Note 1: For this site, use this item to evaluate the coding of tumor size and extension as coded in both CS Extension (clinical for prostate) and Site-Specific Factor 3, Pathologic Extension if prostatectomy was performed.
Note 2: The codes for this item for prostate differ from the codes used for most other sites.AJCC allows pathologic staging to be assigned on the basis of some biopsies without resection.According to the AJCC manual, "In general, total prostatoseminal-vesiculectomy, including regional node specimen, and histologic confirmation are required for pathologic T classification.However, under certain circumstances, pathologic T classification can be determined with other means.For example, (1) positive biopsy of the rectum permits a pT4 classificatiowithout prostatoseminal-vesiculectomy, and (2) a biopsy revealing carcinoma in extraprostatic soft tissue permits a pT3 classification, as does a biopsy revealing adenocarcinoma infiltrating the seminal vesicles." (P. 310)
Note 3: For this site, the T category and its associated c, p, y, or a indicator are assigned based on the values in CS Extension, CS TS/Ext Eval, and Site-Specific Factor 3.For details, see Note 8 under CS Extension.
Note 4: According to AJCC, staging basis for transurethral resection of prostate (TURP) is clinical and is recorded as CS TS/Ext-Eval "1" (c).
| Code | Description | Staging Basis |
|---|---|---|
| 0 | No surgical resection done. Evaluation based on physical examination, imaging examination, or other non-invasive clinical evidence. No autopsy evidence used. | c |
| 1 | No surgical resection done. Evaluation based on endoscopic examination, diagnostic biopsy, including fine needle aspiration biopsy, or other invasive techniques including surgical observation without biopsy. No autopsy evidence used. Does not meet criteria for AJCC pathological T staging. | c |
| 2 | No surgical resection done, but evidence derived from autopsy (tumor was suspected or diagnosed prior to autopsy). | p |
| 3 | Surgical resection performed without pre-surgical systemic treatment or radiation OR surgical resection performed, unknown if pre-surgical systemic treatment or radiation performed. Evidence acquired before treatment, supplemented or modified by the additional evidence acquired during and from surgery, particularly from pathologic examination of the resected specimen. Meets criteria for AJCC pathological T staging. | p |
| 4 | Surgical resection performed without pre-surgical systemic treatment or radiation OR surgical resection performed, unknown if pre-surgical systemic treatment or radiation performed. Evidence acquired before treatment, supplemented or modified by the additional evidence acquired during and from surgery, particularly from pathologic examination of the resected specimen. Meets criteria for AJCC pathologic T staging. | p |
| 5 | Surgical resection performed with pre-surgical systemic treatment or radiation, but tumor size/extension based on clinical evidence. | c |
| 6 | Surgical resection performed with pre-surgical systemic treatment or radiation; tumor size/extension based on pathologic evidence. | y |
| 8 | Evidence from autopsy only (tumor was unsuspected or undiagnosed prior to autopsy). | a |
| 9 |
|
c |