AAPA STAGING 2026 ALL

Endometrium

The mucous membrane lining the uterus, which is involved in the invasion process of endometrial cancer.

T1a - FIGO IA

Limited to endometrium; less than ½ into myometrium.

T1b - FIGO IB

Involves ½ or more into myometrium.

T2 - FIGO II

Invasion of stromal connective tissue of cervix, with no extension beyond uterus.

T3a - FIGO IIIA

Invasion of serosa/adnexa (direct or metastatic).

T3b - FIGO IIIB

Invasion of vagina (direct or metastatic) or parametrium.

T4 - FIGO IVA

Invasion of bladder or bowel mucosa.

T1mi

Invasive breast cancer measuring ≤ 1 mm in greatest dimension.

T1a

Invasive breast cancer measuring > 1 mm, ≤ 5 mm.

T1b

Invasive breast cancer measuring > 5 mm, ≤ 10 mm.

T1c

Invasive breast cancer measuring > 10 mm, ≤ 20 mm.

T2

Invasive breast cancer measuring > 20 mm, ≤ 50 mm.

T3

Invasive breast cancer measuring > 50 mm.

T4a

Extension to chest wall (not pectoralis muscle).

T4b

Ulceration/satellite nodules/edema (peau d’orange).

T1 - FIGO I

Trophoblastic tumors confined to the uterus.

T2 - FIGO II

Trophoblastic tumors extending to other genital structures (direct/metastatic).

M1a - FIGO III

Trophoblastic tumors with lung metastases.

M1b - FIGO IV

Trophoblastic tumors with other distant metastases.

T1a - Vagina

Vaginal tumors measuring ≤ 2 cm.

T1b - Vagina

Vaginal tumors measuring > 2 cm.

T2a - Vagina

Tumors ≤ 2 cm, invading paravaginal tissues, not pelvic wall.

T2b - Vagina

Tumors > 2 cm, invading paravaginal tissues, not pelvic wall.

T3 - Vagina

Extension to pelvic sidewall/cause hydronephrosis or nonfunctioning kidney.

T4 - Vagina

Invades bladder/bowel mucosa/beyond true pelvis.

T1a - Cervix

Cervical cancer with a microscopic lesion, max depth of invasion ≤ 5 mm.

T1a1 - Cervix

Depth of invasion ≤ 3 mm.

T1a2 - Cervix

Depth of invasion > 3 mm, ≤ 5 mm.

T1b - Cervix

Visible cervical lesion with depth of invasion > 5 mm.

T1b1 - Cervix

Depth of invasion > 5 mm, ≤ 2 cm.

T1b2 - Cervix

Depth of invasion > 2 cm, ≤ 4 cm.

T1b3 - Cervix

Depth of invasion > 4 cm.

T2a - Cervix

Upper ⅔ of vagina without parametrial invasion.

T2a1 - Cervix

≤ 4 cm.

T2a2 - Cervix

4 cm.

T2b - Cervix

Parametrial involvement but not up to pelvic wall.

T3a - Cervix

Lower ⅓ vagina without pelvic wall extension.

T3b - Cervix

Extension to pelvic wall/causing hydronephrosis or nonfunctioning kidney.

T4 - Cervix

Invades bladder/bowel mucosa or spread to adjacent organs.

T1a - Vulva

Tumors ≤ 2 cm and ≤ 1 mm stromal invasion.

T1b - Vulva

Tumors > 2 cm or > 1 mm stromal invasion.

T2 - Vulva

Any size with extension to lower ⅓ urethra, vagina, or anus.

T3 - Vulva

Any size with extension to upper ⅔ urethra, vagina, or bladder/bowel mucosa.

T4 - Vulva

Tumor fixed to pelvic bone.

T1a - Ovary

Limited to 1 intact ovary or fallopian tube.

T1b - Ovary

Limited to both intact ovaries or fallopian tubes.

T1c - Ovary

Limited to 1 or both ovaries or fallopian tubes.

