Basal cell carcinoma staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D. Maneesha Nandimandalam, M.B.B.S.[2]

Overview

The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system. T, M, and N are combined into stages, called stage grouping.

Basal Cell Carcinoma Staging

The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system:[1]
T - tumor
N - lymph nodes
M - metastasis

The following table summarizes the T categories:

T Categories Description
TX Primary tumor cannot be identified
Tis Carcinoma in situ
T1 Tumor ≤2 cm in greatest dimension
T2 Tumor >2 cm, but ≤4 cm in greatest dimension
T3 Tumor >4 cm 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

The following table summarizes the N categories:

N categories Description
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in a single ipsilateral lymph node, ≤3 cm in greatest dimension and ENE negative
N2 Metastasis in a single ipsilateral lymph node, ≤3 cm in greatest dimension and ENE positive; or >3 cm but ≤6 cm in greatest dimension and ENE negative; or metastases in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension and ENE negative; or in bilateral or contralateral lymph node(s), none >6 cm in greatest dimension, ENE negative.
N2a Metastasis in single ipsilateral node ≤3 cm in greatest dimension and ENE positive; or a single ipsilateral node >3 cm but ≤6 cm in greatest dimension and ENE negative.
N2b Metastasis in multiple ipsilateral nodes, none >6 cm in greatest dimension and ENE negative.
N2c Metastasis in bilateral or contralateral lymph node(s), none >6 cm in greatest dimension and ENE negative.
N3 Metastasis in a lymph node >6 cm in greatest dimension and ENE negative; or in a single ipsilateral node >3 cm in greatest dimension and ENE positive; or multiple ipsilateral, contralateral, or bilateral nodes, any with ENE-positive status; or a single contralateral node of any size and ENE positive.
N3a Metastasis in a lymph node >6 cm in greatest dimension and ENE negative.
N3b Metastasis in a single ipsilateral node >3 cm in greatest dimension and ENE positive; or multiple ipsilateral, contralateral, or bilateral nodes, any with ENE-positive status; or a single contralateral node of any size and ENE positive.

The following table summarizes the M categories:

M categories Description
M0 No distant metastasis
M1 Distant metastasis

The T, N, and M categories are combined into stages. The following table summarizes the stage grouping.

Stage TNM Grouping
0 Tis, N0, M0
I T1, N0, M0
II T2, N0, M0
III T3, N0, M0; T1-T3, N1, M0
IV T1-T3, N2, M0; Any T, N3, M0; T4, any N, M0; Any T, any N, M1

References

  1. Amin, Mahul (2017). AJCC cancer staging manual. Switzerland: Springer. ISBN 3319406175.

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