California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures
Clinical staging documents the tumor size/extension of the tumor known prior to the start of any therapy.
Source of clinical stage information may come from physical exam, imaging, endoscopies, diagnostic biopsies, or any assessment which is part of the diagnostic workup.
The timeframe from which information may be used for clinical stage is from the time of diagnosis throughout diagnostic workup and before the start of definitive treatment (surgery, systemic or radiation therapy, active surveillance, or palliative care). In other words, the clinical stage timeframe ENDs at the initiation of definitive treatment.
OR within 4 months after diagnosis if treatment has not started, provided there has been no progression of disease.
Use whichever timeframe is shorter.
The following are part of the clinical work-up. This list is not intended to be all inclusive:
Presenting symptoms
Physical examination
Imaging examination
Endoscopic examination
Biopsy of primary site
Diagnostic biopsy
Fine needle aspiration biopsy
Resection of single lymph node/sentinel node(s) with clinical T
Surgical observation without resection
Laboratory tests
Other non-invasive clinical evidence
All information obtained prior to neoadjuvant (preoperative) treatment