TNM STAGING

T Category	T Criteria
TX	Primary tumor cannot be identified
Tis	Carcinoma in situ
T1	Tumor smaller than 2 cm in greatest dimension
T2	Tumor 2 cm or larger, but smaller than 4 cm in greatest dimension
T3	Tumor 4 cm or larger in maximum dimension or minor bone erosion or perineural invasion or deep invasion
T4	Tumor with gross cortical bone/marrow, skull base invasion and/or skull base foramen invasion
T4a	Tumor with gross cortical bone/marrow invasion
T4b	Tumor with skull base invasion and/or skull base foramen involvement

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Single ipsilateral lymph node ≤3 cm, ENE(−)
N2	Single ipsilateral node 3–6 cm & ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Single ipsilateral lymph node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in any node(s) and clinically overt ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in any node(s) and clinically overt ENE(+)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in single ipsilateral or contralateral node 3 cm or smaller in greatest dimension and ENE(+); or a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes and any with ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes and any with ENE(+)

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

T Category Tis T1 T2 T3 T4 Any T N Category N0 N1 N2 N3 Any N M Category M0 M1 Calculate Stage

Supraglottis

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor limited to one subsite of supraglottis with normal vocal cord mobility
T2	Tumor invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynx
T3	Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, preepiglottic space, paraglottic space, and/or inner cortex of thyroid cartilage
T4	Moderately advanced or very advanced
T4a	Moderately advanced local disease Tumor invades through the outer cortex of the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus)
T4b	Very advanced local disease Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures

Glottis

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor limited to the vocal cord(s) (may involve anterior or posterior commissure) with normal mobility
T1a	Tumor limited to one vocal cord
T1b	Tumor involves both vocal cords
T2	Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility
T3	Tumor limited to the larynx with vocal cord fixation and/or invasion of paraglottic space and/or inner cortex of the thyroid cartilage
T4	Moderately advanced or very advanced
T4a	Moderately advanced local disease Tumor invades through the outer cortex of the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, cricoid cartilage, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus)
T4b	Very advanced local disease Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures

Subglottis

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor limited to the subglottis
T2	Tumor extends to vocal cord(s) with normal or impaired mobility
T3	Tumor limited to larynx with vocal cord fixation and/or invasion of paraglottic space and/or inner cortex of the thyroid cartilage
T4	Moderately advanced or very advanced
T4a	Moderately advanced local disease Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus)
T4b	Very advanced local disease Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node, larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral lymph node, larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node, larger than 6 cm in greatest dimension and ENE(−); or metastasis in any lymph node(s) with clinically overt ENE [ENE(+)]
N3a	Metastasis in a lymph node, larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in any lymph node(s) with clinically overt ENE(+)

Note: A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(−) or ENE(+).

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or metastasis in a single ipsilateral lymph node, larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral or contralateral node, 3 cm or smaller in greatest dimension and ENE(+); or metastasis in a single ipsilateral node, larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node, larger than 6 cm in greatest dimension and ENE(−); or metastasis in a single ipsilateral node, larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes and any with ENE(+)
N3a	Metastasis in a lymph node, larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in a single ipsilateral node, larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes and any with ENE(+)

Note: A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(−) or ENE(+).

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T1, T2, T3	N1	M0	III
T4a	N0, N1	M0	IVA
T1, T2, T3, T4a	N2	M0	IVA
Any T	N3	M0	IVB
T4b	Any N	M0	IVB
Any T	Any N	M1	IVC

Calculator

T Category Tis T1 T2 T3 T4a T4b N Category N0 N1 N2 N3 M Category M0 M1 Calculate Larynx Stage

Oropharynx (p16−)

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor 2 cm or smaller in greatest dimension
T2	Tumor larger than 2 cm but not larger than 4 cm in greatest dimension
T3	Tumor larger than 4 cm in greatest dimension or extension to lingual surface of epiglottis
T4	Moderately advanced or very advanced local disease
T4a	Moderately advanced local disease Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible*
T4b	Very advanced local disease Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery

*Note: Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of the larynx.

Hypopharynx

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor limited to one subsite of hypopharynx and/or 2 cm or smaller in greatest dimension
T2	Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures larger than 2 cm but not larger than 4 cm in greatest dimension without fixation of hemilarynx
T3	Tumor larger than 4 cm in greatest dimension or with fixation of hemilarynx or extension to esophagus
T4	Moderately advanced and very advanced local disease
T4a	Moderately advanced local disease Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, or central compartment soft tissue*
T4b	Very advanced local disease Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures

*Note: Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat.

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in any node(s) and clinically overt ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in any node(s) and clinically overt ENE(+)

Note: A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(−) or ENE(+).

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in single ipsilateral or contralateral node 3 cm or smaller in greatest dimension and ENE(+); or a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or multiple ipsilateral, contralateral, or bilateral nodes, any with ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes, any with ENE(+)

Note: A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(−) or ENE(+).

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T1, T2, T3	N1	M0	III
T4a	N0, N1	M0	IVA
T1, T2, T3, T4a	N2	M0	IVA
Any T	N3	M0	IVB
T4b	Any N	M0	IVB
Any T	Any N	M1	IVC

Calculator

T Category Tis T1 T2 T3 T4a T4b N Category N0 N1 N2 N3 M Category M0 M1 Calculate Oropharynx/Hypopharynx Stage

T Category	T Criteria
T0	No primary identified
T1	Tumor 2 cm or smaller in greatest dimension
T2	Tumor larger than 2 cm but not larger than 4 cm in greatest dimension
T3	Tumor larger than 4 cm in greatest dimension or extension to lingual surface of epiglottis
T4	Moderately advanced local disease Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible or beyond*

*Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of the larynx.

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	One or more ipsilateral lymph nodes, none larger than 6 cm
N2	Contralateral or bilateral lymph nodes, none larger than 6 cm
N3	Lymph node(s) larger than 6 cm

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
pN0	No regional lymph node metastasis
pN1	Metastasis in 4 or fewer lymph nodes
pN2	Metastasis in more than 4 lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then stage is…
T0, T1 or T2	N0 or N1	M0	I
T0, T1 or T2	N2	M0	II
T3	N0, N1 or N2	M0	II
T0, T1, T2, T3 or T4	N3	M0	III
T4	N0, N1, N2 or N3	M0	III
Any T	Any N	M1	IV

Calculator

T Category T0 T1 T2 T3 T4 N Category N0 N1 N2 N3 M Category M0 M1 Calculate Clinical Stage

When T is…	And N is…	And M is…	Then stage is…
T0, T1 or T2	N0, N1	M0	I
T0, T1 or T2	N2	M0	II
T3 or T4	N0, N1	M0	II
T3 or T4	N2	M0	III
Any T	Any N	M1	IV

Calculator

T Category T0 T1 T2 T3 T4 N Category N0 N1 N2 M Category M0 M1 Calculate Pathological Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No tumor identified, but EBV-positive cervical node(s) involvement
T1	Tumor confined to nasopharynx, or extension to oropharynx and/or nasal cavity without parapharyngeal involvement
T2	Tumor with extension to parapharyngeal space, and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles)
T3	Tumor with infiltration of bony structures at skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4	Tumor with intracranial extension, involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Unilateral metastasis in cervical lymph node(s) and/or unilateral or bilateral metastasis in retropharyngeal lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N2	Bilateral metastasis in cervical lymph nodes, 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N3	Unilateral or bilateral metastasis in cervical lymph node(s), larger than 6 cm in greatest dimension, and/or extension below the caudal border of cricoid cartilage

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	Stage 0
T1	N0	M0	Stage I
T1, T0	N1	M0	Stage II
T2	N0	M0	Stage II
T2	N1	M0	Stage II
T1, T0	N2	M0	Stage III
T3	N0	M0	Stage III
T3	N1	M0	Stage III
T3	N2	M0	Stage III
T4	N0	M0	Stage IVA
T4	N1	M0	Stage IVA
T4	N2	M0	Stage IVA
Any T	N3	M0	Stage IVA
Any T	Any N	M1	Stage IVB

Calculator

T Category Tis T0 T1 T2 T3 T4 N Category N0 N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Tumor cannot be assessed
T0	No evidence of primary tumor
Tis	High-grade dysplasia, defined as malignant cells confined to the epithelium by the basement membrane
T1	Tumor invades the lamina propria, muscularis mucosae, or submucosa
T1a	Tumor invades the lamina propria or muscularis mucosae
T1b	Tumor invades the submucosa
T2	Tumor invades the muscularis propria
T3	Tumor invades adventitia
T4	Tumor invades adjacent structures
T4a	Tumor invades the pleura, pericardium, azygos vein, diaphragm, or peritoneum
T4b	Tumor invades other adjacent structures, such as the aorta, vertebral body, or airway

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in one or two regional lymph nodes
N2	Metastasis in three to six regional lymph nodes
N3	Metastasis in seven or more regional lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And cN is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0–1	M0	I
T2	N0–1	M0	II
T3	N0	M0	II
T3	N1	M0	III
T1–3	N2	M0	III
T4	N0–2	M0	IVA
Any T	N3	M0	IVA
Any T	Any N	M1	IVB