M1 - Ovary

Distant metastasis in FIGO IV.

T3b - Ovary

Macroscopic peritoneal mets ≤ 2 cm.

T3c - Ovary

Macroscopic peritoneal mets > 2 cm.

T1a - Uterus

Uterine sarcoma ≤ 5 cm.

T1b - Uterus

Uterine sarcoma > 5 cm.

T4 - Uterus

Invades bladder or rectum.

T1b - Melanoma

Melanoma < 0.8 mm thick with ulceration or 0.8-1.0 mm with or without ulceration.

T2a - Melanoma

Melanoma > 1-2 mm thick without ulceration.

T3a - Melanoma

Melanoma > 2-4 mm thick without ulceration.

T4a - Melanoma

Melanoma > 4 mm without ulceration.

T1 - Squamous Cell Carcinoma

≤ 2 cm.

T3 - Squamous Cell Carcinoma

4 cm OR minor bone erosion or perineural invasion or deep invasion.

T1 - Lung

Minimally invasive adenocarcinoma.

T4 - Lung

7 cm or invasion of diaphragm, mediastinal organs.

T1 - Mesothelioma

Limited to ipsilateral parietal pleura.

T4 - Mesothelioma

Invasion of ribs, mediastinal organs, etc.

T4 - Thymus

Invasion into aorta, arch vessels, etc.

T4 - Retinoblastoma

Extraocular tumor with extensive local invasion.

T1 - Ewing Sarcoma

≤ 8 cm.

T2 - Ewing Sarcoma

8 cm.

T1 - ST Sarcoma of Head and Neck

≤ 2 cm.

T1 - ST Sarcoma of Abdomen

Organ confined.

T1 - Orbital Sarcoma

≤ 2 cm.

T3 - Larynx

Limited to larynx with fixation or invasion of specified structures.

T4a - Larynx

Moderately advanced disease with specific invasion.

T1 - Lip/Oral Cavity

≤ 2 cm, DOI ≤ 5 mm.

T4b - Lip/Oral Cavity

Very advanced local disease with extensive invasion.

T1 - Maxillary Sinus

Limited to mucosa without bone erosion.

T4a - Maxillary Sinus

Moderately advanced local disease with specific invasion.

T2 - Nasal Cavity

Invasion of two subsites or extension.

T3 - Nasopharynx

Infiltrates bony structures at skull base, vertebrae, etc.

T4 - Nasopharynx

Intracranial extension or significant soft tissue involvement.

T4 - p16- Oropharynx

Very advanced local disease involving major structures.

T1 - Hypopharynx

Limited to one subsite of hypopharynx/ ≤2 cm.

T2 - Hypopharynx

Invasion of adjacent sites, >2 cm, ≤4 cm without fixation.

T3 - Hypopharynx

4 cm or fixation to hemilarynx.

T4a - Hypopharynx

Moderately advanced disease with specific invasion.

T1 - Salivary Glands

≤ 2 cm without extraparenchymal extension.

T4b - Salivary Glands

Very advanced disease, specific invasion.

T1 - Bladder

Invasion of lamina propria.

T4b - Bladder

Invades pelvic or abdominal wall.

T1 - Urethra

Invasion of subepithelial connective tissue.

T4 - Urethra

Invasion of adjacent organs.

T1 - Kidney

≤4 cm.

T4 - Kidney

Invasion beyond Gerota’s fascia.

T1a - Stomach

Invasion of lamina propria or muscularis mucosa.

T4b - Stomach

Invasion of adjacent structures.

T1a - Small Intestine

Invasion of lamina propria.

T4 - Small Intestine

Invasion of visceral peritoneum or adjacent structures.

T4 - Gallbladder

Invasion of main portal vein or other important structures.

T3 - Esophagus

Invasion of adventitia.

T1 - Colon/Rectum

Invasion of submucosa.

T4b - Colon/Rectum

Invasion or adherence to adjacent organs.