Hello,
can someone decipher the following pathologic staging code of my tongue lesion? pT1pNOMX
Thanks,
Hal

Sort of - algebraically subtracting "p" from the equation would yield T1N0MX which would mean

T1 = Tumor ≤2 cm in greatest dimension
N0 = No regional lymph node metastasis
MX = Distant metastasis cannot be assessed

To the best of my knowledge there is no "p" designator in the AJCC TMN classification system.
Preliminary maybe?

The good news is that this is a very early diagnosis.... By using the X instead of an 0, they likely have not done any testing of any distant locations, with something such as a PET. Making the assumption that if it isn't in the lymph system it hasn't gone elsewhere. Please note the use of the word assumption. While they are likely safe in that posture, I was told once that assumption is the mother of all major F$%^&k- ups. But on the scale of staging this is not a horrible place to be on the oral cancer scale. (Not that any place on it is good.)

Hal sent me an email with some updates on what some of this means... I think it is worth putting up here, but it may delve into an area that falls into the realm of "how do I use that information?" Nevertheless, it's something that we should know for future ref.

posted October 06, 2005 11:07 AM

I'm very familair with what a p-value is but for this to be a p-value it *has* to be followed by a probability. Unless p is simply used as shorthand for "probably" here. In which case it isn't a p-value, it's just shorthand.

I though MX meant no metastasis but tests (lung scan, liver scan etc. ) have not been done so it's really undetermined. That's the way it worked in my diagnosis, Firts I was MX, then after the tests I was M0.

I know what a "p" value is (p= probability) but could not find any correlation to it and the TMN classification system. It's part of a statistical formula usually used in research more than Dx protocol.

But here you go: http://www.sportsci.org/resource/stats/pvalues.html

The good news, as Brian said, in the scheme of things, that's a pretty decent Dx. That means they caught it early. Like Nelie said, the MX part is yet to be determined and more than likely just a conservative rating anyway.

Actually the p-value IS the probability. That's why it is called a "value". The number is presented in research publication with p= or p< before it so there's no ambiguity about what the number means. So again, the letter p without a number is not a p value. Just some statistical trivia for y'all.......

"p" in this case should mean pathological.

I found more information at this web site:

http://training.seer.cancer.gov/module_staging_cancer/unit03_sec03_part04_ajcc_guidelines.html


The excerpts below explain the subject.

16. Each component may be individually defined as clinical or pathological, such as pT3 cN0 cM0. When components with mixed staging bases are stage grouped, the general clinical and pathologic rules for classification apply. For example, clinical M categories may be used for pathologic stage grouping, but pathologic T categories should not be stage grouped with clinically stage grouped cases.

17. The category X is used in each element to indicate that there has been no assessment of that characteristic of the tumor. It is important to differentiate the fact that no attempt was made to assess the element from the fact that nothing was found. For example, NX means that no diagnostic tools were used to evaluate the status of lymph nodes, and N0 means that no lymph node involvement was found by radiography or other methods.

18. If a stage grouping contains the term "any," such as Any T or Any N, the stage grouping is based on other elements and it does not matter what that T or N is. Consequently, even missing information including the X (not assessed) category is acceptable for that element in that stage group. For example, the chest CT scan for a lung cancer patient documents that there is a large mass on the right side and contralateral mediastinal lymph nodes involved. This case would be staged as N3. Assuming that distant metastases are ruled out (M0), it would not matter the size or location of the primary tumor, because the N3 M0 combination is a stage group IIIB. If distant metastases were present (M1), neither the size of the primary nor the lymph node involvement would matter, because the case is automatically stage group IV.

Hal-
Just curious-how did you catch this so early? It seems with alot of the tongue cancers it is hard to detect at such an early stage. What part of the tongue is it? I would love to hear about your story/symptoms. Hopefully by sharing this info it may help someone else catch their symptoms early too.
Thanks
Tami

Hello Hal,

Was your dx from a biospy? Did you have surgery
to remove the lesion? Please post again with more details about how you discovered it and what treatment you have received so far.
What is your treatment plan? The more we know the more information we can give you.

All my Best, Danny Boy