Calculator

T Category Tis T1 T2 T3 T4 AnyT N Category N0 N1 N2 N3 AnyN M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis (DCIS)	Ductal carcinoma in situ
Tis (Paget)	Paget disease of the nipple NOT associated with invasive carcinoma and/or carcinoma in situ (DCIS) in underlying parenchyma
T1	Tumor ≤ 20 mm in greatest dimension
T1mi	Tumor ≤ 1 mm in greatest dimension
T1a	Tumor > 1 mm but ≤ 5 mm
T1b	Tumor > 5 mm but ≤ 10 mm
T1c	Tumor > 10 mm but ≤ 20 mm
T2	Tumor > 20 mm but ≤ 50 mm
T3	Tumor > 50 mm
T4	Tumor of any size with direct extension to chest wall and/or skin (ulceration or macroscopic nodules)
T4a	Extension to chest wall
T4b	Ulceration/ipsilateral macroscopic satellite nodules/edema (peau d’orange)
T4c	T4a and T4b combined
T4d	Inflammatory carcinoma

cN Category	cN Criteria
cNX	Regional lymph nodes cannot be assessed
cN0	No regional lymph node metastases
cN1	Metastases to movable ipsilateral Level I, II axillary lymph nodes
cN1mi	Micrometastases (>0.2 mm but none >2.0 mm)
cN2	Metastases in ipsilateral Level I, II axillary lymph nodes that are clinically fixed/matted; OR in ipsilateral internal mammary nodes (in absence of axillary metastases)
cN2a	Metastases in ipsilateral Level I, II axillary lymph nodes fixed together or to structures
cN3	Metastases in ipsilateral infraclavicular (Level III) lymph nodes OR ipsilateral internal mammary nodes with Level I/II involvement OR ipsilateral supraclavicular nodes
cN3a	Metastases in ipsilateral infraclavicular lymph nodes
cN3b	Metastases in ipsilateral internal mammary nodes with axillary involvement
cN3c	Metastases in ipsilateral supraclavicular lymph nodes

pN Category	pN Criteria
pNX	Regional lymph nodes cannot be assessed
pN0	No regional lymph node metastasis
pN0(i+)	Isolated tumor cell clusters ≤ 0.2 mm
pN0(mol+)	Positive molecular findings, no ITCs detected
pN1	Micrometastases OR 1–3 axillary nodes OR internal mammary micrometastases
pN1mi	Micrometastases (≤2.0 mm, >0.2 mm)
pN1a	1–3 axillary nodes (>2.0 mm)
pN1b	Internal mammary sentinel nodes (excluding ITCs)
pN1c	Combination of pN1a + pN1b
pN2	4–9 axillary nodes OR positive internal mammary nodes
pN2a	4–9 axillary nodes (>2.0 mm)
pN2b	Internal mammary nodes with or without axillary metastases
pN3	10+ axillary nodes OR infraclavicular nodes OR internal mammary nodes (with axillary involvement) OR supraclavicular nodes
pN3a	Infraclavicular lymph nodes
pN3b	Internal mammary nodes + axillary involvement
pN3c	Supraclavicular lymph nodes

M Category	M Criteria
M0	No clinical or radiographic evidence of distant metastases cM0(i+): Tumor cells ≤ 0.2 mm detected microscopically in blood, bone marrow, or nonregional nodes WITHOUT symptoms
M1	Distant metastasis detected clinically/radiographically OR histologically proven metastases >0.2 mm

When T is…	And N is…	And M is…	Stage Group
Tis	N0	M0	0
T1	N0	M0	IA
T0	N1mi	M0	IB
T1	N1mi	M0	IB
T0	N1	M0	IIA
T1	N1	M0	IIA
T2	N0	M0	IIA
T2	N1	M0	IIB
T3	N0	M0	IIB
T0	N2	M0	IIIA
T1	N2	M0	IIIA
T2	N2	M0	IIIA
T3	N1	M0	IIIA
T3	N2	M0	IIIA
T4	N0	M0	IIIB
T4	N1	M0	IIIB
T4	N2	M0	IIIB
Any T	N3	M0	IIIC
Any T	Any N	M1	IV

Calculator

T Category Tis T0 T1 T1mi T1a T1b T1c T2 T3 T4 N Category N0 N1 N1mi N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ, intramucosal carcinoma (involvement of lamina propria with no extension through muscularis mucosae)
T1	Tumor invades the submucosa (through the muscularis mucosa but into the muscularis propria)
T2	Tumor invades the muscularis propria
T3	Tumor invades through the muscularis propria into pericolorectal tissues
T4	Tumor invades the visceral peritoneum or invades or adheres to adjacent organ or structure
T4a	Tumor invades through the visceral peritoneum (including gross perforation of the bowel through tumor and continuous invasion of tumor through areas of inflammation to the surface of the visceral peritoneum)
T4b	Tumor directly invades or adheres to adjacent organs or structures

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	One to three regional lymph nodes are positive (tumor in lymph nodes measuring ≥0.2 mm), or any number of tumor deposits are present and all identifiable lymph nodes are negative
N1a	One regional lymph node is positive
N1b	Two or three regional lymph nodes are positive
N1c	No regional lymph nodes are positive, but there are tumor deposits in the subserosa, mesentery, or nonperitonealized pericolic, or perirectal/mesorectal tissues
N2	Four or more regional lymph nodes are positive
N2a	Four to six regional lymph nodes are positive
N2b	Seven or more regional lymph nodes are positive

M Category	M Criteria
M0	No distant metastasis by imaging, etc.; no evidence of tumor in distant sites or organs (This category is not assigned by pathologists.)
M1	Metastasis to one or more distant sites or organs or peritoneal metastasis is identified
M1a	Metastasis to one site or organ is identified without peritoneal metastasis
M1b	Metastasis to two or more sites or organs is identified without peritoneal metastasis
M1c	Metastasis to the peritoneal surface is identified alone or with other site or organ metastases

AJCC PROGNOSTIC STAGE GROUPS

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1, T2	N0	M0	I
T3	N0	M0	IIA
T4a	N0	M0	IIB
T4b	N0	M0	IIC
T1–T2	N1/N1c	M0	IIIA
T1	N2a	M0	IIIA
T3–T4a	N1/N1c	M0	IIIB
T2–T3	N2a	M0	IIIB
T1–T2	N2b	M0	IIIB
T3	N2b	M0	IIIB
T4a	N2a	M0	IIIC
T3	N2	M0	IIIC
T4b	N1–N2	M0	IIIC
Any T	Any N	M1a	IVA
Any T	Any N	M1b	IVB
Any T	Any N	M1c	IVC

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Stage Calculator

T Category Tis T1 T2 T3 T4a T4b N Category N0 N1 N1a N1b N1c N2 N2a N2b M Category M0 M1a M1b M1c Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor ≤2 cm, ≤5 mm depth of invasion (DOI). DOI is depth of invasion and not tumor thickness.
T2	Tumor ≤2 cm, DOI >5 mm and ≤10 mm OR tumor >2 cm but ≤4 cm, and ≤10 mm DOI
T3	Tumor >4 cm OR any tumor >10 mm DOI
T4	Moderately advanced or very advanced local disease
T4a	Moderately advanced local disease (lip): Tumor invades through cortical bone or involves the inferior alveolar nerve, floor of mouth, or skin of face (i.e., chin or nose). (oral cavity) Tumor involves adjacent structures only (e.g., through cortical bone of mandible or maxilla, or involves maxillary sinus or skin of the face). Note: Superficial erosion of bone/tooth socket alone by a gingival primary is NOT sufficient to classify a tumor as T4.
T4b	Very advanced local disease. Tumor invades masticator space, pterygoid plates, or skull base and/or encases the internal carotid artery.

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in single ipsilateral node >3 cm but ≤6 cm & ENE(−); OR multiple ipsilateral nodes, none >6 cm & ENE(−); OR bilateral/contralateral nodes, none >6 cm & ENE(−)
N2a	Single ipsilateral node >3 cm but ≤6 cm & ENE(−)
N2b	Multiple ipsilateral nodes, none >6 cm, ENE(−)
N2c	Bilateral or contralateral lymph nodes, none >6 cm, ENE(−)
N3	Lymph node >6 cm in greatest dimension & ENE(−); OR metastasis in any node(s) with clinically overt ENE(+)
N3a	Metastasis in node >6 cm, ENE(−)
N3b	Metastasis in any node(s) with clinically overt ENE(+)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node, 3 cm or smaller & ENE(+); OR a single ipsilateral node >3 cm but ≤6 cm & ENE(−); OR metastases in multiple ipsilateral nodes none >6 cm & ENE(−); OR metastasis in bilateral/contralateral nodes none >6 cm & ENE(−)
N2a	Single ipsilateral or contralateral node ≤3 cm & ENE(+); OR single ipsilateral node >3 cm but ≤6 cm & ENE(−)
N2b	Metastases in multiple ipsilateral nodes, none >6 cm and ENE(−)
N2c	Metastases in bilateral or contralateral lymph nodes, none >6 cm and ENE(−)
N3	Metastasis in node >6 cm & ENE(−); OR metastasis in ipsilateral node >3 cm & ENE(+); OR multiple ipsilateral/contralateral/bilateral nodes with ENE(+)
N3a	Metastasis in node >6 cm and ENE(−)
N3b	Metastasis in any node(s) with ENE(+)

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS

When T is…	And N is…	And M is…	Stage
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T1,2,3	N1	M0	III
T4a	N0,1	M0	IVA
T1,2,3,4a	N2	M0	IVA
Any T	N3	M0	IVB
T4b	Any N	M0	IVB
Any T	Any N	M1	IVC

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Stage Calculator

T Category T1 T2 T3 T4a T4b N Category N0 N1 N2 N3 M Category M0 M1 Calculate Stage

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in any node(s) with clinically overt ENE(+)

Note: A designation of "U" or "L" may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(−) or ENE(+).

