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Anal cancer staging

The accepted TNM staging of anal cancer is as follows 1:

Primary tumour (T)
  • TX: primary tumour cannot be assessed
  • T0: no evidence of primary tumour
  • Tis: carcinoma in situ
  • T1: tumour 2 cm or less in greatest dimension
  • T2: tumour >2 cm but <5 cm in greatest dimension
  • T3: tumour >5 cm in greatest dimension
  • T4: tumour of any size invades adjacent organ(s), e.g. vagina urethra, bladder
Regional lymph nodes (N)
  • Nx: regional lymph nodes cannot be assessed
  • N0: no regional lymph node metastasis
  • N1: metastasis in perirectal lymph nodes(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 lymph nodes
Distant metastasis (M)
  • Mx: distant metastasis cannot be assessed
  • M0: no distant metastasis
  • M1: distant metastasis

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