm but ≤ 50 mm in greatest dimension Tis (DCIS) Ductal carcinoma in situ T3 Tumor > 50 mm in greatest dimension Tis (LCIS) Lobular carcinoma in situ T4 Tumor of any size with direct extension to the chest wall Tis (Paget’s) Paget’s disease of the nipple is NOT associated with and/or to the skin (ulceration or skin nodules)* invasive carcinoma and/or carcinoma in situ (DCIS T4a Extension to the chest wall, not including only pectoralis and/or LCIS) in the underlying breast parenchyma. muscle adherence/invasion T1 Tumor ≤ 20 mm in greatest dimension T4b Ulceration and/or ipsilateral satellite nodules and/or edema T1mi Tumor ≤ 1 mm in greatest dimension (including peau d’orange) of the skin which do not meet T1a Tumor > 1 mm but ≤ 5 mm in greatest dimension the criteria for inflammatory carcinoma T1b Tumor > 5 mm but ≤ 10 mm in greatest dimension T4c Both T4a and T4b T1c Tumor > 10 mm but ≤ 20 mm in greatest dimension T4d Inflammatory carcinoma* * *Note: Invasion of the dermis alone does not qualify as T4 **Note: Inflammatory carcinoma is restricted to cases with typical skin changes involving a third or more of the skin of the breast. While the histologic presence of invasive carcinoma invading dermal lymphatics is supportive of the diagnosis, it is not required, nor is dermal lymphatic invasion without typical clinical findings sufficient for a diagnosis of inflammatory breast cancer. Regional Lymph Nodes (N) N0 No regional lymph node metastasis identified histologically N0(i-) No regional lymph node metastasis identified histologically, negative IHC N0(i+) Malignant cells in regional lymph node(s) no greater than 0.2 mm N0(mol-) No regional lymph node metastasis histologically, negative molecular findings N0(mol+) (RT-PCR) Positive molecular findings (RT-PCR), but no regional lymph node metastasis detected by Histology or IHC N1 Metastases in 1 to 3 axillary lymph nodes; and/or in internal mammary nodes with metastasis detected by sentinel lymph node biopsy but not clinically detected N1mi Micrometastases (greater than 0.2 mm and/or more than 200 cells, but none greater than 2.0 mm) N1a Metastases in 1 to 3 axillary lymph nodes, at least one metastasis greater than 2.0 mm N1b Metastases in internal mammary nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected N1c Metastases in 1 to 3 axillary lymph nodes and in internal mammary lymph nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy N2 Metastases in 4 to 9 axillary lymph nodes; or in clinically detected internal mammary lymph nodes in the absence of axillary lymph nodes metastasas N2a Metastases in ipsilateral axillary lymph nodes fixed to one another (matted) or to other structures N2b Metastases only in clinically detected ipsilateral internal mammary nodes and in absence of clinically evident axillary lymph nodes metastases??????????2 N3 Metastases in ipsilateral infraclavicular (level III axillary lymph node(s) with or without level I, II axillary lymph node involvement; or in clinically detected ipsilateral internal mammary lymph node(s) with clinically evident level I, II axillary lymph node metastases; or metastases in ipsilateral supraclavicular lymph node(s) with or N3a Metastases in ipsilateral infraclavicular lymph node(s) N3b Metastases in ipsilateral internal mammary lymph node(s) and axillary lymph node (s) N3c Metastases in ipsilateral supraclavicular lymph node(s)Distant Metastasis (M) M0No distant metastasis M1Distant metastasis Stage Grouping Re-stage if MO at diagnosis & defaulted/declined 0TisN0M0 treatment, now developed metastasis IAT1N0M0Re-stageTNMStage GroupingDate IBT0N1miM0T1N1miM0 IIAT0N1M0T1N1M0T2N0M0 IIBT2N1M0T3N0M0 IIIAT0N2M0T1N2M0T2N2M0T3N1M0T3N2M0 IIIBT4N0M0T4N1M0T4N2M0 IIICAny T N3M0 IVAny TAny NM1 Stage unknownPhysician .......................................Date............../.................../.............Vulva Cancer Staging (AJCC 7th ed. 2010) C51.0 Labium majus C51.2 Clitoris C51.9 Vulva, unspecified C51.1 Labium minus C51.8 Overlapping lesion of vulvaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Verrucous carcinoma (M8051/3) Squamous cell carcinoma (M8070/3) Basal cell carcinoma (M8090/3) Adenocarcinoma (M8140/3) Other …………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) TMN FIGOCATEGORY STAGE Tis Carcinoma in situ (preinvasive carcinoma) T1a IA Lesions ? 2 cm in size, confined to the vulva or perineum and with stromal invasion ? 1.0 mm T1b IB Lesions > 2 cm in size or any size with stromal invasion > 1.0, confined to the vulva or perineum T2 II Tumor of any size with extension to adjacent perineal structures (Lower/distal 1/3 urethra, lower/distal 1/3 vagina, anal involvement) T3 IVA Tumor of any size with extension to any of the following: upper/proximal 2/3 of urethra, upper/proximal 2/3 vagina, bladder mucosa, rectal mucosa, or fixed to pelvic bone Note: Question mark (?) should be ≤Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 One or two regional lymph nodes with the following features N1a IIIA One or two lymph nodes metastases each 5 mm or less N1b IIIA One lymph nodes metastases 5 mm or greater N2 IIIB Regional lymph nodes metastasis with the following features N2a IIIB Three or more lymph nodes metastases each less than 5 mm N2b IIIB Two or more lymph nodes metastases 5 mm or greater N2c IIIC Lymph nodes metastasis with extracapsular spread N3 IVA Fixed or ulcerated regional lymph nodes metastasis An effort should be made to describe the site and laterality of lymph node metastasesDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 IVB Distant metastasis (including pelvic lymph nodes metastasis)Stage Grouping 0 Tis N0 M0 I T1 N0 M0 IA T1a N0 M0 IB T1b N0 M0 II T2 N0 M0 IIIA T1, T2 N1a, N1b M0 IIIB T1, T2 