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral or contralateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm ... and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral or contralateral node 3 cm or smaller in greatest dimension and ENE(+); or a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral lymph nodes, none larger than 6 cm and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in any node(s) and clinically overt ENE (ENE(+))
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−)
N3b	Metastasis in any lymph node(s) with clinically overt ENE(+)

Notes: Midline nodes are considered ipsilateral nodes.
ENE is defined as invasion of skin, infiltration of musculature, dense tethering or fixation to adjacent structures, or cranial nerve, brachial plexus, sympathetic trunk, or phrenic nerve invasion with dysfunction. ENE detected on histopathologic exam is designated as ENE_mi (microscopic ENE ≤ 2 mm) or ENE_ma (major ENE > 2 mm). Both qualify as ENE(+).

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS (Tumors of Unknown Primary)

When T is…	And N is…	And M is…	Then the stage group is…
T0	N1	M0	III
T0	N2	M0	IVA
T0	N3	M0	IVB
T0	Any N	M1	IVC

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Calculator

Note: Unknown primary staging uses T0 (by definition). Choose N (clinical or pathologic) and M then Calculate.

N Category -- select N -- N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor 2 cm or smaller in greatest dimension without extraparenchymal extension
T2	Tumor >2 cm but not larger than 4 cm in greatest dimension without extraparenchymal extension
T3	Tumor >4 cm and/or with extraparenchymal extension
T4a	Moderately advanced local disease — tumor invades skin, mandible, ear canal, facial nerve, or soft tissues beyond the gland
T4b	Very advanced local disease — tumor invades skull base, pterygoid plates, encases carotid artery, or invades the brain

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm and ENE(−)
N2b	Metastases in multiple ipsilateral lymph nodes, none larger than 6 cm and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and/or any node(s) with clinically overt ENE(+)

Note: A designation of "U" or "L" may be used to indicate metastasis above (U) or below (L) the lower border of the cricoid. Clinical ENE should be recorded as ENE(−) or ENE(+).

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed (e.g., not removed)
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral or contralateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm and ENE(−); or bilateral/contralateral lymph nodes none larger than 6 cm and ENE(−)
N2a	Metastasis in a single ipsilateral/contralateral node 3 cm or smaller and ENE(+); or single ipsilateral node >3 cm but ≤6 cm and ENE(−)
N2b	Metastases in multiple ipsilateral nodes none larger than 6 cm and ENE(−)
N2c	Metastases in bilateral or contralateral nodes none larger than 6 cm and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or any node(s) with ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm and ENE(−)
N3b	Metastasis in any node(s) with ENE(+)

Note: Pathological ENE should be recorded as ENE(−), ENE_mi (microscopic ≤2 mm) or ENE_ma (>2 mm), and both qualify as ENE(+).

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS — Major Salivary Glands

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T1, T2, T3	N1	M0	III
T4a	N0, N1	M0	IVA
T1, T2, T3, T4a	N2	M0	IVA
Any T	N3	M0	IVB
T4b	Any N	M0	IVB
Any T	Any N	M1	IVC

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Calculator

Select T, N and M (use clinical or pathological N as appropriate) and click Calculate.

T Category -- select T -- T1 T2 T3 T4a T4b N Category -- select N -- N0 N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor limited to maxillary sinus mucosa with no erosion or destruction of bone
T2	Tumor causing bone erosion or destruction including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of maxillary sinus and pterygoid plates
T3	Tumor invades any of the following: bone of the posterior wall of maxillary sinus, subcutaneous tissues, floor or medial wall of orbit, pterygoid fossa, ethmoid sinuses
T4	Moderately advanced or very advanced local disease
T4a	Moderately advanced local disease — Tumor invades anterior orbital contents, skin of cheek, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid or frontal sinuses
T4b	Very advanced local disease — Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus

T Category	T Criteria
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor restricted to any one subsite, with or without bony invasion
T2	Tumor invading two subsites in a single region or extending to involve an adjacent region within the nasoethmoidal complex, with or without bony invasion
T3	Tumor extends to invade the medial wall or floor of the orbit, maxillary sinus, palate, or cribriform plate
T4	Moderately advanced or very advanced local disease
T4a	Moderately advanced local disease — Tumor invades any of the following: anterior orbital contents, skin of nose or cheek, minimal extension to anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses
T4b	Very advanced local disease — Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than (V2), nasopharynx, or clivus

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral lymph node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(−)
N2a	Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−)
N2b	Metastasis in multiple ipsilateral lymph nodes, none larger than 6 cm and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and/or any node(s) with clinically overt ENE(+)

Note: A designation of "U" (upper) or "L" (lower) may be used for any N category to indicate metastasis above or below the lower border of the cricoid. Clinical ENE should be recorded as ENE(−) or ENE(+).

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(−)
N2	Metastasis in a single ipsilateral or contralateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(−); or metastases in multiple ipsilateral lymph nodes none larger than 6 cm and ENE(−); or bilateral/contralateral lymph nodes none larger than 6 cm and ENE(−).
N2a	Metastasis in a single ipsilateral or contralateral node 3 cm or smaller in greatest dimension and ENE(+); or a single ipsilateral node larger than 3 cm but ≤ 6 cm and ENE(−)
N2b	Metastasis in multiple ipsilateral nodes, none larger than 6 cm and ENE(−)
N2c	Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm and ENE(−)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(−); or metastasis in any node(s) with clinically overt ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm and ENE(−)
N3b	Metastasis in any node(s) with ENE(+)

Notes: ENE detected on histopathologic exam may be recorded as ENE_mi (microscopic ≤2 mm) or ENE_ma (>2 mm). Both are recorded as ENE(+).

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS — Nasal Cavity & Paranasal Sinus

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T1, T2, T3	N1	M0	III
T4a	N0, N1	M0	IVA
T1, T2, T3, T4a	N2	M0	IVA
Any T	N3	M0	IVB
T4b	Any N	M0	IVB
Any T	Any N	M1	IVC

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Calculator

Select T, N and M then click Calculate. (Use clinical or pathological N as required.)

T Category -- select T -- T1 T2 T3 T4a T4b N Category -- select N -- N0 N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria; high-grade dysplasia
T1	Tumor invades the lamina propria, muscularis mucosae, or submucosa
T1a	Tumor invades the lamina propria or muscularis mucosae
T1b	Tumor invades the submucosa
T2	Tumor invades the muscularis propria
T3	Tumor penetrates the subserosal connective tissue without invasion of visceral peritoneum or adjacent structures
T4	Tumor invades the serosa (visceral peritoneum) or adjacent structures
T4a	Tumor invades the serosa (visceral peritoneum)
T4b	Tumor invades adjacent structures/organs

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in one or two regional lymph nodes
N2	Metastasis in three to six regional lymph nodes
N3	Metastasis in seven or more regional lymph nodes
N3a	Metastasis in 7–15 regional lymph nodes
N3b	Metastasis in ≥16 regional lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

Clinical (cTNM) — AJCC Prognostic Stage Groups

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0	M0	I
T2	N0	M0	II
T1	N1, N2, or N3	M0	IIA
T2	N1, N2, or N3	M0	IIA
T3	N0	M0	IIB
T4a	N0	M0	IIB
T3	N1, N2, or N3	M0	III
T4a	N1, N2, or N3	M0	III
T4b	Any N	M0	IVA
Any T	Any N	M1	IVB

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Pathological (pTNM) — AJCC Prognostic Stage Groups

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0	M0	IA
T1	N1	M0	IB
T2	N0	M0	IB
T1	N2	M0	IIA
T2	N1	M0	IIA
T3	N0	M0	IIA
T1	N3a	M0	IIB
T2	N2	M0	IIB
T3	N1	M0	IIB
T4a	N0	M0	IIB
T2	N3a	M0	IIIA
T3	N2	M0	IIIA
T4a	N1	M0	IIIA
T3	N3a	M0	IIIB
T4a	N3a	M0	IIIB
T4b	N1	M0	IIIB
T4b	N2	M0	IIIB
T3	N3b	M0	IIIC
T4a	N3b	M0	IIIC
T4b	N3a	M0	IIIC
T4b	N3b	M0	IIIC
Any T	Any N	M1	IV

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Post-Neoadjuvant Therapy (ypTNM) — AJCC Prognostic Stage Groups

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	I
T2	N0	M0	I
T1	N1	M0	I
T3	N0	M0	II
T2	N1	M0	II
T1	N2	M0	II
T4a	N0	M0	II
T3	N1	M0	II
T2	N2	M0	II
T1	N3	M0	II
T4a	N1	M0	III
T3	N2	M0	III
T2	N3	M0	III
T4b	N0	M0	III
T4b	N1	M0	III
T4a	N2	M0	III
Any T	Any N	M1	IV

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Staging Calculator

Select the staging type (Clinical / Pathological / Post-neoadjuvant), then choose T, N and M and click Calculate. The calculator uses the AJCC mapping shown above. For combinations not explicitly listed above it will return "Not defined for this combination".

Staging type Clinical (cTNM) Pathological (pTNM) Post-Neoadjuvant (ypTNM) T Category -- select T -- Tis T0 T1 T1a T1b T2 T3 T4a T4b N Category -- select N -- N0 N1 N2 N3 N3a N3b M Category -- select M -- M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	High-grade dysplasia / carcinoma in situ
T1	Tumor invades the lamina propria or submucosa
T1a	Tumor invades the lamina propria
T1b	Tumor invades the submucosa
T2	Tumor invades the muscularis propria
T3	Tumor invades through the muscularis propria into the subserosa, or extends into nonperitonealized perimuscular tissue (mesentery or retroperitoneum) without serosal penetration
T4	Tumor perforates the visceral peritoneum or directly invades other organs/structures (e.g., adjacent loops of small intestine, mesentery of adjacent loops, omentum, invasion of pancreas or bile duct for duodenal tumors)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in one or two regional lymph nodes
N2	Metastasis in three or more regional lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis present

Prognostic Stage Groups (Adenocarcinoma)

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1–2	N0	M0	I
T3	N0	M0	IIA
T4	N0	M0	IIB
Any T	N1	M0	IIIA
Any T	N2	M0	IIIB
Any T	Any N	M1	IV

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Calculator

Select T, N and M exactly as defined above and click Calculate.

