Radiation Oncology/Anal canal/Staging

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Anal Cancer Staging


Staging[edit]

Current staging[edit]

AJCC 8th edition (2017)

Primary Tumor:

  • Tis - high-grade squamous intraepithelial lesion
  • T1 - 2 cm or less
  • T2 - >2 - 5 cm
  • T3 - >5 cm
  • T4 - invades adjacent organ, e.g. vagina, urethra, bladder. (invasion of the rectal wall, perirectal skin, subcutaneous tissue, or sphincter muscle is not included as T4.)

Regional Nodes:

Regional lymph nodes include: mesorectal, inguinal (superficial, deep), superior rectal (hemorrhoidal), external iliac, internal iliac (hypogastric)
  • N0 - no regional lymph node metastases
  • N1a - inguinal, mesorectal, or internal iliac lymph nodes
  • N1b - external iliac nodes
  • N1c - external iliac nodes + N1a

Distant Metastases:

  • M0 - no
  • M1 - yes

Stage grouping:

  • 0 - Tis
  • I - T1 N0
  • IIA - T2 N0
  • IIB - T3 N0
  • IIIA - T1-2 N1
  • IIIB - T4 N0
  • IIIC - T3-4 N1
  • IV - M1

Older staging systems[edit]

AJCC 7th edition (2009)

Primary Tumor:

  • Tis - carcinoma in situ
  • T1 - 2 cm or less
  • T2 - 2 - 5 cm
  • T3 - >5 cm
  • T4 - invades adjacent organ, e.g. vagina, urethra, bladder. (invasion of the rectal wall, perirectal skin, subcutaneous tissue, or sphincter muscle is not included as T4.)

Regional Nodes:

Regional lymph nodes include: perirectal, lateral sacral, internal iliac (hypogastric), inguinal
  • N0 - no lymph nodes
  • N1 - perirectal lymph nodes
  • N2 - unilateral internal iliac or (unilateral) inguinal lymph nodes or both
  • N3 - perirectal AND inguinal lymph nodes; and/or bilateral internal iliac; and/or (bilateral) inguinal lymph nodes

Distant Metastases:

  • M0 - no
  • M1 - yes

Stage grouping:

  • 0 - Tis
  • I - T1 N0
  • II - T2-3 N0
  • IIIA - T1-3 N1, T4 N0
  • IIIB - T4 N1, Any N2, Any N3
  • IV - M1

AJCC 6th Edition (2002)
No changes compared to 7th edition