N2a, N2b M0 IIIC T1, T2 N2c M0 IVA T1, T2 N3 M0 T3 Any N M0 IVB Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Vagina Cancer Staging (AJCC 7th ed. 2010)C52 Malignant neoplasm of vaginaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Basal cell carcinoma (M8090/3) Malignant melanoma (M8720/3) Sarcoma (M8800/3) Other …………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) TMN FIGOCATEGORY STAGE Tis Carcinoma in situ T1 I Tumor confined to vagina T2 II Tumor invades paravaginal tissues but not to pelvic wall T3 III Tumor extends to pelvic wall T4 IVA Tumor invades mucosa of the bladder or rectum and/or extends beyond the true pelvis (bullous edema is not sufficient evidence to classify a tumor as T4)Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 III Pelvic or inguinal lymph node metastasis Distant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 IVB Distant metastasisStage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 III T1-3 N1 M0 T3 N0 M0 IVA T4 Any N M0 IVB Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Cervix uteri Cancer Staging (AJCC 7th ed. 2010) C53.0 Endocervix C53.8 Overlapping lesion of cervix uteri C53.1 Exocervix C53.9 Cervix uteri, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Small cell carcinoma (M8041/3) Squamous cell carcinoma (M8070/3) Adenoid basal cell carcinoma (M8098/3) Adenocarcinoma (M8140/3) Adenoid cystic carcinoma (M8200/3) Clear cell carcinoma (M8310/3) Endometrioid carcinoma (M8380/3) Other ………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TNM FIGO CATEGORY STAGE TisCarcinoma in situ T1 I Cervical carcinoma confined to uterus (extension to corpus should be disregarded) T1aIAInvasive carcinoma diagnosed only by microscopy. Stromal invasion with a maximum depth of 5.0 mm measured from the baseof the epithelium and a horizontal spread of 7.0 mm or less. Vascular space involvement, venous or lymphatic, does not affect classification T1a1IA1Measured stromal invasion 3.0 mm or less in depth and 7.0 mm or less in horizontal spread T1a2IA2Measured stromal invasion 3.0 mm and not more than 5.0 mm with a horizontal spread 7.0 mm or less T1bIBClinically visible lesion confined to the cervix or microscopic lesion greater than T1a/IA2 T1b1IB1Clinically visible lesion 4.0 cm or less in greatest dimension T1b2IB2Clinically visible lesion more than 4.0 cm in greatest dimension T2IICervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina T2aIIATumor without parametrial invasion T2a1IIA1Clinically visible lesion 4.0 cm or less in greatest dimension T2a2IIA2Clinically visible lesion more than 4.0 cm in greatest dimension T2bIIBTumor without parametrial invasion T3IIITumor extends to pelvic wall and/or involves lower third of vagina, and/or causes hydronephrosis or non-functioning kidney T3aIIIATumor involves lower third of vagina, no extension to pelvic wall T3bIIIBTumor extends to pelvic wall and/or causes hydronephrosis or non-functioning kidney T4IVATumor invades mucosa of bladder or rectum, and/or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4)Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 IIIB Regional lymph nodes metastasisDistant Metastasis (M) M0 No distant metastasis M1 IVB Distant metastasisStage Grouping 0TisN0M0 IIA1 T2a1 N0 M0 IT1N0M0 IIA2 T2a2 N0 M0 IAT1aN0M0 IIB T2b N0 M0 IA1T1a1N0M0 III T3 N0 M0 IA2T1a2N0M0 IIIA T3a N0 M0 IBT1bN0M0 IIIB T3 Any N M0 IB1T1b1N0M0 T1-3 N1 M0 IB2T1b2N0M0 IVA T4 Any N M0 IIT2 N0M0 IVB Any T Any N M1Physician ........................................ IIAT2aN0M0 FIGO no longer includes stage 0 (Tis) Stage unknown Date............../.................../.............Corpus Uteri Cancer Staging (AJCC 7th ed. 2010) C54.0 Isthmus uteri C54.3 Fundus uteri C55.9 Uterus, part unspecified C54.1 Endometrium C54.8 Overlapping lesion of corpus uteri C54.2 Myometrium C54.9 Corpus uteri, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Clear cell carcinoma (M8310/3) Endometrioid carcinoma (M8380/3) Serous carcinoma (M8441/3) Mucinous carcinoma (M8480/3) Other ………………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TNM FIGO CATEGORY STAGE Tis Carcinoma in situ T1 I Tumor confined to corpus uteri T1a IA Tumor limited to endometrium or invades less than one-half of the myometrium T1b IB Tumor invades one-half or more of the myometrium T2 II Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus** T3a IIIA Tumor involves serosa and/or adnexa (direct extension or metastasis) T3b IIIB Vaginal involvement (direct extension or metastasis) or parametrial involvement T4 IVA Tumor invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumor as T4)* FIGO staging no longer includes Stage 0 (Tis) ** Endocervical glandular involvement only should be considered as stage I and not Stage II.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 IIIC1 Regional lymph node metastasis to pelvic lymph nodes N1 IIIC2 Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodesDistant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 IVB Distant metastasis (includes metastasis to inguinal lymph nodes intraperitoneal disease, or lung, liver, or bone. It excludes metastasis to para - aortic lymph nodes, vagina, pelvic serosa, or adnexa)Stage Grouping 0 Tis N0 M0 IIIB T3b N0 M0 I T1 N0 M0 IIIC1 T1-3 N1 M0 IA T1a N0 M0 IIIC2 T1-3 N2 M0 IB T1b N0 M0 IVA T4 Any N M0 II T2 N0 M0 IVB Any T Any N M1 III T3 N0 M0 Stage unknown IIIA T3a N0 M0Physician .......................................Date............../.................../.............Ovary and Primary Peritoneal Carcinoma Staging (AJCC 7th ed. 2010) C56 Malignant neoplasm of ovary C48.2 Peritoneum, unspecified C48.1 Specified parts of peritoneum C48.8 Overlapping lesion of retroperitoneum and peritoneumDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or Hematology Histology: Undifferentiated carcinoma (M8020/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Clear cell carcinoma (M8310/3) Endometrioid carcinoma (M8380/3) Serous carcinoma (M8441/3) Mucinous carcinoma (M8480/3) Germ cell tumor (M9064/3) Other ……………………………… Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TNM FIGO CATEGORY STAGE T1 I Tumor limited to ovaries (one or both) T1a IA Tumor limited to one ovary; capsule intact, no tumor on ovarian surface. No malignant cells in ascites or peritoneal washings T1b IB Tumor limited to both ovaries; capsule intact, no tumor on ovarian surface. No malignant cells in ascites or peritoneal washings T1c IC Tumor limited to one or both ovaries with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells in ascites or peritoneal washings T2 II Tumor involves one or both ovaries with pelvic extension and/or implants T2a IIA Extension and/or implants on uterus and/or tube(s). No malignant cells in ascites or peritoneal washings T2b IIB Extension and/or implants on pelvic tissues. No malignant cells in ascites or peritoneal washings T2c IIC Pelvic extends and/or implants (T2a or T2b) with malignant cells in ascites or peritoneal washings T3 III Tumor involves one or both ovaries with microscopically confirmed peritoneal metastasis outside the pelvis T3a IIIA Microscopic peritoneal metastasis beyond pelvis (no macroscopic tumor) T3b IIIB Microscopic peritoneal metastasis beyond pelvis 2 cm or less in greatest dimension T3C IIIC Peritoneal metastasis beyond pelvis more than 2 cm in greatest dimension and/or regional lymph node metastasisRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 IIIC Regional lymph nodes metastasis Distant Metastasis (M) M0 No distant metastasis M1 IV Distant metastasisStage Grouping I T1 N0 M0 IIC T2c N0 M0 IA T1a N0 M0 III T3 N0 M0 IB T1b N0 M0 IIIA T3a N0 M0 IC T1c N0 M0 IIIB T3b N0 M0 II T2 N0 M0 IIIC T3c N0 M0 IIA T2a N0 M0 Any T N1 M0 IIB T2b N0 M0 IV Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Fallopian Tube Cancer Staging (AJCC 7th ed. 2010)C57.0 Fallopian tubeDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Adenocarcinoma (M8140/3) (M8773/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TNM FIGO CATEGORY STAGE Tis * Carcinoma in situ (limited to tubal mucosa) T1 I Tumor limited to the fallopian tube(s) T1a IA Tumor limited to one tube, without penetrating the serosal surface; no ascites T1b IB Tumor limited to both tubes, without penetrating the serosal surface; no ascites T1c IC Tumor limited to one or both tubes with extension onto or through the tubal serosa, or with malignant cells in ascites or peritoneal washings T2 II Tumor involves one or both fallopian tubes with pelvic extension T2a IIA Extension and/or metastasis to the uterus and/or ovaries T2b IIB Extension to other pelvic structures T2c IIC Pelvic extension with malignant cells in ascites or peritoneal washings T3 III Tumor involves one or both fallopian tubes, with peritoneal implants outside the pelvis T3a IIIA Microscopic peritoneal metastasis outside the pelvis T3b IIIB Macroscopic peritoneal metastasis outside the pelvis 2 cm or less in greatest dimension T3 IIIC Peritoneal metastasis outside the pelvis and more than 2 cm in diameter * FIGO no longer includes Stage 0 (Tis)Note: Liver capsule metastasis is T3/Stage III; liver parenchymal metastasis M1/Stage IV. Pleural effusion must have positive cytology for M1/Stage IV.Regional Lymph Nodes (N) N0 Regional lymph node metastasis N1 IIIC Regional lymph node metastasisDistant Metastasis (M) M0 No distant metastasis M1 IV Distant metastasis Stage Grouping 0 Tis N0M0 IIC T2c N0 M0 I T1 N0M0 III T3 N0 M0 IA T1a N0M0 IIIA T3a N0 M0 IB T1b N0M0 IIIB T3b N0 M0 IC T1c N0M0 IIIC T3c N0 M0 II T2 N0M0 Any T N1 M0 IIA T2a N0M0 IV Any T Any N M1 IIB T2b N0M0 Stage unknownPhysician .......................................Date............../.................../.............Gestational Trophoblastic Tumors Staging (AJCC 7th ed. 2010) C58 Malignant neoplasm of placentaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Choriocarcinoma (M9100/3) Choriocarcinoma combined with other germ cell elements (M9101/3) Malignant teratoma, trophoblastic (M9102/3) Trophoblastic tumor, epithelioid (M9105/3) Other …………...……………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TNM FIGO CATEGORY STAGE T I Tumor confined to uterus T2 II Tumor extends to other genital structures (ovary, tube, vagina, broad ligaments) by metastasis or direct extensionRegional Lymph Nodes (N)There is no regional nodal designation in the staging of these tumors. Nodal metastases should be classified as metastatic (M1) diseaseDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasis M1a III Lung metastasis M1b IV All other distant metastasisStage GroupingGROUP T N M RISK SCORE I T1M0 Unknown IA T1M0 Low risk IB T1M0 High risk II T2M0 Unknown IIA T2M0 Low risk IIB T2M0 High risk III Any TM1a Unknown IIIA Any TM1a Low risk IIIB Any TM1a High risk IV Any TM1b Unknown IVA Any TM1b Low risk IVB Any TM1b High risk Stage unknownPhysician .......................................Date............../.................../.............Penis Cancer Staging (AJCC 7th ed. 2010) C60.0 Prepuce C60.2 Body of penis C60.9 Penis, unspecified C60.1 Glans penis C60.8 Overlapping lesion of penis Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Verrucous carcinoma (M8051/3) Papillary Squamous cell carcinoma (M8052/3) Squamous cell carcinoma (M8070/3) Basaloid Squamous cell carcinoma (M8083/3) Adenocarcinoma (M8140/3) Other …………...