T Category -- select T -- Tis T1 T1a T1b T2 T3 T4 N Category -- select N -- N0 N1 N2 M Category -- select M -- M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	High-grade dysplasia / carcinoma in situ (intramucosal carcinoma)
Tis (LAMN)	Low-grade appendiceal mucinous neoplasm confined by the muscularis propria (LAMN)
T1	Tumor invades the submucosa (through the muscularis mucosa but not into the muscularis propria)
T2	Tumor invades the muscularis propria
T3	Tumor invades through the muscularis propria into the subserosa or the mesoappendix
T4	Tumor invades the visceral peritoneum, including acellular mucin or mucinous epithelium involving the serosa or directly invades other organs/structures
T4a	Tumor invades through the visceral peritoneum (including acellular mucin or mucinous epithelium involving serosa of appendix or mesoappendix)
T4b	Tumor directly invades or adheres to adjacent organs or structures

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	One to three regional lymph nodes are positive (tumor in lymph nodes ≥0.2 mm) or any number of tumor deposits present and all identifiable nodes are negative
N1a	One regional lymph node is positive
N1b	Two or three regional lymph nodes are positive
N1c	No regional lymph nodes are positive, but tumor deposits are present in subserosa or mesentery
N2	Four or more regional lymph nodes are positive

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis present
M1a	Intraperitoneal acellular mucin without identifiable tumor cells in disseminated peritoneal mucinous deposits
M1b	Intraperitoneal metastasis only, including peritoneal mucinous deposits containing tumor cells
M1c	Metastasis to sites other than peritoneum

G	G Definition
GX	Grade cannot be assessed
G1	Well differentiated
G2	Moderately differentiated
G3	Poorly differentiated

AJCC PROGNOSTIC STAGE GROUPS (Appendix)

When T is…	And N is…	And M is…	And grade is…	Then the stage group is…
Tis	N0	M0	—	0
Tis (LAMN)	N0	M0	—	0
T1	N0	M0	—	I
T2	N0	M0	—	I
T3	N0	M0	—	IIA
T4a	N0	M0	—	IIB
T4b	N0	M0	—	IIC
T1	N1	M0	—	IIIA
T2	N1	M0	—	IIIA
T3	N1	M0	—	IIIB
T4	N1	M0	—	IIIB
Any T	N2	M0	—	IIIC
Any T	N0	M1a	—	IVA
Any T	Any N	M1b	G1	IVA
Any T	Any N	M1b	G2, G3, or GX	IVB
Any T	Any N	M1c	Any G	IVC

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Calculator

Select T, N, M and Histologic Grade (G) and click Calculate. The calculator maps to the AJCC table above.

T Category -- select T -- Tis Tis (LAMN) T1 T2 T3 T4a T4b T4 N Category -- select N -- N0 N1 N1a N1b N1c N2 M Category -- select M -- M0 M1a M1b M1c Histologic Grade (G) -- select grade -- GX G1 G2 G3 Calculate

T Category	T Criteria
TX	Primary tumor not assessed
T0	No evidence of primary tumor
Tis	High-grade squamous intraepithelial lesion (carcinoma in situ)
T1	Tumor ≤ 2 cm
T2	Tumor >2 cm but ≤5 cm
T3	Tumor >5 cm
T4	Tumor of any size invading adjacent organs (e.g., vagina, urethra, bladder)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in inguinal, mesorectal, internal iliac, or external iliac nodes
N1a	Metastasis in inguinal, mesorectal, or internal iliac lymph nodes
N1b	Metastasis in external iliac lymph nodes
N1c	Metastasis in external iliac with any N1a nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS — Anus

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0
T1	N0	M0	I
T1	N1	M0	IIIA
T2	N0	M0	IIA
T2	N1	M0	IIIA
T3	N0	M0	IIB
T3	N1	M0	IIIC
T4	N0	M0	IIIB
T4	N1	M0	IIIC
Any T	Any N	M1	IV

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T Category -- select T -- Tis T0 T1 T2 T3 T4 N Category -- select N -- N0 N1 N1a N1b N1c NX M Category -- select M -- M0 M1 Calculate Stage

T Category	T Description
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	— (in situ)
T1	Tumor encapsulated or extending into the mediastinal fat; may involve the mediastinal pleura
T1a	Tumor with no mediastinal pleura involvement
T1b	Tumor with direct invasion of mediastinal pleura
T2	Tumor with direct invasion of the pericardium (either partial or full thickness)
T3	Tumor with direct invasion into any of the following: lung, brachiocephalic vein, superior vena cava, phrenic nerve, chest wall, or extrapleural pulmonary artery or veins
T4	Tumor with invasion into any of the following: aorta (ascending, arch, or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus

N Category	N Description
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in anterior (perithymic) lymph nodes
N2	Metastasis in deep intrathoracic or cervical lymph nodes

*Involvement should be microscopically confirmed in pathologic staging, if possible.

M Category	M Description
M0	No pleural, pericardial, or distant metastasis
M1	Pleural, pericardial, or distant metastasis
M1a	Separate pleural or pericardial nodule(s)
M1b	Pulmonary intraparenchymal nodule or distant organ metastasis

AJCC PROGNOSTIC STAGE GROUPS — Thymus

When T is…	And N is…	And M is…	Then the stage group is…
T1a, T1b	N0	M0	I
T2	N0	M0	II
T3	N0	M0	IIIA
T4	N0	M0	IIIB
Any T	N1	M0	IVA
Any T	N0 or N1	M1a	IVA
Any T	N2	M0 or M1a	IVB
Any T	Any N	M1b	IVB

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Calculator

Select T, N and M then click Calculate. The logic follows the screenshot table above.

T Category -- select T -- T1a T1b T2 T3 T4 TX T0 Tis N Category -- select N -- N0 N1 N2 NX M Category -- select M -- M0 M1a M1b M1 Calculate Stage

T Category	T Description
TX	Primary tumor cannot be assessed, or tumor proven by malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy
T0	No evidence of primary tumor
Tis	Carcinoma in situ (SCIS) or adenocarcinoma in situ (AIS)
T1mi	Minimally invasive adenocarcinoma (≤3 cm with ≤5 mm invasion)
T1a	Tumor ≤1 cm
T1b	Tumor >1 cm but ≤2 cm
T1c	Tumor >2 cm but ≤3 cm
T2a	Tumor >3 cm but ≤4 cm OR tumor with features such as involvement of main bronchus (without carina), visceral pleura invasion, or associated atelectasis/obstructive pneumonitis
T2b	Tumor >4 cm but ≤5 cm
T3	Tumor >5 cm but ≤7 cm, or directly invading chest wall, diaphragm, phrenic nerve, parietal pleura, or separate tumor nodules in same lobe
T4	Tumor >7 cm or tumor of any size invading mediastinum, heart, great vessels, trachea, esophagus, vertebra, carina or separate tumor nodules in different ipsilateral lobe

N Category	N Description
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in ipsilateral peribronchial and/or ipsilateral hilar and intrapulmonary nodes, including direct extension
N2	Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s)
N3	Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)

M Category	M Description
M0	No distant metastasis
M1	Distant metastasis
M1a	Separate tumor nodule(s) in a contralateral lobe; tumor with pleural or pericardial nodules or malignant pleural/pericardial effusion
M1b	Single extrathoracic metastasis in a single organ (including involvement of a single nonregional node)
M1c	Multiple extrathoracic metastases in a single organ or multiple organs

AJCC PROGNOSTIC STAGE GROUPS — Lung

When T is…	And N is…	And M is…	Then the stage group is…
TX	N0	M0	Occult carcinoma
Tis	N0	M0	0
T1mi	N0	M0	IA1
T1a	N0	M0	IA1
T1a	N1	M0	IIB
T1a	N2	M0	IIIA
T1a	N3	M0	IIIB
T1b	N0	M0	IA2
T1b	N1	M0	IIB
T1b	N2	M0	IIIA
T1b	N3	M0	IIIB
T1c	N0	M0	IA3
T1c	N1	M0	IIB
T1c	N2	M0	IIIA
T1c	N3	M0	IIIB
T2a	N0	M0	IB
T2a	N1	M0	IIB
T2a	N2	M0	IIIA
T2a	N3	M0	IIIB
T2b	N0	M0	IIA
T2b	N1	M0	IIB
T2b	N2	M0	IIIA
T2b	N3	M0	IIIB
T3	N0	M0	IIB
T3	N1	M0	IIIA
T3	N2	M0	IIIB
T3	N3	M0	IIIC
T4	N0	M0	IIIA
T4	N1	M0	IIIA
T4	N2	M0	IIIB
T4	N3	M0	IIIC
Any T	Any N	M1a	IVA
Any T	Any N	M1b	IVA
Any T	Any N	M1c	IVB

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Calculator

Select T, N and M and click Calculate. (If you have M1 subtype choose M1a/M1b/M1c; otherwise choose M1)

