Ocular Oncology Staging & CAP v4.2.0.0 Synoptic Calculator

Retinoblastoma Protocol • CAP v4.2.0.0

Select Staging Classification Mode

Pathologic staging (pTNM) applies to enucleation/exenteration specimens; Clinical staging (cTNM) applies to initial exam.

1. Specimen Context & AJCC Modifiers

Tap to expand

Specimen Laterality

Procedure

Optic Nerve Length (mm)

AJCC TNM Modifiers (Prefixes / Suffix)

y prefix

Post-neoadjuvant therapy

r prefix

Recurrent tumor

(m) suffix

Multiple synchronous tumors

2. Primary Tumor (pT) — Guided Invasion Builder

Primary Staging

Intraocular Tumor Status

Choroidal Invasion (Note J)

Extent of Optic Nerve Invasion

Scleral & Extraocular Extension

Anterior Segment Invasion (pT2b): Tumor invasion of stroma of iris and/or trabecular meshwork and/or Schlemm's canal.

AJCC 8th / CAP Footnote # Rule: Tumors with focal choroidal invasion ONLY (<3 mm) without optic nerve invasion OR pre-/intralaminar optic nerve head involvement ONLY without choroidal invasion are classified as pT1. When BOTH occur concomitantly, the tumor upgrades to pT2a.

Derived / Selected Pathologic T Category (pT)

3. Regional Nodes (N), Metastasis (M) & Heritable (H)

Defaults: N0 M0 HX

Regional Lymph Nodes (pN / cN)

Distant Metastasis (pM / cM)

Heritable Trait Status (H Category)

4. Histopathologic Grade, Growth Pattern & Margins

CAP Synoptic Fields

Histologic Grade (CAP Core)

Tumor Growth Pattern

+Anaplasia Grade

+MYCN Amplification Features

Surgical Margin Status

Uveal Melanoma Protocol • CAP v4.2.0.0

Select Uveal Anatomic Subsite

Posterior uveal melanomas (Ciliary Body & Choroid) use the AJCC Figure 3 Size Matrix; Iris melanomas use clock-hour/extension criteria.

1. Specimen Details & AJCC Modifiers

Tap to expand

Specimen Laterality

Procedure

Tumor Site / Quadrant

y prefix

Post-neoadjuvant therapy

r prefix

Recurrent tumor

(m) suffix

Multiple synchronous tumors

2. Ciliary Body & Choroid pT Staging (AJCC Fig. 3)

Category 2

Largest Basal Diameter (mm) ≈ 7.3 DD

Clinical estimate: 1 Disc Diameter (DD) ≈ 1.5 mm

Greatest Thickness / Height (mm) ≈ 13.8 D

Clinical estimate: 2.5 Diopters (D) ≈ 1.0 mm

Interactive AJCC 8th Edition Figure 3 Size Matrix (Tap any cell or enter mm above)

Thickness (mm) ↓	≤3.0	3.1–6.0	6.1–9.0	9.1–12.0	12.1–15.0	15.1–18.0	>18.0
Largest Basal Diameter (mm) →

Ciliary Body Involvement

Extraocular / Extrascleral Extension (EOE)

Derived / Selected Ciliary Body & Choroid pT Category

2. Iris Melanoma Primary Tumor (pT) Classification

AJCC 8th Iris Criteria

CAP Note: Iris melanomas originate from, and are predominantly located in, this region of the uvea. If less than half the tumor volume is located within the iris, the tumor may have originated in the ciliary body and should be classified accordingly.

Select Iris pT Category

3. Regional Nodes / Orbital Deposits (pN) & Metastasis (pM)

Defaults: pN0 cM0

Regional Lymph Nodes & Orbital Deposits (pN)

Distant Metastasis (pM / cM)

4. Histologic Cell Type (Callender) & Molecular Studies

GEP • TCGA • BAP1

Histologic Type / Modified Callender Grade

Scleral & Margin Status

+Gene Expression (GEP)

+TCGA Classification

+BAP1 IHC Status

+PRAME Status

AJCC 8th Edition • Retinoblastoma

Calculated TNM & Prognostic Stage Group

TNM Classification

pT1 pN0 cM0 HX

Intraocular tumor without local invasion

AJCC Stage Group

Stage I

Localized intraocular

Prognostic & High-Risk Feature Flags

CAP v4.2.0.0 Synoptic Summary

Tap to view or copy formatted pathology report

Paired Data Element: Response format

pT	N	M	H	Stage
pT1, pT2, pT3	pN0	cM0	Any	Stage I
pT4	pN0	cM0	Any	Stage II
Any pT	pN1	cM0	Any	Stage III
Any pT	Any pN	cM1 / pM1	Any	Stage IV

cT	cN	M	H	Stage
cT1, cT2, cT3	cN0	cM0	Any	Stage I
cT4a	cN0	cM0	Any	Stage II
cT4b	cN0	cM0	Any	Stage III
Any cT	cN1	cM0	Any	Stage III
Any cT	Any cN	cM1 / pM1	Any	Stage IV

Stage Group	T Category	N Category	M Category
Stage I	T1a	N0	M0
Stage IIA	T1b–d, T2a	N0	M0
Stage IIB	T2b, T3a	N0	M0
Stage IIIA	T2c–d, T3b–c, T4a	N0	M0
Stage IIIB	T3d, T4b–c	N0	M0
Stage IIIC	T4d–e	N0	M0
Stage IV	Any T / Any T	N1 / Any N	M0 / M1a–c

Ocular Oncology AJCC 8th Edition Staging Calculator

Select Staging Classification Mode

1. Specimen Context & AJCC Modifiers

2. Primary Tumor (pT) — Guided Invasion Builder

2. Clinical Primary Tumor (cT) — AJCC 8th Edition

3. Regional Nodes (N), Metastasis (M) & Heritable (H)

4. Histopathologic Grade, Growth Pattern & Margins

Select Uveal Anatomic Subsite

1. Specimen Details & AJCC Modifiers

2. Ciliary Body & Choroid pT Staging (AJCC Fig. 3)

2. Iris Melanoma Primary Tumor (pT) Classification

3. Regional Nodes / Orbital Deposits (pN) & Metastasis (pM)

4. Histologic Cell Type (Callender) & Molecular Studies

Calculated TNM & Prognostic Stage Group

CAP v4.2.0.0 Synoptic Summary

Select Staging Classification Mode

1. Specimen Context & AJCC Modifiers

2. Primary Tumor (pT) — Guided Invasion Builder

2. Clinical Primary Tumor (cT) — AJCC 8th Edition

3. Regional Nodes (N), Metastasis (M) & Heritable (H)

4. Histopathologic Grade, Growth Pattern & Margins

Select Uveal Anatomic Subsite

1. Specimen Details & AJCC Modifiers

2. Ciliary Body & Choroid pT Staging (AJCC Fig. 3)

2. Iris Melanoma Primary Tumor (pT) Classification

3. Regional Nodes / Orbital Deposits (pN) & Metastasis (pM)

4. Histologic Cell Type (Callender) & Molecular Studies

Calculated TNM & Prognostic Stage Group

CAP v4.2.0.0 Synoptic Summary

AJCC 8th Edition Stage Grouping Reference Tables (CAP v4.2.0.0)

Retinoblastoma — Pathologic Stage (pTNM)

Retinoblastoma — Clinical Stage (cTNM)

Uveal Melanoma — AJCC 8th Prognostic Stage Groups