……………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) TisCarcinoma in situ TaNoninvasive verrucous carcinoma T1aTumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly diff. (i.e., grade 3-4) T1bTumor invades subepithelial connective tissue with LVI or is poorly diff. T2Tumor invades corpus spongiosum or cavernosum T3Tumor invades urethra T4Tumor invades other adjacent structures*Note: Broad pushing penetration (invasion) is permitted - destructive invasion is against this diagnosisRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph nodes metastasis Distant Metastasis (M) M0No distant metastasis M1Distant metastasis*Note: Lymph node metastasis outside of the true pelvis in addition to visceral or bone sites. Stage Grouping 0Tis N0 M0 IAT1 N0 M0 IBT2 N0 M0 IIAT3 N0 M0 IIBT1 N1 M0T2 N1 M0T3 N1 M0 IIIT4 Any N M0 IVAny T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Prostate gland Cancer Staging (AJCC 7th ed. 2010)C61Malignant neoplasm of prostate Diagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Other ………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Clinically in apparent tumor neither T2aTumor involves one-half of one lobe or lesspalpable nor visible by imaging T2bTumor involves more than one-half of one lobe but not both lobes T1aTumor incidental histologic finding T2cTumor involves both lobesin 5% or less of tissue resected T3Tumor extends through the prostate capsule T1bTumor incidental histologic finding T3aExtracapsular extension (Unilateral or bilateral)in more than 5% of tissue resected T3bTumor invades seminal vesicle(s) T1cTumor identified by needle biopsy T4Tumor is fixed or invades adjacent structures other than seminal vesicle (for example, because of elevated PSA) such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall T2Tumor confined within prostateRegional Lymph Nodes (N) N0No regional lymph node metastasis N1Metastasis in regional lymph node(s)Distant Metastasis (M) M0No distant metastasis M1Distant metastasis M1a Nonregional lymph node(s) M1bBone(s) M1cOther site (s) with or without bone diseaseStage GroupingGroupTNMPSAGleason IT1a-cN0M0PSA<10Gleason≤6?T2aN0M0PSA<10Gleason≤6?T1-T2aN0M0PSA XGleason X IIAT1a-cN0M0PSA<20Gleason7?T1a-cN0M0PSA≥10<20Gleason≤6?T2aN0M0PSA≥10<20Gleason≤6?T2aN0M0PSA<20Gleason7?T2bN0M0PSA<20Gleason≤7?T2bN0M0PSA XGleason X IIBT2cN0M0Any PSAAny Gleason?T1-T2N0M0PSA≥20Any Gleason?T1-T2N0M0Any PSAGleason ≥8 IIIT3a-bN0M0Any PSAPhysician…………………………..Date………/…………/……………Any Gleason IVT4N0M0Any PSAAny Gleason?AnyTN1M0Any PSAAny Gleason?AnyTAny NM1Any PSAAny Gleason Stage unknownTestis Cancer Staging (AJCC 7th ed. 2010) C62.0 Undescended testis C62.1 Descended testis C62.9 Testis, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Seminoma (M9061/3) Seminoma, anaplastic (M9062/3) Spermatocytic seminoma (M9063/3) Germ cell tumor, nonseminomatous (M9061/3) Yolk sac tumor (M9071/3) Other ………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) pTisIntratubular germ cell neoplasia (carcinoma in situ) pT1Tumor limited to the testis and epididymis without vascular/lymphatic invasion. tumor may invade into the tunica albuginea but not the tunica vaginalis pT2Tumor limited to the testis and epididymis with vascular/lymphatic invasion, or tumor extending through the tunica albuginea with involvement of the tunica vaginalis pT3Tumor invades the spermatic cord with or without vascular/lymphatic invasion pT4Tumor invades the scrotum with or without vascular/lymphatic invasionRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis with a lymph node mass 2 cm or less in greatest dimension; or multiple lymph nodes, none more than 2 cm in greatest dimension pN1 Metastasis with a lymph node mass 2 cm or less in greatest dimension and less than or equal to 5 nodes positive, none more than 2 cm in greatest dimension N2Metastasis with a lymph node mass more than 2 cm but not more than 5 cm in greatest dimension; or multiple lymph nodes, any one mass greater than 2cm but not more than 5 cm in greatest dimension pN2Metastasis with a lymph node mass more than 2 cm but not more than 5 cm in greatest dimension; or more than 5 nodes positive, none more than 5 cm; or evidence of extranodal extension of tumor N3Metastasis with a lymph node mass more than 5 cm in greatest dimensionDistant Metastasis (M) M0No distant metastasis M1aNon regional nodal or pulmonary metastasis M1Distant metastasis M1aDistant metastasis other than to non-regional lymph nodes and lungStage GroupingGROUP T N M S GROUP TN M S(serum tumor markers) (serum tumor markers) 0pTis N0 M0 S0 IIC Any pT/TxN3 M0 S0 IpT1-4 N0 M0 SX Any pT/TxN3 M0 S1 IApT1 N0 M0 S0 III Any pT/TxAny N M1 SX IBpT2 N0 M0 S0 IIIA Any pT/TxAny N M1a S0pT3 N0 M0 S0 Any pT/TxAny N M1a S1pT4 N0 M0 S0 IIIB Any pT/TxN1-3 M0 S2 ISAny pT/Tx N0 M0 S1-3 Any pT/TxAny N M1a S2 IIAny pT/Tx N1-3 M0 SX IIIC Any pT/TxN1-3 M0 S3 IIAAny pT/Tx N1 M0 S0 Any pT/TxAny N M1a S3Any pT/Tx N1 M0 S1 Any pT/TxAny N M1b Any S IIBAny pT/Tx N2 M0 S0Any pT/Tx N2 M0 S1 Stage unknownPhysician .......................................Date............../.................../.............Kidney Cancer Staging (AJCC 7th ed. 2010)C64.9 Malignant neoplasm of kidney, except renal pelvisDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Clear cell carcinoma (M8310/3) Renal cell carcinoma (M8312/3) Renal, chromophobe cell carcinoma (M8317/3) Renal, collecting duct type carcinoma (M9061/3) Yolk sac tumor (M9071/3) Other ………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1Tumor 7 cm or less in greatest dimension, limited to the kidney T1aTumor 4 cm or less in greatest dimension, limited to the kidney T1bTumor more than 4 cm but not more than 7 cm in greatest dimension limited to the kidney T2Tumor more than 7 cm in greatest dimension, limited to the kidney T2aTumor more than 7 cm but less than or equal to 10 cm in greatest