T Category -- select T -- TX T0 Tis T1mi T1a T1b T1c T2a T2b T3 T4 N Category -- select N -- NX N0 N1 N2 N3 M Category -- select M -- M0 M1 M1a M1b M1c Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor limited to the ipsilateral parietal with or without involvement of visceral pleura, mediastinal pleura or diaphragmatic pleura (tumor ≤ ? per source image)
T2	Tumor involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of: involvement of diaphragmatic muscle OR extension of tumor from visceral pleura into the underlying pulmonary parenchyma
T3	Locally advanced but potentially resectable tumor involving all ipsilateral pleural surfaces with at least one of: endothoracic fascia involvement, extension into mediastinal fat, solitary completely resectable focus extending into soft tissues of chest wall, or nontransmural involvement of pericardium
T4	Locally advanced technically unresectable tumor; tumor involving all ipsilateral pleural surfaces with at least one of: diffuse extension or multifocal masses of tumor in chest wall, direct transdiaphragmatic extension to peritoneum, direct extension to contralateral pleura, mediastinal organs, spine, or tumor involving internal surface of pericardium with/without effusion

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in ipsilateral bronchopulmonary, hilar, or mediastinal (including internal mammary, peridiaphragmatic, pericardial fat pad, or intercostal) lymph nodes
N2	Metastases in contralateral mediastinal, ipsilateral or contralateral supraclavicular lymph nodes
N3	(if present in your source) metastasis in more distant nodal stations - include if needed

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis present
M1a	Separate tumor nodule(s) in a contralateral lobe; tumor with pleural or pericardial nodules or malignant pleural/pericardial effusion
M1b	Single extrathoracic metastasis in a single organ (including involvement of a single nonregional node)
M1c	Multiple extrathoracic metastases in a single organ or multiple organs

AJCC PROGNOSTIC STAGE GROUPS

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	IA
T2 or T3	N0	M0	IB
T1	N1	M0	II
T2	N1	M0	II
T3	N1	M0	IIIA
T1–3	N2	M0	IIIB
T4	Any N	M0	IIIB
Any T	Any N	M1	IV

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T Category -- select T -- TX T0 Tis T1 T2 T3 T4 N Category -- select N -- NX N0 N1 N2 N3 M Category -- select M -- M0 M1 M1a M1b M1c Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor ≤ 8 cm in greatest dimension
T2	Tumor > 8 cm in greatest dimension
T3	Discontinuous tumors in the primary bone site

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor confined to one vertebral segment or two adjacent vertebral segments
T2	Tumor confined to three adjacent vertebral segments
T3	Tumor confined to four or more adjacent vertebral segments, or any nonadjacent vertebral segments
T4	Extension into the spinal canal or great vessels
T4a	Extension into the spinal canal
T4b	Evidence of gross vascular invasion or tumor thrombus in the great vessels

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor confined to one pelvic segment with no extraosseous extension
T1a	Tumor ≤ 8 cm in greatest dimension
T1b	Tumor > 8 cm in greatest dimension
T2	Tumor confined to one pelvic segment with extraosseous extension or to two segments without extraosseous extension
T2a	Tumor ≤ 8 cm in greatest dimension
T2b	Tumor > 8 cm in greatest dimension
T3	Tumor spanning two pelvic segments with extraosseous extension
T3a	Tumor ≤ 8 cm in greatest dimension
T3b	Tumor > 8 cm in greatest dimension
T4	Tumor spanning three pelvic segments or crossing the sacroiliac joint

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed. Because lymph node involvement is rare in bone sarcomas, NX may not be appropriate and cases should be considered N0 unless clinical node involvement is evident.
N0	No regional lymph node metastasis
N1	Regional lymph node metastasis

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis
M1a	Lung
M1b	Bone or other distant sites

G	G Definition
GX	Grade cannot be assessed
G1	Well differentiated
G2	Moderately differentiated
G3	Poorly differentiated

AJCC PROGNOSTIC STAGE GROUPS — Appendicular skeleton, trunk, skull, and facial bones

When T is…	And N is…	And M is…	And grade is…	Then the stage group is…
T1	N0	M0	G1 or GX	IA
T2	N0	M0	G1 or GX	IB
T3	N0	M0	G1 or GX	IB
T1	N0	M0	G2 or G3	IIA
T2	N0	M0	G2 or G3	IIB
T3	N0	M0	G2 or G3	III
Any T	N0	M1a	Any G	IVA
Any T	N1	Any M	Any G	IVB
Any T	Any N	M1b	Any G	IVB

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Calculator

Choose T, N, M and Grade (G) exactly as defined above then click Calculate.

T Category -- select T -- T1 T2 T3 TX T0 N Category -- select N -- NX N0 N1 M Category -- select M -- M0 M1 M1a M1b Histologic Grade (G) -- select grade -- GX G1 G2 G3 Calculate Stage

T Category	FIGO Stage	T Criteria
TX	—	Primary tumor cannot be assessed
T0	—	No evidence of primary tumor
T1	I	Tumor confined to the vulva and/or perineum. Multifocal lesions should be designated as such. Depth of invasion is measured from epithelial–stromal junction to the deepest point of invasion.
T1a	IA	Lesions 2 cm or less, confined to the vulva and/or perineum, with stromal invasion ≤1.0 mm
T1b	IB	Lesions more than 2 cm, or any size with stromal invasion >1.0 mm, confined to the vulva and/or perineum
T2	II	Tumor of any size with extension to adjacent perineal structures (lower/distal urethra, vagina, anus)
T3	IVA	Tumor of any size with extension to upper/proximal urethra, upper/proximal vagina, bladder mucosa, rectal mucosa, or fixed to pelvic bone

N Category	FIGO Stage	N Criteria
Nx	—	Regional lymph nodes cannot be assessed
N0	—	No regional lymph node metastasis
N0(i+)	—	Isolated tumor cells in regional lymph nodes ≤0.2 mm
N1	III	Regional nodal metastasis with 1–2 lymph node metastases each <5 mm OR one metastasis ≥5 mm
N1a	IIIA	1–2 lymph node metastases <5 mm
N1b	IIIA	One lymph node metastasis ≥5 mm
N2	IIIB / IIIC	Three or more <5 mm metastases OR ≥2 metastases ≥5 mm OR lymph nodes with extranodal extension
N2a	IIIB	Three or more <5 mm metastases
N2b	IIIB	Two or more ≥5 mm metastases
N2c	IIIC	Lymph nodes with extranodal extension
N3	IVA	Fixed or ulcerated regional lymph node metastasis

M Category	FIGO Stage	M Criteria
M0	—	No distant metastasis (no pathological M0; use clinical M to complete staging)
M1	IVB	Distant metastasis (including pelvic lymph node metastasis)

AJCC Prognostic Stage Groups

When T is…	And N is…	And M is…	Then stage is…
T1	N0	M0	I
T1a	N0	M0	IA
T1b	N0	M0	IB
T2	N0	M0	II
T1–T2	N1–N2c	M0	III
T1–T2	N1	M0	IIIA
T1–T2	N2a, N2b	M0	IIIB
T1–T2	N2c	M0	IIIC
T3	Any N	M0	IVA
Any T	Any N	M1	IVB

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Calculator

T Category -- select T -- T1 T1a T1b T2 T3 N Category -- select N -- N0 N1 N2a N2b N2c N3 M Category -- select M -- M0 M1 Calculate Stage

T Category	FIGO Stage	T Criteria
TX	—	Primary tumor cannot be assessed
T0	—	No evidence of primary tumor
T1	I	Tumor confined to the vagina
T1a	IA	Tumor confined to the vagina, measuring ≤2.0 cm
T1b	IB	Tumor confined to the vagina, measuring >2.0 cm
T2	II	Tumor invading paravaginal tissues but not to pelvic sidewall
T2a	II	Tumor invading paravaginal tissues but not pelvic wall, measuring ≤2.0 cm
T2b	II	Tumor invading paravaginal tissues but not pelvic wall, measuring >2.0 cm
T3	III	Tumor extending to the pelvic sidewall and/or involving the lower third of the vagina and/or causing hydronephrosis or nonfunctioning kidney
T4	IVA	Tumor invading bladder or rectal mucosa and/or extending beyond the true pelvis (Bullous edema is not sufficient evidence to classify T4)

N Category	FIGO Stage	N Criteria
NX	—	Regional lymph nodes cannot be assessed
N0	—	No regional lymph node metastasis
N0(i+)	—	Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm
N1	III	Pelvic or inguinal lymph node metastasis

M Category	FIGO Stage	M Criteria
M0	—	No distant metastasis
M1	IVB	Distant metastasis

When T is…	And N is…	And M is…	Then Stage Group is…
T1a	N0	M0	IA
T1b	N0	M0	IB
T2a	N0	M0	IIA
T2b	N0	M0	IIB
T1–T3	N1	M0	III
T3	N0	M0	III
T4	Any N	M0	IVA
Any T	Any N	M1	IVB

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Calculator

T Category -- select T -- T1a T1b T2a T2b T3 T4 N Category -- select N -- N0 N1 M Category -- select M -- M0 M1 Calculate Stage

T Category	FIGO Stage	T Criteria
TX	—	Primary tumor cannot be assessed
T0	—	No evidence of primary tumor
T1	I	Cervical carcinoma confined to the uterus (extension to corpus should be disregarded)
T1a	IA	Invasive carcinoma diagnosed only by microscopy. Stromal invasion ≤5.0 mm deep and ≤7.0 mm horizontal spread. Vascular invasion does not affect classification.
T1a1	IA1	Measured stromal invasion ≤3.0 mm depth and ≤7.0 mm horizontal spread
T1a2	IA2	Measured stromal invasion >3.0 mm and ≤5.0 mm depth, ≤7.0 mm horizontal spread
T1b	IB	Clinically visible lesion confined to cervix OR microscopic lesion >T1a/IA2. Includes all macroscopic visible lesions.

