Anal cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Staging of anal cancer

Primary Tumor

Staging according to 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.

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.