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2014

Anal Cancer Staging

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Dr. M Bratu

Anal Cancer Staging

Author: Jeffrey B VanDeusen, MD, PhD; Chief Editor: Jules E Harris, MD more...
Updated: Sep 6, 2013

TNM Classification for Anal Cancer

The TNM classification system for anal cancer staging is provided below.[1, 2]
Table. TNM Classification for Anal Cancer (Open Table in a new window)
Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ (Bowen disease, high-grade squamous intraepithelial lesion [HSIL], anal intraepithelial
neoplasia II-III (AIN II-III)
T1 Tumor 2 cm or less in greatest dimension
T2 Tumor more than 2 cm but not more than 5 cm in greatest dimension
T3 Tumor more than 5 cm in greatest dimension
T4 Tumor of any size invades adjacent organ(s) (eg, vagina, urethra, bladder);direct invasion of the rectal
wall, perirectal skin, subcutaneous tissue, or the sphincter muscle(s) is not classified as T4
Regional lymph nodes (N)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in perirectal lymph node(s)
N2 Metastasis in unilateral internal iliac and/or inguinal lymph node(s)
N3 Metastasis in perirectal and inguinal lymph nodes and/or bilateral internal iliac and/or inguinal lymph
nodes
Distant metastasis (M)
M0 No distant metastasis
M1 Distant metastasis
Table. Anatomic stage/prognostic group (Open Table in a new window)
Stage

Tis

N0

M0

T1

N0

M0

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II
IIIA

IIIB

IV

Anal Cancer Staging

T2

N0

M0

T3

N0

M0

T1

N1

M0

T2

N1

M0

T3

N1

M0

T4

N0

M0

T4

N1

M0

Any T N2

M0

Any T N3

M0

Any T Any N M1

Contributor Information and Disclosures

Author
Jeffrey B VanDeusen, MD, PhD Fellow, Department of Hematology/Oncology, Duke University School of
Medicine
Disclosure: Nothing to disclose.
Specialty Editor Board
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of
Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital
Disclosure: Nothing to disclose.
Chief Editor
Jules E Harris, MD Clinical Professor of Medicine, Section of Hematology/Oncology, University of Arizona
College of Medicine, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research,
American Association for the Advancement of Science, American Association of Immunologists, American
Society of Hematology, and Central Society for Clinical Research
Disclosure: Nothing to disclose.

References
1. January 17, 2013. American Cancer Society Anal Cancer Overview. Available at
http://www.cancer.org/cancer/analcancer/overviewguide/anal-cancer-overview-staging. Accessed
September 5, 2013.
2. NCCN Clinical Practice Guidelines in Oncology: Anal Carcinoma. V 2.2013. 2. National Comprehensive
Cancer Network. Available at http://bit.ly/iH4XWj. Accessed September 5, 2013.
Medscape Reference 2011 WebMD, LLC

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