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Penile Cancer Treatment (PDQ®)

  • Last Modified: 03/07/2014

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Stage Information for Penile Cancer

Definitions of TNM



Definitions of TNM

The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define penile cancer.[1]

Table 1. Primary Tumor (T)a
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
TisCarcinoma in situ.
TaNoninvasive verrucous carcinoma.b
T1aTumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4).
T1bTumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated.
T2Tumor invades corpus spongiosum or cavernosum.
T3Tumor invades urethra.
T4Tumor invades other adjacent structures.

aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.
bBroad pushing penetration (invasion) is permitted; destructive invasion is against this diagnosis.

Table 2. Regional Lymph Nodes (N)a
Clinical Stage Definition b
cNXRegional lymph nodes cannot be assessed.
cN0No palpable or visibly enlarged inguinal lymph nodes.
cN1Palpable mobile unilateral inguinal lymph node.
cN2Palpable mobile multiple or bilateral inguinal lymph nodes.
cN3Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral.
Pathologic Stage Definition c
pNXRegional lymph nodes cannot be assessed.
pN0No regional lymph node metastasis.
pN1Metastasis in a single inguinal lymph node.
pN2Metastases in multiple or bilateral inguinal lymph nodes.
pN3Extranodal extension of lymph node metastasis or pelvic lymph node(s) unilateral or bilateral.

aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.
bClinical stage definition based on palpation, imaging.
cPathologic stage definition based on biopsy or surgical excision.

Table 3. Distant Metastasis (M)a
M0No distant metastasis.
M1Distant metastasis.b

aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.
bLymph node metastasis outside of the true pelvis in addition to visceral or bone sites.

Additional Descriptor. The m suffix indicates the presence of multiple primary tumors and is recorded in parentheses – e.g., pTa (m) N0M0.[1]

Table 4. Anatomic Stage/Prognostic Groupsa
Stage T N M 
aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.
0TisN0M0
TaN0M0
IT1aN0M0
IIT1bN0M0
T2N0M0
T3N0M0
IIIaT1–3N1M0
IIIbT1–3N2M0
IVT4Any NM0
Any TN3M0
Any TAny NM1

References
  1. Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.