dimension, limited to the kidney T2bTumor more than 10 cm, limited to the kidney T3Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia T3aTumor grossly extends into the renal vein or its segmental (muscle containing) branches, or tumor invades perirenal and/or renal sinus fat but not beyond Gerota’s fascia T3b Tumor grossly extends into the vena cava below the diaphragm T3cTumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava T4Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland)Regional Lymph Nodes (N) N0No regional lymph node metastasis N1Regional lymph node metastasisDistant Metastasis (M) M0No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1Distant metastasisStage Grouping I T1 N0 M0 II T2 N0 M0 III T1 or T2 N1 M0 T3 N0 or N1 M0 IV T4 Any N M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Renal Pelvis and Ureter Cancer Staging (AJCC 7th ed. 2010) C65.9 Malignant neoplasm of renal pelvis C66.9 Malignant neoplasm of ureterDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Urothelial (transitional cell) carcinoma (M8120/3) Papillary transitional cell carcinoma (M8130/3) Other ……………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ T1 Tumor invades subepithelial connective tissue T2 Tumor invades the muscularis T3 (For renal pelvis only) Tumor invades beyond muscularis into peripelvic fat or the renal parenchyma T3. (For ureter only) Tumor invades beyond muscularis into periureteric fat T4 Tumor invades adjacent organs, or through the kidney into the perinephric fatRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single lymph node, 2 cm or less in greatest dimension N2 Metastasis in a single lymph node, more than 2 cm but not more than 5 cm in greatest dimension; or multiple lymph nodes, none more than 5 cm in greatest dimension N3 Metastasis in a lymph node, more than 5 cm in greatest dimensionDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping 0Tis N0 M0 IT1 N0 M0 IIT2 N0 M0 IIIT3 N0 M0 IVT4 N0 M0Any T N1-3 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Urinary Bladder Cancer Staging (AJCC 7th ed. 2010) C67.0 Trigone of bladder C67.5 Bladder neck C67.1 Dome of bladder C67.6 Ureteric orifice C67.2 Lateral wall of bladder C67.7 Urachus C67.3 Anterior wall of bladder C67.8 Overlapping lesion of bladder C67.4 Posterior wall of bladder C67.9 Bladder, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Undifferentiated carcinoma (M8020/3) Squamous cell carcinoma (M8070/3) Adenocarcinoma (M8140/3) Urothelial (transitional cell) carcinoma (M8120/3) Papillary transitional cell carcinoma (M8130/3) Other ……………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ: “flat tumor” T1 Tumor invades subepithelial connective tissue T2 Tumor invades the muscularis propria T2 Tumor invades the muscularis propria pT2a Tumor invades superficial muscularis propria (inner half) Tumor pT2b invades deep muscularis propria (outer half) T3 Tumor invades perivesical tissue pT3a microscopically pT3b macroscopically (extravesical mass) T4 Tumor invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall T4a Tumor invades prostatic stroma, uterus, vagina T4b Tumor invades pelvic wall, abdominal wallRegional Lymph Nodes (N) N0 No lymph node metastasis N1 Single regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac or presacral lymph node) N2 Multiple regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac or presacral lymph node metastasis) N3 Lymph node metastasis to the common iliac lymph nodesDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2a-b N0 M0 III T3a-b N0 M0 T4a N0 M0 IV T4b N0 M0 Any T N1-3 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Urethra Cancer Staging (AJCC 7th ed. 2010)C68.0 UrethraDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Transitional cell carcinoma (M8120/3) Papillary Transitional cell carcinoma (M8130/3) Other ………………………………………….Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) Tis Carcinoma in situ T1 Tumor invades subepithelial connective tissue T2 Tumor invades any of the following: corpus spongiosum, prostate, periurethral muscle T3 Tumor invades any of the following: corpus cavernosum, beyond prostatic capsule, anterior vagina, bladder neck T4 Tumor invades other adjacent organs Urothelial (Transitional Cell) Carcinoma of the ProstateRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in a single lymph node 2 cm or less in greatest dimension N2 Metastasis in a single node more than 2 cm in greatest dimension, or in multiple nodesDistant Metastasis (M) M0 No distant metastasis M1 Distant metastasisStage Grouping 0 Tis N0 M0 I T1 N0 M0 II T2 N0 M0 III T1-2 N1 M0 T3 N0-1 M0 IV T4 N0-1 M0 Any T N2 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Adrenal Cancer Staging (AJCC 7th ed. 2010) C74.0 Cortex of adrenal gland C74.9 Adrenal gland, unspecifiedDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Carcinoma (M8010/3) (C74.0 only) Adenocarcinoma (M8140/3) (C74.0 only) Adrenal cortical carcinoma (M8370/3) Other …………………………………………………Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1 Tumor 5 cm or less in greatest dimension, no extra-adrenal invasion T2 Tumor greater than 5 cm, no extra-adrenal invasion T3 Tumor of any size with local invasion, but not invading adjacent organs (Adjacent organs include kidney, diaphragm, great vessels, pancreas, spleen, and liver) T4 Tumor of any size with invasion of adjacent organs (Adjacent organs include kidney, diaphragm, great vessels, pancreas, spleen, and liver)Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Metastasis in regional lymph node(s)Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping IT1 N0 M0 IIT2 N0 M0 IIIT1-2 N1 M0T3 N0 M0 IVT3 N1 M0T4 N0-1 M0 Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Carcinoma