TNM Classification of Carcinoma Arising at the Ampulla of Vater

Description

A carcinoma at the Ampulla of Vater can be staged using the TNM classification system.

Group	Description	Code
T	primary tumor cannot be assessed	TX
	no evidence of primary tumor	T0
	carcinoma in situ	Tis
	tumor confined to the Ampulla of Vater or sphincter of Oddi	T1
	tumor invades the duodenal wall	T2
	tumor invades into pancreas a distance <= 2 cm	T3
	tumor invades into the pancreas > 2 cm, or invades adjacent organs	T4
N	regional lymph nodes cannot be assessed	NX
	no regional lymph node metastasis	N0
	regional lymph node metastasis	N1
M	presence of distant metastasis cannot be assessed	MX
	no definite metastasis	M0
	distant metastasis present, including metastasis to splenic lymph nodes and nodes in the tail of the pancreas	M1

where:

• Regional lymph nodes include those about the head and body of the pancreas, the pancreaticoduodenal, pyloric, common bile duct and proximal mesenteric groups. Other regional lymph nodes include: infrapyloric, subpyloric, celiac, hepatic, lateral aortic and retroperitoneal.

• Splenic lymph nodes and nodes in the tail of the pancreas are distant lymph nodes.

TNM	Stage
Tis N0 M0	0
T1 N0 M0	I
T2 N0 M0 T3 N0 M0	II
T1-3 N1 M0	III
T4 N0-1 M0 T1-4 N0-1 M1	IV

NOTE: This classification is not used for carcinoid or other neuroendocrine tumors.

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TNM Classification of Carcinoma Arising at the Ampulla of Vater

Description

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