Chart 2.

American Joint Committee on Cancer TMN classification for penile cancer

Primary Tumor (T)
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
Ta	Noninvasive verrucous carcinoma*
T1a	Tumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3-4)
T1b	Tumor invades subepithelial connective tissue with lymph vascular invasion and is poorly differentiated
T2	Tumor invades corpus spongiosum or cavernosum
T3	Tumor invades urethra
T4	Tumor invades other adjacent structures
* Note: Broad pushing penetration (invasion) is permitted; destructive invasion is against this diagnosis.
Regional Lymph Nodes (N)
Clinical Stage Definition*
cNX	Regional lymph nodes cannot be assessed
cN0	No palpable or visibly enlarged inguinal lymph nodes
cN1	Palpable mobile unilateral inguinal lymph node
cN2	Palpable mobile multiple or bilateral inguinal lymph nodes
cN3	Palpable fixed inguinal lymph nodal mass or pelvic lymphadenopathy unilateral or bilateral
* Note: Clinical stage definition based on palpation, imaging
Pathologic Stage Definition*
pNX	Regional lymph nodes cannot be assessed
pN0	No regional lymph node metastasis
pN1	Metastasis in a single inguinal lymph node
pN2	Metastasis in multiple or bilateral inguinal lymph nodes
pN3	Extranodal extension of lymph node metastasis or pelvic lymph node(s) unilateral or bilateral
*Note: Pathologic stage definition based on biopsy or surgical excision.
Distant Metastasis (M)
M0	No distant metastasis
M1	Distant metastasis*
*Note: Lymph node metastasis outside of the true pelvis in addition to visceral or bone sites.

Reproduced with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer Science and Business Media LLC, www.springer.com.