T Category	FIGO Stage	T Criteria
T1b1	IB1	Clinically visible lesion ≤4.0 cm
T1b2	IB2	Clinically visible lesion >4.0 cm
T2	II	Cervical carcinoma invading beyond uterus but not to pelvic wall or lower third of vagina
T2a	IIA	Tumor without parametrial invasion
T2a1	IIA1	Clinically visible ≤4.0 cm
T2a2	IIA2	Clinically visible >4.0 cm
T2b	IIB	Tumor with parametrial invasion
T3	III	Tumor extending to pelvic sidewall and/or involving lower third of vagina and/or causing hydronephrosis or nonfunctioning kidney
T3a	IIIA	Tumor involves lower third of vagina only
T3b	IIIB	Tumor extends to pelvic wall and/or causes hydronephrosis or nonfunctioning kidney
T4	IVA	Tumor invading bladder or rectal mucosa and/or extending beyond true pelvis

N Category	FIGO Stage	N Criteria
NX	—	Regional lymph nodes cannot be assessed
N0	—	No regional lymph node metastasis
N0(i+)	—	Isolated tumor cells ≤0.2 mm
N1	III	Regional lymph node metastasis

M Category	FIGO Stage	M Criteria
M0	—	No distant metastasis
M1	IVB	Distant metastasis (including peritoneal spread or involvement of supraclavicular, mediastinal, or distant lymph nodes; lung; liver; bone)

When T is…	And N is…	And M is…	Then Stage Group is…
T1	Any N	M0	I
T1a	Any N	M0	IA
T1a1	Any N	M0	IA1
T1a2	Any N	M0	IA2
T1b	Any N	M0	IB
T1b1	Any N	M0	IB1
T1b2	Any N	M0	IB2
T2	Any N	M0	II
T2a	Any N	M0	IIA
T2a1	Any N	M0	IIA1
T2a2	Any N	M0	IIA2
T2b	Any N	M0	IIB
T3	Any N	M0	III
T3a	Any N	M0	IIIA
T3b	Any N	M0	IIIB
T4	Any N	M0	IVA
Any T	Any N	M1	IVB

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Calculator

T Category -- select T -- T1a1 T1a2 T1b1 T1b2 T2a1 T2a2 T2b T3a T3b T4 N Category -- select N -- Any N M Category -- select M -- M0 M1 Calculate Stage

T Category	FIGO Stage	T Criteria
TX	—	Primary tumor cannot be assessed
T0	—	No evidence of primary tumor
T1	I	Tumor confined to the corpus uteri, including endocervical glandular involvement
T1a	IA	Tumor limited to the endometrium or invading less than half of the myometrium
T1b	IB	Tumor invading one half or more of the myometrium
T2	II	Tumor invading the stromal connective tissue of the cervix but not extending beyond the uterus. Does NOT include endocervical glandular involvement.
T3	III	Tumor involving serosa, adnexa, vagina, or parametrial tissue
T3a	IIIA	Tumor involving the serosa and/or adnexa (direct extension or metastasis)
T3b	IIIB	Vaginal involvement (direct extension or metastasis) or parametrial involvement
T4	IVA	Tumor invading the mucosa of the bladder or rectum and/or extending beyond the true pelvis (bullous edema is not sufficient evidence to classify a tumor as T4)

N Category	FIGO Stage	N Criteria
N X	—	Regional lymph nodes cannot be assessed
N0	—	No regional lymph node metastasis
N0(i+)	—	Isolated tumor cells in regional lymph node(s) ≤ 0.2 mm
N1	IIIC1	Regional lymph node metastasis to pelvic lymph nodes
N1mi	IIIC1	Micro-metastasis ( >0.2 mm but ≤2.0 mm ) to pelvic lymph nodes
N1a	IIIC1	Regional lymph node metastasis > 2.0 mm to pelvic lymph nodes
N2	IIIC2	Regional lymph node metastasis to para-aortic lymph nodes, with or without pelvic lymph node involvement
N2mi	IIIC2	Micrometastasis to para-aortic lymph nodes
N2a	IIIC2	Metastasis > 2.0 mm to para-aortic lymph nodes

M Category	FIGO Stage	M Criteria
M0	—	No distant metastasis
M1	IVB	Distant metastasis (includes metastasis to inguinal lymph nodes, intraperitoneal disease, lung, liver, or bone; excludes pelvic / para-aortic lymph nodes, vagina, uterine serosa, or adnexa)

When T is…	And N is…	And M is…	Then Stage Group is…
T1	N0	M0	I
T1a	N0	M0	IA
T1b	N0	M0	IB
T2	N0	M0	II
T3	N0	M0	III
T3a	N0	M0	IIIA
T3b	N0	M0	IIIB
T1–T3	N1/N1mi/N1a	M0	IIIC1
T1–T3	N2/N2mi/N2a	M0	IIIC2
T4	Any N	M0	IVA
Any T	Any N	M1	IVB

T Category T1 T1a T1b T2 T3 T3a T3b T4 AnyT N Category N0 N1 N1mi N1a N2 N2mi N2a AnyN M Category M0 M1 Calculate Stage

Adenosarcoma

T Category	FIGO Stage	T Criteria
TX	–	Primary tumor cannot be assessed
T0	–	No evidence of primary tumor
T1	I	Tumor limited to the uterus
T1a	IA	Tumor limited to the endometrium/endocervix
T1b	IB	Tumor invades less than half of the myometrium
T1c	IC	Tumor invades more than half of the myometrium
T2	II	Tumor extends beyond uterus but within the pelvis
T2a	IIA	Tumor involves adnexa
T2b	IIB	Tumor involves other pelvic tissues
T3	III	Tumor infiltrates abdominal tissues
T3a	IIIA	One site
T3b	IIIB	More than one site
T4	IVA	Tumor invades bladder or rectum

Leiomyosarcoma & Endometrial Stromal Sarcoma

T Category	FIGO Stage	T Criteria
TX	–	Primary tumor cannot be assessed
T0	–	No evidence of primary tumor
T1	I	Tumor limited to the uterus
T1a	IA	Tumor ≤5 cm in greatest dimension
T1b	IB	Tumor >5 cm
T2	II	Tumor extends beyond uterus but within the pelvis
T2a	IIA	Tumor involves adnexa
T2b	IIB	Tumor involves other pelvic tissues
T3	III	Tumor infiltrates abdominal tissues
T3a	IIIA	One site
T3b	IIIB	More than one site
T4	IVA	Tumor invades bladder or rectum

N Category	FIGO Stage	N Criteria
NX	–	Regional lymph nodes cannot be assessed
N0	–	No regional lymph node metastasis
N0(i+)	–	Isolated tumor cells ≤0.2 mm
N1	IIIC	Regional lymph node metastasis

M Category	FIGO Stage	M Criteria
M0	–	No distant metastasis
M1	IVB	Distant metastasis (excluding adnexa, pelvic & abdominal tissues)

Leiomyosarcoma & Endometrial Stromal Sarcoma

When T is…	And N is…	And M is…	Stage Group
T1	N0	M0	I
T1a	N0	M0	IA
T1b	N0	M0	IB
T1c	N0	M0	IC
T2	N0	M0	II
T3a	N0	M0	IIIA
T3b	N0	M0	IIIB
T1–3	N1	M0	IIIC
T4	Any N	M0	IVA
Any T	Any N	M1	IVB

Adenosarcoma

When T is…	And N is…	And M is…	Stage Group
T1	N0	M0	I
T1a	N0	M0	IA
T1b	N0	M0	IB
T2	N0	M0	II
T3a	N0	M0	IIIA
T3b	N0	M0	IIIB
T1–3	N1	M0	IIIC
T4	Any N	M0	IVA
Any T	Any N	M1	IVB

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Stage Calculator

Histology Type Leiomyosarcoma / Endometrial Stromal Sarcoma Adenosarcoma T Category T1 T1a T1b T1c T2 T3a T3b T4 N Category N0 N1 M Category M0 M1 Calculate Stage

T Category	FIGO Stage	T Criteria
TX	–	Primary tumor cannot be assessed
T0	–	No evidence of primary tumor
T1	I	Tumor limited to ovaries (one or both) or fallopian tube(s)
T1a	IA	Tumor limited to one ovary (capsule intact) or fallopian tube surface; no malignant cells in ascites or peritoneal washings
T1b	IB	Tumor limited to one or both ovaries or tubes; no tumor on ovarian or tubal surface; no malignant cells in ascites/washings
T1c	IC	Tumor limited to one or both ovaries or fallopian tubes, with any of the following:
T1c1	IC1	Surgical spill
T1c2	IC2	Capsule ruptured before surgery or tumor on ovarian/fallopian tube surface
T1c3	IC3	Malignant cells in ascites or peritoneal washings
T2	II	Tumor involves one or both ovaries or tubes with pelvic extension below pelvic brim or primary peritoneal cancer
T2a	IIA	Extension and/or implants on uterus and/or fallopian tubes and/or ovaries
T2b	IIB	Extension to other pelvic tissues
T3	III	Tumor involves one or both ovaries or fallopian tubes, or primary peritoneal cancer, with microscopically confirmed peritoneal metastasis outside the pelvis and/or metastasis to the retroperitoneal lymph nodes
T3a	IIIA2	Microscopic extrapelvic (above pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
T3b	IIIB	Macroscopic peritoneal metastasis beyond pelvis 2 cm or less in greatest dimension ± retroperitoneal node metastasis
T3c	IIIC	Macroscopic metastasis beyond pelvis more than 2 cm ± retroperitoneal lymph nodes (includes splenic/liver capsule involvement)