of the Eyelid Staging (AJCC 7th ed. 2010) C44.1 Skin of eyelid, including canthusDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Basal cell carcinoma (M8090/3) Adenoid cystic carcinoma (M8200/3) Merkel cell carcinoma (M8247/3) Primary eccrine adenocarcinoma (M8408/3) Sebaceous carcinoma (M8410/3) Mucoepidermoid carcinoma (M8430/3) Other ……………………………..Grade: Well diff. Moderate diff. Poorly diff. UndifferentiatedPrimary Tumor (T) T1 Tumor 5 mm or less in greatest dimension. Not invading the tarsal plate or eyelid margin. T2a Tumor more than 5 mm, but not more than 10 mm in greatest dimension. Or, any tumor that invades the tarsal plate or eyelid margin. T2bTumor more than 10mm, but not more than 20 mm in greatest dimension. Or, involves full thickness eyelid. T3a Tumor more than 20 mm in greatest dimension. Or, any tumor that invades adjacent ocular, or orbital structures. Any T with perineural tumor invasion. T3bTumor complete resection requires enucleation, exenteration or bone resection. T4 Tumor is not resectable due to extensive invasion of ocular, orbital, craniofacial structures or brain.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis.Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage Grouping 0 Tis N0 M0 IA T1 N0 M0 IB T2a N0 M0 IC T2b N0 M0 II T3a N0 M0 IIIA T3b N0 M0 IIIB Any T N1 M0 IIIC T4 Any N M0 IV Any T Any N M1 Stage unknownPhysician .......................................Date............../.................../.............Carcinoma of the Conjunctiva Staging (AJCC 7th ed. 2010) C69.0 ConjunctivaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Squamous cell carcinoma (M8070/3) Mucoepidermoid carcinoma (M8430/3) Other ……………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) Tis Carcinoma in situ T1 Tumor 5 mm or less in greatest dimension. T2 Tumor more than 5 mm in greatest dimension, without invasion of adjacent structures T3Tumor invades adjacent structures (excluding the orbit) T4 Tumor invades the orbit with or without further extension T4a Tumor invades orbital soft tissues, without bone invasion T4b Tumor invades bone T4cTumor invades adjacent paranasal sinuses T4d Tumor invades brainRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis.Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage GroupingNo stage grouping is presently recommendedPhysician .......................................Date............../.................../.............Malignant Melanoma of the Conjunctiva Staging (AJCC 7th ed. 2010) C69.0 ConjunctivaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Spindle cell melanoma, type A (M8773/3) Spindle cell melanoma, type B (M8774/3) Other …………………………………………Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) Tis Melanoma confined to the conjunctival epithelium Malignant T1 conjunctival melanoma of the bulbar conjunctiva Less than or T1aequal to 1 quadrant* pT1aMelanoma of the bulbar conjunctiva not more than 0.5 mm in thickness with invasion of the substantia propria T1bMore than 1 but less than or equal to 2 quadrants pT1bMelanoma of the bulbar conjunctiva more than 0.5 mm but not more than 1.5 mm in thickness with invasion of the substantia propria T1cMore than 2 but less than or equal to 3 quadrants pT1cMelanoma of the bulbar conjunctiva greater than 1.5 mm in thickness with invasion of the substantia propria T1dGreater than 3 quadrants T2Malignant conjunctival melanoma of the non-bulbar (palpebral, forniceal caruncular) T2aNon-caruncular, less than or equal to 1 quadrant pT2aMelanoma of the palpebral, forniceal or caruncular conjunctiva not more than 0.5 mm in thickness with invasion of the substantia propria T2bNon-caruncular, greater than 1 quadrant pT2bMelanoma more than 0.5 but not greater than 1.5 mm in thickness with invasion of the substantia propria T2cAny caruncular, less than or equal to 1 quadrant pT2bMelanoma of the palpebral, forniceal or caruncular conjunctiva greater than 1.5 mm in thickness with invasion of the substantia propria T2dAny caruncular, greater than 1 quadrant T3Any malignant conjunctival melanoma with local invasion pT3Melanoma invades the eye, eyelid, nasolacrimal system, sinuses or orbit T3aGlobe T3bEyelid T3cOrbit T3dSinus T4Tumor invades the central nervous system pT4Melanoma invades the central nervous system*pT(is) Melanoma in situ (includes the term primary acquired melanosis) with atypia replacing greater than 75 % of the normal epithelial thickness, with cytologic features of epithelioid cells, including abdundant cytoplasm, vesicular nuclei or prominent nucleoli, and/or presence of intraepithelial nests of atypical cells.Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis.Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis Stage GroupingNo stage grouping is presently recommendedPhysician .......................................Date............../.................../.............Malignant Melanoma of the Uvea Staging (AJCC 7th ed. 2010) C69.3 ChoroidDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Spindle Melanoma, type A (M8773/3) Spindle Melanoma, type B (M8774/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumor limited to the iris T1a Tumor limited to the iris not more than 3 clock hours in size T1bTumor limited to the iris more than 3 clock hours in size T1c Tumor limited to the iris with secondary glaucoma T2Tumor confluent with or extending into the ciliary body, choroid or both T2aTumor confluent with or extending into the ciliary body, choroid or both, with secondary glaucoma T3Tumor confluent with or extending into the ciliary body, choroid or both, with scleral extension T3aTumor confluent with or extending into the ciliary body, choroid or both, with scleral extension and secondary