LUNG STAGING FORM LATERALITY: LEFT RIGHT BILATERAL

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1 LUNG STAGING FORM LATERALITY: LEFT RIGHT BILATERAL ( ) Tx Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy ( ) Tis Carcinoma in situ ( ) Tis ( ) T1 Tumor 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus* (i.e., not in the main bronchus) ( ) T1a Tumor 2 cm or less in greatest dimension ( ) T1a ( ) T1b Tumor more than 2 cm but 3 cm or less in greatest dimension ( ) T1b ( ) T2 Tumor more than 3 cm but 7cm or less or tumor with any of the following features (T2 tumors with these features are classified T2a if 5cm or less): Involves main bronchus, 2cm or more distal to the carina Invades visceral pleura (PL1 or PL2) Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung ( ) T2a Tumor more than 3 cm but 5cm or less in greatest dimension ( ) T2a ( ) T2b Tumor more than 5 cm but 7 cm or less in greatest dimension ( ) T2b ( ) T3 Tumor more than 7cm OR one that directly invades any of the following: parietal pleural (PL3) chest wall (including superior sulcus tumors), diaphragm, phrenic nerve, mediastinal pleura, parietal pericardium OR tumor in the main bronchus (less than 2 cm distal to the carina but without involvement of the carina) OR associated atelectasis or obstructive pneumonitis of the entire lung OR separate tumor nodule(s) in the same lobe ( ) T4 Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina OR separate tumor nodule(s) in a different ipsilateral lobe ( ) Tx ( ) T1 ( ) T2 ( ) T3 ( ) T4 REGIONAL LYMPH NODES (N) PATHO ( ) Nx Regional lymph nodes cannot be assessed ( ) Nx ( ) N0 No regional lymph node metastases ( ) N0 ( ) N1 Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension ( ) N1 ( ) N2 Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s) ( ) N2 ( ) N3 Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s) ( ) N3 DISTANT METASTASIS (M) PATHO ( ) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) ( ) M1 Distant metastasis ( ) M1 ( ) M1a Separate tumor nodule(s) in a contralateral lobe, tumor with pleural nodules, or malignant pleural (or pericardial) effusion ( ) M1a ( ) M1b Distant metastasis ( ) M1b

2 LUNG STAGING FORM page 2 ANATOMIC STAGE/PROGNOSTIC S T N M PATHO Occult Tx N0 M0 ( ) 0 Tis N0 M0 ( ) 0 ( ) IA T1a, T1b N0 M0 ( ) IA ( ) IB T2a N0 M0 ( ) IB ( ) IIA T2b N0 M0 ( ) IIA T1a, T1b, T2a N1 M0 ( ) IIB T2b N1 M0 ( ) IIB ( ) IIIA T1a, T1b, T2a, T2b T3 N0 M0 T3 ( ) IIIB T1a, T1b, T2a, T2b, T3, T4 N2 M0 ( ) IIIA T3 N1 M0 T4 N0, N1 M0 N3 M0 ( ) IIIB T4 N2 M0 ( ) IV Any T Any N M1a ( ) IV Any T Any N M1b Histopathologic Type This staging classification applies to carcinomas that arise in the lung. The classification does not apply to sarcomas and other rare tumors. The World Health Organization histologic classification of tumors of the lung, 2004: Adenocarcinoma Adenocarcinoma, acinar Adenocarcinoma, clear cell Adenocarcinoma, fetal Adenocarcinoma, mixed subtype Adenocarcinoma, mucinous (colloid) carcinoma Adenocarcinoma, mucinous cystadenocarcinoma Adenocarcinoma, papillary Adenocarcinoma, signet ring Adenocarcinoma, solid with mucin production Adenoid cystic carcinoma Adenosquamous carcinoma Basaloid carcinoma Bronchioloalveolar carcinoma Bronchioloalveolar carcinoma, mixed non and mucinous Bronchioloalveolar carcinoma, mucinous Bronchioloalveolar carcinoma, nonmucinous Carcinoid tumor Carcinoid, atypical Carcinoid, typical Carcinosarcoma Clear cell carcinoma Epithelial-myoepithelial carcinoma Giant cell carcinoma Large cell carcinoma Large cell carcinoma with rhabdoid phenotype Large cell neuroendocrine carcinoma Lymphoepithelioma-like carcinoma Mucoepidermoid carcinoma Pleomorphic carcinoma Pulmonary blastoma Sarcomatoid carcinoma Small cell carcinoma Small cell carcinoma, combined Spindle cell carcinoma Squamous cell carcinoma Squamous cell, basaloid Squamous cell, clear cell Squamous cell, papillary Squamous cell, small cell

