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

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.


Staging according to 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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