N Category	FIGO Stage	N Criteria
NX	–	Regional lymph nodes cannot be assessed
N0	–	No regional lymph node metastasis
N0(i+)	–	Isolated tumor cells in regional lymph nodes ≤0.2 mm
N1	IIIA1	Positive retroperitoneal lymph nodes only (histologically confirmed)
N1a	IIIA1i	Metastasis up to 10 mm
N1b	IIIA1ii	Metastasis more than 10 mm

M Category	FIGO Stage	M Criteria
M0	–	No distant metastasis
M1	IV	Distant metastasis, including pleural effusion with positive cytology; liver/splenic parenchymal mets; extra-abdominal organ mets including inguinal nodes & nodes outside abdominal cavity; transmural bowel involvement
M1a	IVA	Pleural effusion with positive cytology
M1b	IVB	Liver/splenic parenchymal metastasis; metastasis to extra-abdominal organs; transmural bowel involvement

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	I
T1a	N0	M0	IA
T1b	N0	M0	IB
T1c	N0	M0	IC
T2	N0	M0	II
T2a	N0	M0	IIA
T2b	N0	M0	IIB
T1/T2	N1	M0	IIIA1
T3a	N0/N1	M0	IIIA2
T3b	N0/N1	M0	IIIB
T3c	N0/N1	M0	IIIC
Any T	Any N	M1a	IVA
Any T	Any N	M1b	IVB

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T Category T1 T1a T1b T1c T2 T2a T2b T3a T3b T3c N Category N0 N1 M Category M0 M1a M1b Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ (Penile intraepithelial neoplasia | PeIN)
Ta	Noninvasive localized squamous cell carcinoma
T1	Glans: Tumor invades lamina propria Foreskin: Tumor invades dermis, lamina propria, or dartos fascia Shaft: Tumor invades connective tissue between epidermis and corpora regardless of location All sites: With or without lymphovascular invasion or perineural invasion and is or is not high grade
T1a	Tumor is without lymphovascular invasion or perineural invasion and is not high grade (i.e., grade 3 or sarcomatoid)
T1b	Tumor exhibits lymphovascular invasion and/or perineural invasion or is high grade (i.e., grade 3 or sarcomatoid)
T2	Tumor invades into corpus spongiosum (either glans or ventral shaft) with or without urethral invasion
T3	Tumor invades into corpora cavernosa (including tunica albuginea) with or without urethral invasion
T4	Tumor invades into adjacent structures (i.e., scrotum, prostate, pubic bone)

cN Category	cN Criteria
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 ≥2 unilateral inguinal nodes or bilateral inguinal lymph nodes
cN3	Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral

pN Category	pN Criteria
pNX	Lymph node metastasis cannot be established
pN0	No lymph node metastasis
pN1	≤2 unilateral inguinal metastases, no ENE
pN2	≥3 unilateral inguinal metastases or bilateral metastases
pN3	ENE of lymph node metastases or pelvic lymph node metastases

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis present

When T is…	And N is…	And M is…	Then stage group is…
T1a	N0	M0	I
T1b	N0	M0	IIA
T2	N0	M0	IIB
T3	N0	M0	IIC
T1–3	N1	M0	IIIA
T1–3	N2	M0	IIIB
T4	Any N	M0	IV
Any T	N3	M0	IIIC
Any T	Any N	M1	IV

T Category T1a T1b T2 T3 T4 N Category N0 N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Clinically inapparent tumor that is not palpable
T1a	Tumor incidental histologic finding in 5% or less of tissue resected
T1b	Tumor incidental histologic finding in more than 5% of tissue resected
T1c	Tumor identified by needle biopsy found in one or both sides, but not palpable
T2	Tumor is palpable and confined within prostate
T2a	Tumor involves one-half of one side or less
T2b	Tumor involves more than one-half of one side but not both sides
T2c	Tumor involves both sides
T3	Extraprostatic tumor that is not fixed or does not invade adjacent structures
T3a	Extraprostatic extension (unilateral or bilateral)
T3b	Tumor invades seminal vesicle(s)
T4	Tumor is fixed or invades adjacent structures (external sphincter, rectum, bladder, levator muscles, pelvic wall)

T Category	T Criteria
T2	Organ confined
T3	Extraprostatic extension
T3a	Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck
T3b	Tumor invades seminal vesicle(s)
T4	Tumor is fixed or invades adjacent structures other than seminal vesicles (external sphincter, rectum, bladder, levator muscles, pelvic wall)

N Category	N Criteria
NX	Regional nodes were not assessed
N0	No positive regional nodes
N1	Metastases in regional node(s)

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis
M1a	Nonregional lymph node(s)
M1b	Bone(s)
M1c	Other site(s) with or without bone disease

Note: When more than one site is present, the most advanced category is used. M1c is most advanced.

PSA Category
<10
≥10 <20
≥20
Any value

Grade Group	Gleason Score	Gleason Pattern
1	≤6	≤3+3
2	7	3+4
3	7	4+3
4	8	4+4
5	9 or 10	4+5, 5+4, or 5+5

When T is…	And N is…	And M is…	And PSA is…	And Grade Group is…	Then Stage is…
cT1a–c, cT2a	N0	M0	<10	1	I
cT1a–c, cT2a	N0	M0	≥10 <20	1	IIA
cT2b	N0	M0	<20	1	IIA
T1–2	N0	M0	<20	2	IIB
T1–2	N0	M0	<20	3	IIC
T1–2	N0	M0	<20	4	IIC
T3–4	N0	M0	Any	1–4	IIIB
Any T	N1	M0	Any	Any	IIIA
Any T	Any N	M1	Any	Any	IVB

T Category T1 T1a T1b T1c T2a T2b T2c T3 T3a T3b T4 N Category N0 N1 M Category M0 M1 PSA <10 ≥10 <20 ≥20 Any Grade Group 1 2 3 4 5 Calculate Stage

cT Category	cT Criteria
cTX	Primary tumor cannot be assessed
cT0	No evidence of primary tumor
cTis	Germ cell neoplasia in situ
cT4	Tumor invades scrotum with or without vascular/lymphatic invasion

pT Category	pT Criteria
pTX	Primary tumor cannot be assessed
pT0	No evidence of primary tumor
pTis	Germ cell neoplasia in situ
pT1	Tumor limited to testis (including rete testis invasion) without lymphovascular invasion
pT1a*	Tumor smaller than 3 cm in size
pT1b*	Tumor 3 cm or larger in size
pT2	Tumor limited to testis (including rete testis invasion) with lymphovascular invasion OR tumor invading hilar soft tissue or epididymis or penetrating visceral mesothelial layer covering tunica albuginea with or without lymphovascular invasion
pT3	Tumor invades spermatic cord with or without lymphovascular invasion
pT4	Tumor invades scrotum with or without lymphovascular invasion

* Subclassification of pT1 applies only to pure seminoma.

cN Category	cN Criteria
cNX	Regional lymph nodes cannot be assessed
cN0	No regional lymph node metastasis
cN1	Metastasis with lymph node mass 2 cm or smaller OR multiple nodes, none larger than 2 cm
cN2	Metastasis with node mass more than 2 cm but not larger than 5 cm OR multiple nodes, any one mass larger than 2 cm but none larger than 5 cm
cN3	Metastasis with lymph node mass larger than 5 cm in greatest dimension

pN Category	pN Criteria
pNX	Regional lymph nodes cannot be assessed
pN0	No regional lymph node metastasis
pN1	Metastasis with lymph node mass 2 cm or smaller and ≤5 nodes positive, none larger than 2 cm
pN2	Metastasis with lymph node mass larger than 2 cm but not larger than 5 cm OR more than five nodes positive, none larger than 5 cm OR extranodal extension of tumor
pN3	Metastasis with lymph node mass larger than 5 cm in greatest dimension

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis
M1a	Non-retroperitoneal nodal or pulmonary metastases
M1b	Non-pulmonary visceral metastases

S Category	S Criteria
SX	Marker studies not available or not performed
S0	Marker study levels within normal limits
S1	LDH < 1.5 × N* OR hCG < 5,000 mIU/mL OR AFP < 1,000 ng/mL
S2	LDH 1.5–10 × N* OR hCG 5,000–50,000 mIU/mL OR AFP 1,000–10,000 ng/mL
S3	LDH >10 × N* OR hCG >50,000 mIU/mL OR AFP >10,000 ng/mL

*N indicates ULN of LDH assay.

