Ampulla of vater (ICD10 C24.1)

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This is the data sheet for TNM 8th edition staging of the ampulla of vater (ICD10 C24.1)

For more detailed information regarding TNM staging, please see pages 91-92 of the UICC TNM 8 book or visit the Wiley and UICC website.

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
TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
Tis	Carcinoma in situ
T1a	Tumour limited to ampulla of vater or sphincter of Oddi
T1b	Tumour invades beyond the sphincter of Oddi (perisphincteric invasion) and/or into the duodenal submucosa
T2	Tumour invades the muscularis propria of the duodenum
T3	Tumour invades pancreas T3a - Tumour invades 0.5 cm or less into the pancreas T3b - Tumour invades more than 0.5 cm 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
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in 1 to 3 regional lymph nodes
N2	Metastasis in 4 or more regional lymph nodes

M value	Description
M0	No distant metastasis
M1	Distant metastasis

The pT categories correspond to the T and N 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