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Penile Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Penile Cancer

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

a Reprinted 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.
b Broad pushing penetration (invasion) is permitted; destructive invasion is against this diagnosis.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
TisCarcinomain situ.
TaNoninvasive verrucous carcinoma.b
T1aTumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4).
T1bTumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated.
T2Tumor invades corpus spongiosum or cavernosum.
T3Tumor invades urethra.
T4Tumor invades other adjacent structures.

Table 2. Regional Lymph Nodes (N)a

a Reprinted 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.
b Clinical stage definition based on palpation, imaging.
c Pathologic stage definition based on biopsy or surgical excision.
Clinical Stage Definitionb
cNXRegional lymph nodes cannot be assessed.
cN0No palpable or visibly enlarged inguinal lymph nodes.
cN1Palpable mobile unilateral inguinal lymph node.
cN2Palpable mobile multiple or bilateral inguinal lymph nodes.
cN3Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral.
Pathologic Stage Definitionc
pNXRegional lymph nodes cannot be assessed.
pN0No regional lymph node metastasis.
pN1Metastasis in a single inguinal lymph node.
pN2Metastases in multiple or bilateral inguinal lymph nodes.
pN3Extranodal extension of lymph node metastasis or pelvic lymph node(s) unilateral or bilateral.

Table 3. Distant Metastasis (M)a

a Reprinted 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.
b Lymph node metastasis outside of the true pelvis in addition to visceral or bone sites.
M0No distant metastasis.
M1Distant metastasis.b

Additional Descriptor. The m suffix indicates the presence of multiple primary tumors and is recorded in parentheses – e.g., pTa (m) N0M0.[1]

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