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Table 1 T N M classification of carcinoma of the ampulla of Vater

From: Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study

T (Primary tumour)
Tx Primary tumour cannot be assessed
T1 Tumour limited to the ampulla of Vater or aphincter of Oddi
T2 Tumour invades duodenal wall
T3 Tumor invades 2 cm or less into pancreas
T4 Tumor invades more than 2 cm into pancreas and/or into other adjacent organs
N (Regional lymph nodes)
Nx Regional lymph nodes cannot be assessed
NO No regional lymph nodes metastasis
N1 Regional lymph nodes metastasis
M (Distant metastasis)
Mx Distant metastasis not assessable
M0 No distant metastasis
M1 Distant metastasis: Hepatic metastasis, peritoneal dissemination, lymph nodes metastasis along the splenic vein or at the splenic hilum