Stage Information for Penile Cancer
Definitions of TNM
Note: This Stage Information section has been updated to include information from the seventh edition (2010) of the American Joint Committee on Cancer’s AJCC Cancer Staging Manual. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging categories to determine whether additional changes need to be made to other parts of the summary. Any necessary changes will be made as soon as possible.
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| TX | Primary tumor cannot be assessed. |
| T0 | No evidence of primary tumor. |
| Tis | Carcinoma in situ. |
| Ta | Noninvasive verrucous carcinoma.b |
| T1a | Tumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4). |
| T1b | Tumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated. |
| T2 | Tumor invades corpus spongiosum or cavernosum. |
| T3 | Tumor invades urethra. |
| T4 | Tumor 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 |
| cNX | Regional lymph nodes cannot be assessed. |
| cN0 | No palpable or visibly enlarged inguinal lymph nodes. |
| cN1 | Palpable mobile unilateral inguinal lymph node. |
| cN2 | Palpable mobile multiple or bilateral inguinal lymph nodes. |
| cN3 | Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral. |
| Pathologic Stage Definition c |
| pNX | Regional lymph nodes cannot be assessed. |
| pN0 | No regional lymph node metastasis. |
| pN1 | Metastasis in a single inguinal lymph node. |
| pN2 | Metastases in multiple or bilateral inguinal lymph nodes. |
| pN3 | Extranodal 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| M0 | No distant metastasis. |
| M1 | Distant 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. |
| 0 | Tis | N0 | M0 |
| Ta | N0 | M0 |
| I | T1a | N0 | M0 |
| II | T1b | N0 | M0 |
| T2 | N0 | M0 |
| T3 | N0 | M0 |
| IIIa | T1–3 | N1 | M0 |
| IIIb | T1–3 | N2 | M0 |
| IV | T4 | Any N | M0 |
| Any T | N3 | M0 |
| Any T | Any N | M1 |
References
- 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.
Last Modified: 01/06/2012