When T is…	And N is…	And M is…	And S is…	Then the stage group is…
pTis	N0	M0	S0	0
pT1–T4	N0	M0	SX	I
pT1	N0	M0	S0	IA
pT2	N0	M0	S0	IB
pT3	N0	M0	S0	IC
pT1–T2	N1	M0	S0	IIA1
pT3a	N0/N1	M0	S0	IIIA2
pT3b	N0/N1	M0	S0	IIIB
pT3c	N0/N1	M0	S0	IIIC
Any pT/TX	N2	M0	S0	IIIB
Any pT/TX	N1–3	M0	SX	II
Any pT/TX	Any N	M1a	S1	IIIA
Any pT/TX	N1–3	M0	S2	IIIB
Any pT/TX	Any N	M1a	S2	IIIB
Any pT/TX	N1–3	M0	S3	IIIC
Any pT/TX	Any N	M1a	S3	IIIC
Any pT/TX	Any N	M1b	Any S	IIIC

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Stage Calculator

T Category (pT) pTis pT1 pT1a pT1b pT2 pT3 pT3a pT3b pT3c pT4 N Category (pN) N0 N1 N2 N3 M Category M0 M1a M1b S Category S0 SX S1 S2 S3 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor ≤ 7 cm in greatest dimension, limited to the kidney
T1a	Tumor ≤ 4 cm in greatest dimension, limited to the kidney
T1b	Tumor > 4 cm but ≤ 7 cm in greatest dimension, limited to the kidney
T2	Tumor > 7 cm in greatest dimension, limited to the kidney
T2a	Tumor > 7 cm but ≤ 10 cm in greatest dimension, limited to the kidney
T2b	Tumor > 10 cm, limited to the kidney
T3	Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia
T3a	Tumor extends into the renal vein or its segmental branches, or invades the pelvicalyceal system, or invades perirenal and/or renal sinus fat but not beyond Gerota’s fascia
T3b	Tumor extends into the vena cava below the diaphragm
T3c	Tumor extends into the vena cava above the diaphragm or invades the wall of the vena cava
T4	Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in regional lymph node(s)

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
T1	N0	M0	I
T1	N1	M0	III
T2	N0	M0	II
T2	N1	M0	III
T3	N0	M0	III
T3	N1	M0	III
T4	Any N	M0	IV
Any T	Any N	M1	IV

T Category T1 T2 T3 T4 N Category N0 N1 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Papillary noninvasive carcinoma
Tis	Carcinoma in situ
T1	Tumor invades subepithelial connective tissue
T2	Tumor invades the muscularis
T3	Renal pelvis only: Tumor invades beyond muscularis into peripelvic fat or into the renal parenchyma Ureter only: Tumor invades beyond muscularis into periureteric fat
T4	Tumor invades adjacent organs, or through the kidney into perinephric fat

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single lymph node ≤2 cm in greatest dimension
N2	Metastasis in a single lymph node >2 cm, or multiple lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

AJCC PROGNOSTIC STAGE GROUPS

When T is…	And N is…	And M is…	Then the stage group is…
Ta	N0	M0	0a
Tis	N0	M0	0is
T1	N0	M0	I
T2	N0	M0	II
T3	N0	M0	III
T4	N0	M0	IV
Any T	N1	M0	IV
Any T	N2	M0	IV
Any T	Any N	M1	IV

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T Category Ta Tis T1 T2 T3 T4 N Category N0 N1 N2 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Non-invasive papillary carcinoma
Tis	Urothelial carcinoma in situ: “flat tumor”
T1	Tumor invades lamina propria (subepithelial connective tissue)
T2	Tumor invades muscularis propria
pT2a	Tumor invades superficial muscularis propria (inner half)
pT2b	Tumor invades deep muscularis propria (outer half)
T3	Tumor invades perivesical soft tissue
pT3a	Microscopically (extravesical mass)
pT3b	Macroscopically (extravesical mass)
T4	Extravesical tumor directly invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall
T4a	Extravesical tumor invades directly into prostatic stroma, uterus, vagina
T4b	Extravesical tumor invades pelvic wall, abdominal wall

N Category	N Criteria
NX	Lymph nodes cannot be assessed
N0	No lymph node metastasis
N1	Single regional lymph node metastasis in the true pelvis (perivesical, obturator, internal/external iliac, sacral)
N2	Multiple regional lymph node metastases in the true pelvis
N3	Lymph node metastasis to the common iliac lymph nodes

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis
M1a	Distant metastasis limited to lymph nodes beyond the common iliacs
M1b	Non-lymph-node distant metastases

When T is…	And N is…	And M is…	Then the stage group is…
Ta	N0	M0	0a
Tis	N0	M0	0is
T1	N0	M0	I
T2a	N0	M0	II
T2b	N0	M0	II
T3a, T3b, T4a	N0	M0	IIIA
T1–T4a	N1	M0	IIIB
T1–T4a	N2, N3	M0	IIIB
T4b	Any N	M0	IVA
Any T	Any N	M1a	IVA
Any T	Any N	M1b	IVB

T Category Ta Tis T1 T2a T2b T3a T3b T4a T4b N Category N0 N1 N2 N3 M Category M0 M1a M1b Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Non-invasive papillary carcinoma
Tis	Carcinoma in situ
T1	Tumor invades subepithelial connective tissue
T2	Tumor invades any of the following: corpus spongiosum, periurethral muscle
T3	Tumor invades any of the following: corpus cavernosum, anterior vagina
T4	Tumor invades other adjacent organs (e.g., invasion of the bladder wall)

T Category	T Definition
Tis	Carcinoma in situ involving the prostatic urethra or periurethral or prostatic ducts without stromal invasion
T1	Tumor invades urethral subepithelial connective tissue immediately underlying the urothelium
T2	Tumor invades the prostatic stroma surrounding ducts either by direct extension or by invasion from prostatic ducts
T3	Tumor invades the periprostatic fat
T4	Tumor invades other adjacent organs (e.g., extraprostatic invasion of the bladder wall, rectal wall)

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Single regional lymph node metastasis in the inguinal region or true pelvis (perivesical, obturator, internal/external iliac, or presacral lymph node)
N2	Multiple regional lymph node metastasis in the inguinal region or true pelvis (perivesical, obturator, internal/external iliac, or presacral lymph node)

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
Tis	N0	M0	0is
Ta	N0	M0	0a
T1	N0	M0	I
T2	N0	M0	II
T3, T3b, T4a	N0	M0	IIIA
T1–T4a	N1	M0	IIIB
T1–T4a	N2, N3	M0	IIIC
T4b	Any N	M0	IVA
Any T	Any N	M1	IVB

T Category Tis Ta T1 T2 T3 T3b T4a T4b N Category N0 N1 N2 N3 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor ≤10 mm in greatest dimension
T1a	Tumor does not invade the tarsal plate or eyelid margin
T1b	Tumor invades the tarsal plate or eyelid margin
T1c	Tumor involves full thickness of the eyelid
T2	Tumor >10 mm but ≤20 mm in greatest dimension
T2a	Tumor does not invade the tarsal plate or eyelid margin
T2b	Tumor invades the tarsal plate or eyelid margin
T2c	Tumor involves full thickness of the eyelid
T3	Tumor >20 mm but ≤30 mm in greatest dimension
T3a	Tumor does not invade the tarsal plate or eyelid margin
T3b	Tumor invades the tarsal plate or eyelid margin
T3c	Tumor involves full thickness of the eyelid
T4	Any eyelid tumor invading adjacent ocular, orbital, or facial structures
T4a	Tumor invades ocular or intraorbital structures
T4b	Tumor invades (or erodes through) the bony walls of the orbit or extends to paranasal sinuses or invades the lacrimal sac/nasolacrimal duct or brain

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No evidence of lymph node involvement
N1	Metastasis in a single ipsilateral regional lymph node ≤3 cm
N1a	Metastasis in a single ipsilateral lymph node ≤3 cm based on clinical/imaging
N1b	Metastasis in single ipsilateral lymph node ≤3 cm based on biopsy
N2	Metastasis in single lymph node >3 cm or multiple lymph nodes
N2a	Metastasis in lymph node(s) based on clinical/imaging findings
N2b	Metastasis in lymph node(s) based on biopsy findings

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

When T is…	And N is…	And M is…	Then the stage group is…
T2b–d, T3	N0	M0	IIA
T4	N0	M0	IIB
Any T	N1	M0	IIIA
Any T	N2	M0	IIIB
Any T	Any N	M1	IV

T Category Tis T1 T2 T2b T2c T3 T4 N Category N0 N1 N2 M Category M0 M1 Calculate Stage

T Category	T Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor (≤5 mm in greatest dimension) invades through the conjunctival basement membrane without invasion of adjacent structures
T2	Tumor (>5 mm in greatest dimension) invades through the conjunctival basement membrane without invasion of adjacent structures
T3	Tumor invades adjacent structures (excluding the orbit)
T4	Tumor invades the orbit with or without further extension
T4a	Tumor invades orbital soft tissues without bone invasion
T4b	Tumor invades bone
T4c	Tumor invades adjacent paranasal sinuses
T4d	Tumor invades brain

N Category	N Criteria
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Regional lymph node metastasis

M Category	M Criteria
M0	No distant metastasis
M1	Distant metastasis

cT Category	cT Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor of the bulbar conjunctiva
T1a	<1 quadrant
T1b	≥1 to <2 quadrants
T1c	≥2 to <3 quadrants
T1d	≥3 quadrants
T2	Tumor of the nonbulbar conjunctiva (forniceal, palpebral, tarsal) involving caruncle
T2a	Noncaruncular, and ≤1 quadrant of nonbulbar conjunctiva involved
T2b	Noncaruncular, and >1 quadrant nonbulbar conjunctiva involved
T2c	Caruncular, and ≤1 quadrant nonbulbar conjunctiva involved
T2d	Caruncular, and >1 quadrant nonbulbar conjunctiva involved
T3	Tumor of any size with local invasion
T3a	Globe
T3b	Eyelid
T3c	Orbit
T3d	Nasolacrimal duct and/or paranasal sinuses
T4	Tumor of any size with invasion of central nervous system

pT Category	pT Criteria
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Melanoma confined to conjunctival epithelium
T1	Tumor of bulbar conjunctiva
T1a	Invasion ≤2.0 mm thickness
T1b	Invasion >2.0 mm thickness
T2	Tumor of nonbulbar conjunctiva including caruncle
T2a	Invasion ≤2.0 mm thickness
T2b	Invasion >2.0 mm thickness
T3	Tumor of any size with local invasion
T3a	Globe
T3b	Eyelid
T3c	Orbit
T3d	Nasolacrimal duct and/or paranasal sinuses
T4	Tumor of any size with invasion of paranasal sinuses and/or central nervous system