Ampulla of vater (ICD10 C24.1)

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This is the data sheet for TNM 9th edition staging of the ampulla of vater (ICD10 C24.1)

For more detailed information regarding TNM staging, please see pages 93-94 of the UICC TNM 9 book.

Stage Group	T stage	N stage	M stage
Stage 0	Tis	N0	M0
Stage IA	T1a	N0	M0
Stage IB	T1b, T2	N0	M0
Stage IIA	T3a	N0	M0
Stage IIB	T3b	N0	M0
Stage IIIA	T1a, T1b, T2, T3	N1	M0
Stage IIIB	Any T	N2	M0
Stage IIIB	T4	Any N	M0
Stage IV	Any T	Any N	M1

T value	Description
cTX	Primary tumour cannot be assessed
cT0	No evidence of primary tumour
cTis	Carcinoma in situ
cT1a	Tumour limited to ampulla of vater or sphincter of Oddi
cT1b	Tumour invades beyond the sphincter of Oddi (perisphincteric invasion) and/or into the duodenal submucosa
cT2	Tumour invades the muscularis propria of the duodenum
cT3	Tumour invades pancreas cT3a - Tumour invades 5mm or less into the pancreas cT3b - Tumour invades more than 5mm into the pancreas or extends into peripancreatic tissue or duodenal serosa but without involvement of the celiac axis or the superior mesenteric artery
T4	Tumour with vascular involvement of the superior mesenteric artery or celiac axis, or common hepatic artery

N value	Description
cNX	Regional lymph nodes cannot be assessed
cN0	No regional lymph node metastasis
cN1	Metastasis in 1 to 3 regional lymph nodes
cN2	Metastasis in 4 or more regional lymph nodes

M value	Description
cM0	No distant metastasis
cM1	Distant metastasis

The pT and pN categories correspond to the cT and cN categories as per above.

pN value	Description
pN0	Histological examination of a regional lymphadenectomy specimen will ordinarily include 12 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0