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Ampulla of Vater cancer TNM staging AJCC UICC 8th edition

Ampulla of Vater cancer TNM staging AJCC UICC 8th edition
Primary tumor (T)
T category T criteria
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1 Tumor limited to ampulla of Vater or sphincter of Oddi or tumor invades beyond the sphincter of Oddi (perisphincteric invasion) and/or into the duodenal submucosa
T1a Tumor limited to ampulla of Vater or sphincter of Oddi
T1b Tumor invades beyond the sphincter of Oddi (perisphincteric invasion) and/or into the duodenal submucosa
T2 Tumor invades into the muscularis propria of the duodenum
T3 Tumor directly invades the pancreas (up to 0.5 cm) or tumor extends more than 0.5 cm into the pancreas, or extends into peripancreatic or periduodenal tissue or duodenal serosa without involvement of the celiac axis or superior mesenteric artery
T3a Tumor directly invades pancreas (up to 0.5 cm)
T3b Tumor extends more than 0.5 cm into the pancreas, or extends into peripancreatic tissue or periduodenal tissue or duodenal serosa without involvement of the celiac axis or superior mesenteric artery
T4 Tumor involves the celiac axis, superior mesenteric artery, and/or common hepatic artery, irrespective of size
Regional lymph nodes (N)
N category N criteria
NX Regional lymph nodes cannot be assessed
N0 No regional lymph nodes metastasis
N1 Metastasis to one to three regional lymph nodes
N2 Metastasis to four or more regional lymph nodes
Distant metastasis (M)
M category M criteria
M0 No distant metastasis
M1 Distant metastasis
Prognostic stage groups
When T is... And N is... And M is... Then the stage group is...
Tis N0 M0 0
T1a N0 M0 IA
T1a N1 M0 IIIA
T1b N0 M0 IB
T1b N1 M0 IIIA
T2 N0 M0 IB
T2 N1 M0 IIIA
T3a N0 M0 IIA
T3a N1 M0 IIIA
T3b N0 M0 IIB
T3b N1 M0 IIIA
T4 Any N M0 IIIB
Any T N2 M0 IIIB
Any T Any N M1 IV
TNM: tumor, node, metastasis; AJCC: American Joint Committee on Cancer; UICC: Union for International Cancer Control.
Used with permission of the American College of Surgeons, Chicago, Illinois. The original source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. Corrected at 4th printing, 2018.
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