Anal Cancer TNM Staging – Classification System

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anal cancer tnm staging

TNM Staging of Anal Cancer

Anal cancer TNM staging helps to determine the disease prognosis and to select an appropriate treatment strategy. The AJCC (American Joint Committee on Cancer) or TNM is the most commonly used system for staging anal cancer. Staging is based on the various investigations done to diagnose and stage the disease when someone presents with the signs and symptoms of anal cancer.

The system utilizes 3 parameters (represented by letters – T, N, and M) for assigning a stage to anal cancer. “T” stands for “Tumor Size”, “N” for “Lymph Nodes”, “M” for “Metastasis”.

Numbers. and/or letters after T (0, is, 1, 2, 3, and 4), N (0 and 1), and M (0 and 1) provide more details about each of these parameters. Once T, N, and M categories are determined, this information is combined to assign an overall stage (from 0 to IV) to the disease.

Stage 0 (Tis N0 M0)

Pre-cancerous cells (CIS or high-grade AIN) found only in the surface layer of the anal canal. No evidence of primary tumor mass.

Stage I (T1 N0 M0)

The primary tumor is </=2 cm in size. No spread to nearby lymph nodes or distant body parts.

Stage IIA (T2 N0 M0)

The primary tumor is >2 cm but </=5 cm in size. No spread to nearby lymph nodes or distant body parts.

Stage IIB (T3 N0 M0)

The primary tumor is >5 cm in size. No spread to nearby lymph nodes or distant body parts.

Stage IIIA (T1-2 N1 M0)

The primary tumor is </=5 cm in size and it has spread to nearby lymph node(s). No spread to distant body parts.

Stage IIIB (T4 N0 M0)

The primary tumor of any size that has invaded in a nearby organ, such as the vagina, prostate gland, urethra, or bladder. No spread to nearby lymph nodes or distant body parts.

Stage IIIC (T3-4 N1 M0)

The primary tumor is >5 cm in size or it has invaded in a nearby organ and it has spread to nearby lymph node(s). No spread to distant body parts.

Stage IV (Any T Any N M1)

The primary tumor has spread to the distant site(s), such as the lung, liver, peritoneum, etc.

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