Stage Information for Penile Cancer
Definitions of TNM
Definitions of TNM The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define penile cancer.[1]
Table 1. Primary Tumor (T)a| TX | Primary tumor cannot be assessed. |
| T0 | No evidence of primary tumor. |
| Tis | Carcinoma in situ. |
| Ta | Noninvasive verrucous carcinoma.b |
| T1a | Tumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4). |
| T1b | Tumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated. |
| T2 | Tumor invades corpus spongiosum or cavernosum. |
| T3 | Tumor invades urethra. |
| T4 | Tumor invades other adjacent structures. |
| aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55. |
| bBroad pushing penetration (invasion) is permitted; destructive invasion is against this diagnosis. |
Table 2. Regional Lymph Nodes (N)a| Clinical Stage Definition b |
| cNX | Regional lymph nodes cannot be assessed. |
| cN0 | No palpable or visibly enlarged inguinal lymph nodes. |
| cN1 | Palpable mobile unilateral inguinal lymph node. |
| cN2 | Palpable mobile multiple or bilateral inguinal lymph nodes. |
| cN3 | Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral. |
| Pathologic Stage Definition c |
| pNX | Regional lymph nodes cannot be assessed. |
| pN0 | No regional lymph node metastasis. |
| pN1 | Metastasis in a single inguinal lymph node. |
| pN2 | Metastases in multiple or bilateral inguinal lymph nodes. |
| pN3 | Extranodal extension of lymph node metastasis or pelvic lymph node(s) unilateral or bilateral. |
| aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55. |
| bClinical stage definition based on palpation, imaging. |
| cPathologic stage definition based on biopsy or surgical excision. |
Table 3. Distant Metastasis (M)a| M0 | No distant metastasis. |
| M1 | Distant metastasis.b |
| aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55. |
| bLymph node metastasis outside of the true pelvis in addition to visceral or bone sites. |
Additional Descriptor. The m suffix indicates the presence of multiple primary tumors and is recorded in parentheses – e.g., pTa (m) N0M0.[1]
Table 4. Anatomic Stage/Prognostic Groupsa| Stage | T | N | M |
| aReprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55. |
| 0 | Tis | N0 | M0 |
| Ta | N0 | M0 |
| I | T1a | N0 | M0 |
| II | T1b | N0 | M0 |
| T2 | N0 | M0 |
| T3 | N0 | M0 |
| IIIa | T1–3 | N1 | M0 |
| IIIb | T1–3 | N2 | M0 |
| IV | T4 | Any N | M0 |
| Any T | N3 | M0 |
| Any T | Any N | M1 |
References - Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.
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