PALM 625 Staging

Breast: ductal carcinoma in situ

Tis (DCIS)

Breast: Paget disease without DCIS or invasive carcinoma

Tis (Paget)

Breast: >1–5 mm

T1a

Breast: >5–10 mm

T1b

Breast: >10–20 mm

T1c

Breast: 20–50 mm

T2

Breast: >50 mm

T3

Breast: chest wall invasion

T4a

Breast: skin ulceration or nodules

T4b

Breast: chest wall + skin involvement

T4c

Breast: inflammatory carcinoma

T4d

Prostate: organ confined

T2

Prostate: EPE ± microscopic bladder neck invasion

T3a

Prostate: seminal vesicle invasion

T3b

Prostate: invasion of adjacent structures

T4

Testis: limited to testis, no lymphovascular invasion

pT1

Testis: <3 cm (pure seminoma only)

pT1a

Testis: ≥3 cm (pure seminoma only)

pT1b

Testis: LVI or epididymis/hilar/tunica vaginalis invasion

pT2

Testis: spermatic cord invasion

pT3

Testis: scrotal invasion

pT4

Uterus: ≤50% myometrium

T1a

Uterus: ≥50% myometrium

T1b

Uterus: cervical stroma invasion

T2

Uterus: serosa and/or adnexa invasion

T3a

Uterus: vagina or parametrium invasion

T3b

Uterus: bladder or bowel mucosal invasion

T4

Cervix: microscopic only

T1a

Cervix: invasion >5 mm

T1b

Cervix: upper 2/3 vagina, no parametrium

T2a

Cervix: parametrial involvement

T2b

Cervix: lower 1/3 vagina or pelvic wall

T3

Cervix: bladder or rectum mucosa

T4

Ovary: one ovary

T1a

Ovary: both ovaries

T1b

Ovary: surgical spill

T1c1

Ovary: capsule rupture before surgery

T1c2

Ovary: malignant cells in ascites/washings

T1c3

Ovary: extension to uterus/tubes/ovaries

T2a

Ovary: extension to other pelvic tissue not uterus, FT, and ovaries

T2b

Ovary: microscopic spread beyond the pelvis or to retroperitoneal lymph nodes

T3a

Ovary: Tumor extends beyond the pelvis or to retroperitoneal lymph nodes and implants ≤2 cm

T3b

Ovary: Tumor extends beyond the pelvis or to retroperitoneal lymph nodes >2 cm

T3c

Lung: Tumor ≤ 1cm OR limited to the bronchial wall or extend to the main bronchus

T1a

Lung: Tumor 1–2 cm

T1b

Lung: Tumor 2–3 cm

T1c

Lung: Tumor 3–4 cm OR invade visceral pleura, adjacent lobes, main bronchus without the carina, associated with atelectasis or pneumonitis

T2a

Lung: Tumor 4–5 cm

T2b

Lung: Tumor 5–7 cm OR invades chest wall, pericardium, phrenic n, azygus v, thoracic nerve roots, or is a separate tumor nodule in the same lobe as primary tumor

T3

Lung: Tumor >7 cm or mediastinum invasion

T4

Adrenal: ≤5 cm, no invasion

T1

Adrenal: >5 cm, no invasion

T2

Adrenal: local invasion not into organs

T3

Adrenal: invasion of adjacent organs/vessels

T4

Kidney: ≤4 cm limited to kidney

T1a

Kidney: >4–7 cm limited to kidney

T1b

Kidney: >7–10 cm limited to kidney

T2a

Kidney: >10 cm limited to kidney

T2b

Kidney: renal vein/sinus/pelvicalyceal involvement

T3a

Kidney: IVC below diaphragm

T3b

Kidney: IVC above diaphragm or invasion of IVC wall

T3c

Kidney: beyond Gerota fascia or direct extension into adrenal

T4

Bladder: lamina propria

T1

Bladder: inner half of detrusor muscle

T2a

Bladder: outer half of detrusor muscle

T2b

Bladder: microscopic invasion of perivesical fat

T3a

Bladder: macroscopic invasion of perivesical fat

T3b

Bladder: prostate/uterus/vagina invasion

T4a

Bladder: pelvic/abdominal wall invasion

T4b

Esophagus: lamina propria

T1a

Esophagus: muscularis mucosae

T1b

Esophagus: muscularis propria

T2

Esophagus: adventitia

T3

Esophagus: beyond esophagus

T4

Stomach: lamina propria

T1a

Stomach: muscularis mucosae

T1b

Stomach: muscularis propria

T2

Stomach: subserosa

T3

Stomach: peritoneum

T4a

Stomach: adjacent organs

T4b

GIST: ≤2 cm

T1

GIST: 2–5 cm

T2

GIST: 5–10 cm

T3

GIST: >10 cm

T4

Colorectal: submucosa

T1

Colorectal: muscularis propria

T2

Colorectal: pericolic/adventitia

T3

Colorectal: visceral peritoneum

T4a

Colorectal: adjacent organs extension

T4b

Anus: ≤2 cm

T1

Anus: 2–5 cm

T2

Anus: >5 cm

T3

Anus: adjacent organs

T4

Pancreas: ≤0.5 cm

T1a

Pancreas: 0.5–1 cm

T1b

Pancreas: 1–2 cm

T1c

Pancreas: 2–4 cm

T2

Pancreas: >4 cm

T3

Pancreas: invasion of celiac axis/SMA/common hepatic artery

T4

Liver: solitary tumor ≤2 cm

T1a