Most Common Exceptions to AJCC Staging

Dec. 5, 2017

From the CAnswer Forum:

MOST COMMON EXCEPTIONS TO AJCC STAGING

Thyroid:

Papillary or follicular for patients under 45 years ANY T and ANY N with M0 – STAGE I

ANY T and ANY N with M1 – STAGE II

Over 45 years & medullary carcinoma all age groups – at least one lymph node must be removed in order for the patient to be eligible for pathologic stage

Soft Tissue Sarcoma

Nodal involvement is rare in adult soft tissue sarcoma. In assigning stage group patients whose nodal status is not determined to be positive for tumor, either clinically or pathologically, should be designated as N0

Kidney:

T3, and N, M0 – STAGE III

T4, any N M0 – STAGE IV

Melanoma:

Pathologic Stage 0 and Stage IA are the exception and do not require pathologic evaluation of their lymph nodes for pathologic stage pTis cN0 cM0 – Stage 0

pT1a cN0 cM0 – Stage IA

 In-Situ Rule when lymph nodes are not removed:

pTis, cN0 cM0 – Stage 0

cTa, cN0 cM0 – Stage 0a

 Vulva:

T3, any N, M0 – STAGE IVA

Vagina:

T4, any N, M0 – STAGE IVA

Endometrium:

T3B, any N, M0  STAGE IIIB

Ovary & Primary:

Any T, N1, M0 – STAGE IIIC

 Lip & Oral Cavity, Larynx, Nasal Cavity & Paranasal Sinuses, Salivary Gland:

Stage IVB = Any T N3 or T4b Any N M0

Pharynx:

Stage IVB = Any T N3 M0

Pancreas:

T4, any N M0 – Stage III

Prostate:

Any T, N1 M0 – STAGE IV
There will be other exceptions as we begin cases diagnosed in 2018.