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Cancer Health Center

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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.
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.

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 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.

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.
M0 No distant metastasis.
M1 Distant 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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