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Anal Cancer Treatment (PDQ®)

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Stage Information for Anal Cancer

The anal canal extends from the rectum to the perianal skin and is lined by a mucous membrane that covers the internal sphincter. The following is a staging system for anal canal cancer that has been described by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer.[1] Tumors of the anal margin (below the anal verge and involving the perianal hair-bearing skin) are classified with skin tumors.

Definitions of TNM

The following is a staging system for anal canal cancer that has been described by the AJCC and the International Union Against Cancer.[1]

Table 1. Primary Tumor (T)a
aReprinted with permission from AJCC: Anus. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 165-73.
bDirect invasion of the rectal wall, perirectal skin, subcutaneous tissue, or the sphincter muscle(s) is not classified as T4.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
TisCarcinoma in situ (i.e., Bowen disease, high-grade squamous intraepithelial lesion, and anal intraepithelial neoplasia II–III.)
T1Tumor ≤2 cm in greatest dimension.
T2Tumor >2 cm but ≤5 cm in greatest dimension.
T3Tumor >5 cm in greatest dimension.
T4Tumor of any size invades adjacent organ(s), e.g., vagina, urethra, and bladder.b
Table 2. Regional Lymph Nodes (N)a
aReprinted with permission from AJCC: Anus. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 165-73.
NXRegional lymph nodes cannot be assessed.
N0No regional lymph node metastasis.
N1Metastases in perirectal lymph node(s).
N2Metastases in unilateral internal iliac and/or inguinal lymph node(s).
N3Metastases in perirectal and inguinal lymph nodes and/or bilateral internal iliac and/or inguinal lymph nodes.
Table 3. Distant Metastasis (M)a
aReprinted with permission from AJCC: Anus. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 165-73.
M0No distant metastasis.
M1Distant metastasis.
Table 4. Anatomic Stage/Prognostic Groupsa
StageTNM
aReprinted with permission from AJCC: Anus. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 165-73.
0TisN0M0
IT1N0M0
IIT2N0M0
T3N0M0
IIIAT1N1M0
T2N1M0
T3N1M0
T4N0M0
IIIBT4N1M0
Any TN2M0
Any TN3M0
IVAny TAny NM1

References

  1. Anus. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 167-169.
  • Updated: July 31, 2014