Stages of nonmelanoma skin cancer

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Stages of nonmelanoma skin cancer

Staging for nonmelanoma skin cancer is based on the size of the cancer, lymph node involvement, and the involvement of underlying structures, such as muscle or bone. Staging of nonmelanoma skin cancer has been classified by the American Joint Committee on Cancer (AJCC).¹

TX: Primary tumor cannot be assessed.
T0: No evidence of primary tumor.
Tis: Cancer at this stage is contained in the skin lesion (in situ).
T1: Tumor is or smaller.
T2: Tumor is larger than but not larger than .
T3: Tumor is larger than .
T4: Tumor size varies but tumor has spread deeply into muscle, cartilage, or bone.

After the tumor (T) is staged, the TNM system stages lymph node involvement (N) to help determine the treatment options at each stage. Lymph node involvement is staged in the following way:

NX: Nearby (regional) lymph nodes cannot be assessed.
N0: Cancer has not spread (metastasized) to nearby lymph nodes.
N1: Cancer has spread to nearby lymph nodes.

The last part is to determine whether cancer has spread to other parts of the body (metastasized). The TNM system stages metastasis (M) in the following way:

MX: The presence of distant metastasis cannot be assessed.
M0: Cancer has not metastasized.
M1: Cancer has metastasized.

The TNM staging system allows your doctor to recommend the most effective treatment options and discuss your long-term outcome (prognosis) based on the type of tumor, the stage of the cancer, your age, and your overall health.

The stage and TNM class are grouped in the following table.

**Nonmelanoma skin cancer stage and class**
Stage	TNM class
Stage 0	Tis, N0, M0
Stage I	T1, N0, M0
Stage II	T2 or T3, N0, M0
Stage III	T4, N0, M0 Any T, N1, M0
Stage IV	Any T, any N, M1

References

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Citations
American Joint Committee on Cancer (2002). Carcinoma of the skin (excluding eyelid, vulva, and penis). In AJCC Cancer Staging Manual, 6th ed., pp. 203–208. New York: Springer-Verlag.

Credits

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Author	Bets Davis, MFA
Editor	Maria Essig
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Alexander H. Murray, MD, FRCPC - Dermatology
Last Updated	October 14, 2008

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Last updated:	October 14, 2008
Author:	Bets Davis, MFA
Reviewed By:	Kathleen Romito, MD - Family Medicine, Alexander H. Murray, MD, FRCPC - Dermatology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC

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