Stage Information
TNM Definitions
AJCC Stage Groupings
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.
TNM Definitions
Primary tumor (T)
- TX: Primary tumor cannot be assessed
- T0: No evidence of primary tumor
- Tis: Carcinoma in situ
- 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 that invades adjacent organ(s), e.g., vagina,
urethra, bladder*
[Note: *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)
- MX: Distant metastasis cannot be assessed
- M0: No distant metastasis
- M1: Distant metastasis
AJCC Stage Groupings
Stage 0
Stage I
Stage II
Stage IIIA
- T1, N1, M0
- T2, N1, M0
- T3, N1, M0
- T4, N0, M0
Stage IIIB
- T4, N1, M0
- Any T, N2, M0
- Any T, N3, M0
Stage IV
References
-
Anal canal. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 125-130.
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