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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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