3 KIDNEY STAGING FORM ( ) Tx Primary tumor cannot be assessed ( ) Tx ( ) T1 Tumor 7 cm or less in greatest dimension, limited to the kidney ( ) T1 ( ) T1a Tumor 4 cm or less in greatest dimension, limited to the kidney ( ) T1a ( ) T1b Tumor more than 4 cm but not more than 7 cm in greatest dimension, limited to the kidney ( ) T1b ( ) T2 Tumor more than 7 cm in greatest dimension, limited to the kidney ( ) T2 ( ) T2a Tumor more than 7 cm but less than or equal to 10 cm in greatest dimension, limited to the kidney ( ) T2a ( ) T2b Tumor more than 10 cm in greatest dimension, limited to the kidney ( ) T2b ( ) T3 Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota s fascia ( ) T3a Tumor grossly extends into the renal vein or its segmental (muscle containing) branches, OR tumor invades perirenal and/or renal sinus fat but not beyond Gerota s fascia ( ) T3 ( ) T3a ( ) T3b Tumor grossly extends into the vena cava below the diaphragm ( ) T3b ( ) T3c Tumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava ( ) T3c ( ) T4 Tumor invades beyond Gerota s fascia (including contiguous extension into the ipsilateral adrenal gland) ( ) T4 REGIONAL LYMPH NODES (N) PATHO ( ) Nx Regional lymph nodes cannot be assessed ( ) Nx ( ) N0 No regional lymph node metastases ( ) N0 ( ) N1 Metastasis in regional lymph node(s) ( ) N1 DISTANT METASTASIS (M) PATHO ( ) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) ( ) M1 Distant metastasis ( ) M1 ANATOMIC STAGE/PROGNOSTIC S T N M PATHO ( ) I T1 N0 M0 ( ) I ( ) II T2 N0 M0 ( ) II ( ) III T1, T2 N1 M0 ( ) III T3 N0, N1 M0 ( ) IV T4 Any N M0 ( ) IV Any T Any N M1

4 BREAST STAGING FORM LATERALITY: LEFT RIGHT ( ) Tx Primary tumor cannot be assessed ( ) Tx ( ) Tis Carcinoma in situ; Ductal carcinoma in situ (DCIS); Lobular carcinoma in situ (LCIS); Paget s disease of the nipple NOT associated with invasive carcinoma and/or carcinoma in situ (DCIS and/or LCIS) in the underlying breast parenchyma. Carcinomas in the breast parenchyma associated with Paget s disease are categorized based on the size and characteristics of the parenchymal disease, although the presence of Paget s disease should still be noted (Paget s) ( ) T1 Tumor 20mm in greatest dimension ( ) T1 ( ) Tis ( ) T1mi Tumor 1mm in greatest dimension ( ) T1mi ( ) T1a Tumor > 1mm but 5mm in greatest dimension ( ) T1a ( ) T1b Tumor > 5mm but 10mm in greatest dimension ( ) T1b ( ) T1c Tumor > 10mm but 20mm in greatest dimension ( ) T1c ( ) T2 Tumor > 20mm but 50mm in greatest dimension ( ) T2 ( ) T3 Tumor > 50mm in greatest dimension ( ) T3 ( ) T4 Tumor of any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules) NOTE: Invasion of the dermis alone does not qualify as T4 ( ) T4a Extension to the chest wall, not including only pectoralis muscle adherence/invasion ( ) T4a ( ) T4b Ulceration and/or ipsilateral satellite nodules and/or edema (including peau d orange) of the skin, which do not meet the criteria for inflammatory carcinoma ( ) T4 ( ) T4b ( ) T4c Both T4a and T4b ( ) T4c ( ) T4d Inflammatory carcinoma NOTE: The rare case that exhibits all the features of inflammatory breast carcinoma, but in which skin changes involve less than one third of the skin, should be classified as T4b or T4c. ( ) T4d REGIONAL LYMPH NODES (N) ( ) Nx Regional lymph nodes cannot be assessed (e.g. previously removed) ( ) N0 No regional lymph node metastasis ( ) N1 Metastasis in movable ipsilateral level I, II axillary lymph node(s) ( ) N2 Metastases in ipsilateral level I, II axillary lymph nodes that are clinically fixed or matted; or in clinically detected* ipsilateral internal mammary nodes in the absence of clinically evident axillary lymph node metastases ( ) N2a Metastasis in ipsilateral level I, II axillary lymph nodes fixed to one another (matted) or to other structures ( ) N2b Metastasis only in clinically detected* ipsilateral internal mammary nodes and in the absence of clinically evident axillary lymph node metastases ( ) N3 Metastasis in ipsilateral infraclavicular (level III axillary) lymph node(s) with or without level I, II axillary lymph node involvement; or in clinical detected* ipsilateral internal mammary lymph node(s) with clinically evident level I, II axillary lymph node metastases; or metastases in ipsilateral supraclavicular lymph node(s) with or without axillary or internal mammary lymph node involvement ( ) N3a Metastasis in ipsilateral infraclavicular lymph node(s) ( ) N3b Metastasis in ipsilateral internal mammary lymph node(s) and axillary lymph node(s) ( ) N3c Metastases in ipsilateral supraclavicular lymph node(s) *Note: Clinically detected* is defined as detected by imaging studies (excluding lymphoscintigraphy) or by clinical examination and having characteristics highly suspicious for malignancy or a presumed pathologic macrometastasis based on fine needle aspiration biopsy with cytologic examination.

