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

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.

Staging according to 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.