DATA FORM FOR CANCER STAGING - MALIGNANT MELANOMA OF THE UVEA
Form # 785-1-051
| CLIN | PATH | DEFINITIONS | ||
| IRIS | ||||
| PRIMARY TUMOR (T) | ||||
| TX | Primary tumor cannot be assessed | |||
| T0 | No evidence of primary tumor | |||
| T1 | Tumor limited to the iris | |||
| T2 | Tumor involves one quadrant or less, with invasion into the anterior chamber angle | |||
| T3 | Tumor involves more than one quadrant, with invasion into the anterior chamber angle | |||
| T4 | Tumor with extraocular extension | |||
| LYMPH NODE (N) | ||||
| NX | Regional lymph nodes cannot be assessed | |||
| N0 | No regional lymph node metastasis | |||
| N1 | Regional lymph node metastasis | |||
| DISTANT METASTASIS (M) | ||||
| MX | Presence of distant metastasis cannot be assessed | |||
| M0 | No distant metastasis | |||
| M1 | Distast metastasis | |||
| CILIARY BODY | ||||
| PRIMARY TUMOR (T) | ||||
| TX | Primary tumor cannot be assessed | |||
| T0 | No evidence of primary tumor | |||
| T1 | Tumor limited to the ciliary body | |||
| T2 | Tumor invades into anterior chamber and/or iris | |||
| T3 | Tumor invades choroid | |||
| T4 | Tumor with extraocular extension | |||
| LYMPH NODE (N) | ||||
| NX | Regional lymph nodes cannot be assessed | |||
| N0 | No regional lymph node metastasis | |||
| N1 | Regional lymph node metastasis | |||
| DISTANT METASTASIS (M) | ||||
| MX | Presence of distant metastasis cannot be assessed | |||
| M0 | No distant metastasis | |||
| M1 | Distast metastasis | |||
| CHOROID | ||||
| PRIMARY TUMOR (T) | ||||
| TX | Primary tumor cannot be assessed | |||
| T0 | No evidence of primary tumor | |||
| T1 | Tumor 10 mm or less in greatest dimension with an elevation 3 mm or less | |||
| T1a | Tumor 7 mm or less in greatest dimension with an elevation 3 mm or less | |||
| T1b | Tumor more than 7 mm but not more than 10 mm in greatest dimension with an elevation more than 2 mm but not more than 3 mm | |||
| T2 | Tumor more than 10 mm but not more than 15 mm in greatest dimension with an elevation of more than 3 mm but not more than 5 mm | |||
| T3 | Tumor more than 15 mm in greatest dimension or with an elevation of more than 5 mm | |||
| T4 | Tumor with extraocular extension | |||
| LYMPH NODE (N) | ||||
| NX | Regional lymph nodes cannot be assessed | |||
| N0 | No regional lymph node metastasis | |||
| N1 | Regional lymph node metastasis | |||
| DISTANT METASTASIS (M) | ||||
| MX | Presence of distant metastasis cannot be assessed | |||
| M0 | No distant metastasis | |||
| M1 | Distant metastasis | |||
| CLIN | PATH | STAGE GROUPING | |||
| Iris and Ciliary Body | |||||
| I | T1 | N0 | M0 | ||
| II | T2 | N0 | M0 | ||
| III | T3 | N0 | M0 | ||
| IVA | T4 | N0 | M0 | ||
| IVB | Any T | N0 | M0 | ||
| Any T | Any N | M1 | |||
| Choroid | |||||
| IA | T1a | N0 | M0 | ||
| II | T2 | N0 | M0 | ||
| IB | T1b | N0 | M0 | ||
| II | T2 | N0 | M0 | ||
| III | T3 | N0 | M0 | ||
| IVA | T4 | N0 | M0 | ||
| IVB | Any T | N1 | M0 | ||
| Any T | Any N | M1 | |||
THE FINAL STAGE GROUPING (CLINICAL & PATHOLOGICAL) IS THE RESPONSIBILITY OF THE ATTENDING PHYSICIAN.
| Comments: |
| Patient Name: |