5 BREAST STAGING FORM page 2 PATHO REGIONAL LYMPH NODES (pn) Regional lymph nodes cannot be assessed (e.g. previously removed or not removed for pathologic study) No regional lymph node metastasis identified histologically No regional lymph node metastases histologically, negative IHC Malignant cells in regional lymph node(s) no greater than 0.2mm (detected by H&E or IHC including ITC) No regional lymph node metastasis histologically, negative molecular findings (RT-PCR) Positive molecular findings (RT-PCR) but no regional lymph node metastasis metastases detected by histology or IHC Micrometastases; or metastases in 1-3 axillary lymph nodes; and/or in internal mammary nodes with metastases detected by sentinel lymph node biopsy but not clinically detected Micrometastases (greater than 0.2mm and/or more than 200 cells but none greater than 2.0mm) Metastases in 1-3 axillary lymph nodes, at least one metastasis greater than 2.0mm Metastases in internal mammary nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected Metastases in 1-3 axillary lymph nodes and in internal mammary lymph nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected Metastases in 4-9 axillary lymph nodes; or in clinically detected internal mammary lymph nodes in the absence of axillary lymph node metastases Metastases in 4-9 axillary lymph nodes (at least one tumor deposit greater than 2.0mm) Metastases in clinically detected internal mammary lymph nodes in the absence of axillary lymph node metastases Metastases in ten or more axillary lymph nodes; or in infraclavicular (level III axillary) lymph nodes; or in clinically detected ipsilateral internal mammary lymph nodes in the presence of one or more positive level I, II axillary lymph nodes; or in more than three axillary lymph nodes and in internal mammary lymph nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected; or in ipsilateral supraclavicular lymph nodes Metastases in ten or more axillary lymph nodes (at least one tumor deposit greater than 2.0mm); or metastases to the infraclavicular (level III axillary lymph) nodes Metastases in clinically detected ipsilateral internal mammary lymph nodes in the presence of one or more positive axillary lymph nodes; or in more than three axillary lymph nodes and in internal mammary with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected Metastases in ipsilateral supraclavicular lymph nodes ( ) pnx ( ) pn0 ( ) pn0(i-) ( ) pn0(i+) ( ) pn0(mol-) ( ) pn0(mol+) ( ) pn1 ( ) pnmi ( ) pn1a ( ) pn1b ( ) pn1c ( ) pn2 ( ) pn2a ( ) pn2b ( ) pn3 ( ) pn3a ( ) pn3b ( ) pn3c DISTANT METASTASIS (M) ( ) M0 No clinical or radiographic evidence of distant metastases (no pathologic M0; use clinical M to complete stage group) ( ) cm0(i+) No clinical or radiographic evidence of distant metastases but deposits of molecularly or microscopically detected tumor cells in circulating blood, bone marrow, or other nonregional nodal tissue that are no larger than 0.2mm in a patient without symptoms or signs of metastases ( ) M1 Distant detectable metastases as determined by classic clinical and radiographic means and/or histologically proven larger than 0.2mm ANATOMIC STAGE/PROGNOSTIC S T N M PATHO ( ) 0 Tis N0 M0 ( ) 0 ( ) IA T1, T1mic N0 M0 ( ) IA ( ) IB T0 or T1 N1mi M0 ( ) IB ( ) IIA T0 or T1 N1 M0 ( ) IIA T2 N0 M0 ( ) IIB T2 N1 M0 ( ) IIB T3 N0 M0 ( ) IIIA T0, T1, T2, T3 N2 M0 ( ) IIIA T3 N1 M0 ( ) IIIB T4 N0, N1, N2 M0 ( ) IIIB ( ) IIIC Any T N3 M0 ( ) IIIC ( ) IV Any T Any N M1 ( ) IV