glaucoma T4 Tumor with extrascleral extension T4aTumor with extrascleral extension less than or equal to 5 mm in diameter T4b Tumor with extrascleral extension more than 5 mm in diameter Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis.Distant Metastasis (M) M0 No distant metastasis M1b Largest diameter of the largest metastasis 3.1-8.0 cm M1 Distant metastasis M1cLargest diameter of the largest metastasis 8.1 or more M1a Largest diameter of the largest metastasis ≤ 3 cmStage Grouping I T1a N0 M0 IIA T1b-d N0 M0 T2a N0 M0 IIb T2b N0 M0 T3a N0 M0 IIIA T2c-d N0 M0 T3b-c N0 M0 T4a N0 M0 IIIB T3d N0 M0 T4b-c N0 M0 IIIC T4d-e N0 M0 IV Any T N1 M0 Any T Any N M1a-c Stage unknownPhysician .......................................Date............../.................../.............Retinoblastoma Staging (AJCC 7th ed. 2010) C69.2 RetinaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Retinoblastoma (M9510/3) Retinoblastoma, diff. (M9511/3) Retinoblastoma, undiff. (M9512/3) Retinoblastoma,diffuse (M9513/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumors no more than 2/3 the volume of the eye with no vitreous or subretinal seeding. pT1Tumor confined to eye with no optic nerve or choroidal invasion. T1a No tumor in either eye is greater than 3 mm in largest dimension or located closer than 1.5 mm to the optic nerve or fovea. T1bAt least one tumor is greater than 3 mm in largest dimension or located closer than 1.5 mm to the optic nerve or fovea. No retinal detachment or subretinal fluid beyond 5 mm from the base of the tumor. T1c At least one tumor is greater than 3 mm in largest dimension or located closer than 1.5 mm to the optic nerve or fovea. With retinal detachment or subretinal fluid beyond 5 mm from the base of the tumor. T2Tumors no more than 2/3 the volume of the eye with vitreous or subretinal seeding. Can have retinal detachment. pT2Tumor with minimal optic nerve and/or choroidal invasion T2aFocal vitreous and/or subretinal seeding of fine aggregates of tumor cells is present, but no large clumps or “snowballs” of tumor cells. pT2aTumor superficially invades optic nerve head but does not extend past lamina cribrosa or tumor exhibits focal choroidal invasion. T2bMassive vitreous and/or subretinal seeding is present, defined as diffuse clumps or “snowballs” of tumor cells. pT2bsuperficially invades optic nerve head but does not extend past lamina cribrosa and exhibits focal choroidal invasion. T3Severe intraocular disease pT3Tumor with significant optic nerve and/or choroidal invasion T3aTumor fills more than 2/3 of the eye. pT3aTumor invades optic nerve past lamina cribrosa but not to surgical resection line or tumor exhibits massive choroidal invasion. T3aOne or more complications present, which may include tumor-associated neovascular or angle closure glaucoma, tumor extension into the anterior segment, hyphema, vitreous hemorrhage, or orbital cellulitis. pT3bTumor invades optic nerve past lamina cribrosa but not to surgical resection line and exhibits massive choroidal invasion. T4 Extraocular disease detected by imaging studies. pT4Tumor invades optic nerve to resection line or exhibits extraocular extension elsewhere. T4aInvasion of optic nerve pT4aTumor invades optic nerve to resection line but no extraocular extension identified T4b Invasion into the orbit. pT4bTumor invades optic nerve to resection line and extraocular extension identified T4cIntracranial extension not past chiasm. T4dIntracranial extension past chiasm.Regional Lymph Nodes (N) N0 No regional lymph node involvement N1 Regional lymph node involvement (preauricular, cervical, submandibular) N2Distant lymph node involvement Distant Metastasis (M) M0 No distant metastasis M1c Prechiasmatic CNS lesion(s) M1 Systemic metastasis M1d Postchiasmatic CNS lesion(s) M1a Single lesion to sites other than CNS M1e Leptomeningeal and/or CSF involvement M1b Multiple lesions to sites other than CNSPathologic M1 Metastasis to sites other than CNS. M1c CNS metastasis. M1e Leptomeningeal and/or CSF involvement M1a Single lesion. M1b Multiple lesions. M1d Discrete mass(es) without leptomeningeal and/or CSF involvemenNo stage grouping is presently recommendedPhysician .......................................Date............../.................../.............Carcinoma of the Lacrimal Gland Staging (AJCC 7th ed. 2010) C69.5 Lacrimal gland and ductDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Mucoepidermoid carcinoma (M8430/3) Mucinous adenocarcinoma (M8480/3) Acinic cell carcinoma (M8550/3) Epithelial-myoepithelial carcinoma (M8562/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumor 2 cm or less in greatest dimension, with or without extraglandular extension into the orbital soft tissue T2Tumor more than 2 cm but not more than 4 cm in greatest dimension* T3Tumor more than 4 cm in greatest dimension.* T4 Tumor invades periosteum or orbital bone or adjacent structures T4aTumor invades periosteum T4b Tumor invades orbital bone. T4cTumor invades adjacent structures (brain, sinus, pterygoid fossa, temporal fossa) *As the maximum size of the lacrimal gland is 2 cm, T2 and greater tumors will usually extend into the orbital soft tissue. Regional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasisNo stage grouping is presently recommendedPhysician .......................................Date............../.................../.............Sarcoma of the Orbit Staging (AJCC 7th ed. 2010) C69.6 Orbit C69.8 Overlapping lesion of eye and adnexaDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Sarcoma (M8700/3) Stromal sarcoma (M8935/3) Medulloepithelioma (M9501/3) Other ………………………………………………………..Grade: Well diff. Moderate diff. Poorly diff. Undifferentiated Primary Tumor (T) T1 Tumor 15 mm or less in greatest dimension T2 Tumor more than 15 mm in greatest dimension without invasion of globe or bony wall T3Tumor of any size with invasion of orbital tissues and/or bony walls T4Tumor invasion of globe or periorbital structure, such as eyelids, temporal fossa, nasal cavity and paranasal sinuses, and/or central nervous systemRegional Lymph Nodes (N) N0 No regional lymph node metastasis N1 Regional lymph node metastasis.Distant Metastasis (M) M0 No distant metastasis M1 Distant metastasis No stage grouping is presently recommended.Physician .......................................Date............../.................../.............Ocular Adnexal Lymphoma Staging (AJCC 7th ed. 2010) C44.1 Orbit C69.5 Lacrimal gland and duct C69.0 Conjunctiva C69.6 OrbitDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Lymphoplasmacytic lymphoma (M9671/3) Mantle cell lymphoma (M9673/3) Diffuse large B-cell lymphoma (9680/3) Burkitt lymphoma (M9687/3) Follicular lymphoma (M9690/3) MALT lymphoma (M9699/3) Mycosis fungoides (M9700/3) Peripheral T-cell lymphoma (M9702/3) Anaplastic large cell lymphoma (M9714/3) NK/T-cell lymphoma, nasal type (M9719/3) Plasmacytoma (M9731/3) Other ……………………………………Grade: Positive T-cell Positive B-cellPrimary Tumor (T) T1 Lymphoma involving the conjunctiva alone without orbital involvement T1aBulbar conjunctiva only T1bPalpebral conjunctiva +/- fornix +/- caruncle T1cExtensive conjunctival involvement T2 Lymphoma with orbital involvement +/- any conjunctival involvement T2aAnterior orbital involvement (+/- conjunctival involvement) T2bAnterior orbital involvement (+/- conjunctival involvement + lacrimal involvement) T2cPosterior orbital involvement (+/- conjunctival involvement +/- anterior involvement and +/- any extraocular muscle involvement) T2dNasolacrimal drainage system involvement (+/- conjunctival involvement but not including nasopharynx) T3Lymphoma with pre-septal eyelid involvement (defined above) +/- orbital involvement +/- any conjunctival involvement T4Orbital adnexal lymphoma extending beyond orbit to adjacent structures such as bone and brain T4aInvolvement of nasopharynx T4bOsseous involvement (including periosteum) T4cInvolvement of maxillofacial, ethmoidal and/or frontal sinuses T4dIntracranial spreadRegional Lymph Nodes (N) N0 No evidence of lymph node involvement N3 Involvement of peripheral lymph nodes not draining ocular adnexal region N1 Involvement of ipsilateral regional lymph nodes* N4 Involvement of central lymph nodes N2 Involvement of contra lateral or bilateral regional lymph nodes * * The regional lymph nodes included preauricular (parotid), submandibular, and cervicalDistant Metastasis (M) M0No evidence of involvement of other extranodal sites M1aNoncontiguous involvement of tissues or organs external to the ocular adnexa (e.g., parotid glands, submandibular gland, lung, liver, spleen, kidney, breast, etc.) M1bLymphomatous involvement of the bone marrow M1cBoth M1a and M1b involvement No stage grouping is presently recommended. Physician .......................................Date............../.................../.............Primary cutaneous Lymphoma Staging (AJCC 7th ed. 2010) C81 Hodgkin's disease C84 Peripheral and cutaneous T-cell lymphomas C82 Follicular [nodular] non-Hodgkin's lymphoma C85 Other and unspecified types of non-Hodgkin's lymphoma C83 Diffuse non-Hodgkin's lymphoma C88 Malignant immunoproliferative diseasesDiagnosis: Clinical by Histology & Physical exam. Endoscopy & Radiology Specific tumor markers Pathologic by Histology of Primary Histology & Metastasis Cytology or HematologyHistology: Malignant lymphoma (M9590/3) Malignant lymphoma, non-Hodgkin's lymphoma (M9591/3) Hodgkin lymphoma (M9650/3) Malignant lymphoma, small B lymphocytic (M9670/3) Malignant lymphoma, large B-cell diffuse (M9680/3) Mature T-cell lymphoma (M9702/3) Other ………………………………………………………..Grade: Positive T-cell Positive B-cell Primary Tumor (T) T1 Limited patches*, papules, and/or plaques**covering <10% of the skin surface. May further stratify into T1a (patch only) vs T1b (plaque ± patch). T2 Patches, papules or plaques covering ≥ 10% of the skin surface. May further stratify into T2a (patch only) vs T2b (plaque ± patch). T3 One or more tumors***( ≥ 1-cm diameter) T4 Confluence of erythema covering ≥ 80% body surface areaRegional Lymph Nodes (N) N0 No clinically abnormal peripheral lymph nodes^; biopsy not required N2a Clone negative N1 Clinically abnormal peripheral lymph nodes; histopathology Dutch N2b Clone positive# grade 1 or NCI LN0-2 N3 Clinically abnormal peripheral lymph nodes; N1a Clone negative# histopathology Dutch grades 3-4 or NCI LN4; N1b Clone positive# clone positive or negative N2 Clinically abnormal peripheral lymph nodes; histopathology Dutch grade 2 or NCI LN3Distant Metastasis (M) M0 No visceral organ involvement M1 Visceral involvement (must have pathology confirmation^^ and organ involved should be specified)PERIPHERAL BLOOD INVOLVEMENT (B) B0 Absence of significant blood involvement: ≤ 5% of peripheral blood lymphocytes are atypical (Sézary) cells|| B0a Clone negative# B0b Clone negative# B1 Low blood tumor burden: > 5% of peripheral blood lymphocytes are atypical (Sézary) cells but does not meet the criteria of B 2 B1a Clone negative# B1b Clone positive# B2 High blood tumor burden: ≥ 1000/?L Sézary cells^^^ with positive clone# Stage Grouping Group TN M B IA1000,1 IB2000,1 IIA1,21,200,1 IIB30-200,1 III40-200,1 IIIA40-200 IIIB40-201 IVA11-40-202 IVA21-4300-2 IVB1-40-310-2 Physician ....................................... Stage unknownDate............../.................../............. ................
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