TNM 7 classification
TNM 6 classification
1. Rules for Classification
The anal canal extends from rectum to perianal skin (to the junction with hair-bearing
skin). It is lined by the mucous membrane overlying the internal sphincter,
including the transitional epithelium and dentate line. Tumours of anal margin
(ICD-O C44.5) are classified with skin tumours.
The classification applies only to carcinomas. There should be histological confirmation of the disease.
The following are the procedures for assessing T, N, and M categories.
T categories. Physical examination, imaging, endoscopy, and/or surgical exploration
N categories. Physical examination, imaging, and/or surgical exploration
M categories. Physical examination, imaging, and/or surgical exploration
2. Regional Lymph Nodes
The regional lymph nodes are the perirectal, the internal iliac, and the inguinal lymph nodes.
3. TNM Clinical Classification
3.1. T - Primary Tumour
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 more than 2 cm but not more than 5 cm in greatest dimension
T3. Tumour more than 5 cm in greatest dimension
T4. Tumour of any size invades adjacent organ(s), e.g., vagina, urethra, bladder
Note: Direct invasion of the rectal wall, perirectal skin, subcutaneous tissue,
or the sphincter muscle(s) alone is not classified as T4.
3.2. N - Regional Lymph Nodes
NX. Regional lymph nodes cannot be assessed
N0. No regional lymph node metastasis
N1. Metastasis in perirectal lymph node(s)
N2. Metastasis in unilateral internal iliac and/or unilateral inguinal lymph node(s)
N3. Metastasis in perirectal and inguinal lymph nodes and/or bilateral internal iliac and/or bilateral inguinal lymph nodes
3.3. M - Distant Metastasis
MX. Distant metastasis cannot be assessed
M0. No distant metastasis
M1. Distant metastasis
4. pTNM Pathological Classification
The pT, pN, and pM categories correspond to the T, N, and M categories.
pN0. Histological examination of a regional perirectal-pelvic lymphadenectomy
specimen will ordinarily include 12 or more lymph nodes; histological examination
of an inguinal lymphadenectomy specimen will ordinarily include 6 or more lymph
nodes. If the lymph nodes are negative, but the number ordinarily examined is
not met, classify as pN0.
5. G Histopathological Grading
See definitions on Digestive System.
6. Stage Grouping
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7. Summary
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