6 COLON AND RECTUM STAGING FORM LATERALITY: LEFT RIGHT BILATERAL ( ) Tx Primary tumor cannot be assessed ( ) Tx ( ) Tis Carcinoma in situ; intraepithelial or invasion of lamina propria* ( ) Tis ( ) T1 Tumor invades submucosa ( ) T1 ( ) T2 Tumor invades muscularis propria ( ) T2 ( ) T3 Tumor invades through the muscularis propria into pericolorectal tissues ( ) T3 ( ) T4a Tumor penetrates to the surface of the visceral peritoneum** ( ) T4a ( ) T4b Tumor directly invades or is adherent to other organs or structures^, ** ( ) T4b * Tis includes cancer cells confined within the glandular basement membrane (intraepithelial) or mucosal lamina propria (intramucosal) with no extension through the muscularis mucosae into the submucosa. ^ Direct invasion in T4 includes invasion of other organs or other segments of the colorectum as a result of direct extension through the serosa, as confirmed on microscopic examination (for example, invasion of the sigmoid colon by a carcinoma of the cecum) or, for cancers in a retro-peritoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria (i.e., respectively a tumor on the posterior wall of the descending colon invading the left kidney or lateral abdominal wall; or a mid or distal rectal cancer with invasion of prostate, seminal vesicles, cervix or vagina.) ** Tumor that is adherent to other organs or structures, grossly, is classified ct4b. However, if no tumor is present in the adhesion, microscopically, the classification should be pt1-4a depending on the anatomical depth of wall invasion. REGIONAL LYMPH NODES (N) PATHO- ( ) Nx Regional lymph nodes cannot be assessed ( ) Nx ( ) N0 No regional lymph node metastasis ( ) N0 ( ) N1 Metastasis in 1 to 3 regional lymph nodes ( ) N1 ( ) N1a Metastasis in 1 regional lymph node ( ) N1a ( ) N1b Metastasis in 2 to 3 regional lymph nodes ( ) N1b ( ) N1c Tumor deposit(s) in the subserosa, mesentery, or non-peritonealized pericolic or perirectal tissues without regional nodal metastasis ( ) N1c ( ) N2 Metastasis in 4 or more regional lymph nodes ( ) N2 ( ) N2a Metastasis in 4 to 6 regional lymph nodes ( ) N2a ( ) N2b Metastasis in 7 or more regional lymph nodes ( ) N2b Note: A satellite peritumoral nodule in the pericolorectal adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule may represent discontinuous spread, venous invasion with extravascular spread (V1/2) or a totally replaced lymph node (N1/2). Replaced nodes should be counted separately as positive nodes in the N category, whereas discontinuous spread or venous invasion should be classified and counted in the Site-Specific Factor category Tumor Deposits (TD). DISTANT METASTASIS (M) PATHO- ( ) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) ( ) M1 Distant metastasis ( ) M1 ( ) M1a Metastasis confined to one organ or site (e.g., liver, lung, ovary, non-regional nodes) ( ) M1a ( ) M1b Metastases in more than one organ/site or the peritoneum. ( ) M1b

7 COLON AND RECTUM STAGING FORM page 2 ANATOMIC STAGE * PROGNOSTIC S T N M DUKES* MAC* PATHO ( ) 0 Tis N0 M0 - - ( ) 0 ( ) I T1 N0 M0 A A ( ) I T2 N0 M0 A B1 ( ) IIA T3 N0 M0 B B2 ( ) IIA ( ) IIB T4a N0 M0 B B2 ( ) IIB ( ) IIC T4b N0 M0 B B3 ( ) IIC ( ) IIIA T1-T2 N1/N1c M0 C C1 ( ) IIIA T1 N2a M0 C C1 ( ) IIIB T3-T4a N1/N1c M0 C C2 ( ) IIIB T2-T3 N2a M0 C C1/C2 T1-T2 N2b M0 C C1 ( ) IIIC T4a N2a M0 C C2 ( ) IIIC T3-T4a N2b M0 C C2 T4b N1-N2 M0 C C3 ( ) IVA Any T Any N M1a - - ( ) IVA ( ) IVB Any T Any N M1b - - ( ) IVB *Dukes B is a composite of better (T3 N0 M0) and worse (T4 N0 M0) prognostic groups, as is Dukes C (AnyT N1 M0 and AnyT N2 M0). MAC is the modified Astler-Coller classification. HISTO GRADE (G) (also known as overall grade Grading System Grade ( ) 2 grade system ( ) Grade I or 1 ( ) 3 grade system ( ) Grade II or 2 ( ) 4 grade system ( ) Grade III or 3 ( ) No 2, 3, or 4 grade system is available ( ) Grade IV or 4 Histopathologic Type This staging classification applies to carcinomas that arise in the colon or rectum. The classification does not apply to sarcomas, to lymphomas, or to carcinoid tumors of the large intestine or appendix. The histologic types include: Adenocarcinoma Adenocarcinoma in situ Adenosquamous carcinoma Carcinoma, NOS Medullary carcinoma Mucinous carcinoma (colloid type; greater than 50% mucinous carcinoma) Signet ring cell carcinoma (greater than 50% signet ring cell) Small cell carcinoma Squamous cell (epidermoid) carcinoma Undifferentiated carcinoma