Anal cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

The staging of Anal cancer is based on the TNM staging system [1]

Staging of anal cancer

Primary Tumor

According to the TNM staging system, there are four stages of anal cancer based on the tumor size, lymph node involvement, and metastasis.

Tumor size (T)

TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ (i.e., Bowen disease, high-grade squamous intraepithelial lesion, and anal intraepithelial neoplasia II–III.)
T1 Tumor ≤2 cm in greatest dimension
T2 Tumor >2 cm but ≤5 cm in greatest dimension
T3 Tumor >5 cm in greatest dimension
T4 Tumor of any size invades adjacent organ(s), e.g., vagina, urethra, and bladder

Regional lymph node (N)

NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastases in perirectal lymph node(s)
N2 Metastases in unilateral internal iliac and/or inguinal lymph node(s)
N3 Metastases in perirectal and inguinal lymph nodes and/or bilateral internal iliac and/or inguinal lymph nodes


Distant metastasis (M)

M0 No distant metastasis
M1 Distant metastasis

Anatomic stage/prognostic group

0 Tis N0 M0
I T1 N0 M0
II T2 N0 M0
T3 N0 M0
IIIA T1 N1 M0
T2 N1 M0
T3 N1 M0
T4 N0 M0
IIIB T4 N1 M0
Any T N2 M0
Any T N3 M0
IV Any T Any N M1

References

  1. National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/anal/hp/anal-treatment-pdq#cit/section_3.1


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