V.6.1 TNM Staging Classifications

TNM Staging includes the following stage classifications:

• Clinical Stage (cTNM) = Pretreatment Stage  

• Uses information on extent of disease from diagnostic workup before start of definitive treatment

• Pathologic Stage (pTNM) = Postsurgical Stage  

• Uses all information from diagnosis through completion of definitive surgery as part of 1st course treatment before systemic or radiation therapy
• Neoadjuvant Stage (y) = Post-therapy Stage  ycTNM or ypTNM

• Must use “y” prefix in conjunction with either clinical stage or pathologic stage

• Clinical ycTNM* = stage after systemic therapy or radiation and before surgical resection

• Pathologic ypTNM = stage after systemic therapy or radiation and after surgical resection

• Autopsy Stage (aTNM*) = Stage diagnosed at autopsy

• Applies only when cancer was unknown prior to death

• Retreatment Stage = (rTNM*) Recurrent/Progression stage

• Used for patients who have had a disease free interval but now have recurrent disease.

Guidelines:

• Only clinical (cTNM), pathologic (pTNM), and neoadjuvant post therapy (ypTNM) are collected in registry T, N, and M data fields.

• DO NOT CODE clinical ycTNM stage (after systemic therapy or radiation and before surgical resection).

• DO NOT CODE Retreatment Stage in the T, N, or M data fields.

• DO NOT CODE Autopsy Stage in the T, N, or M data fields.

• There are currently no stage descriptors available to identify these classifications in registry software.

*If your facility collects ycTNM, aTNM or rTNM stage information, document in text fields or software user specific fields only.

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