7th Edition of the AJCC Staging Manual

October 18, 2016

7th Edition MCC Staging System Table

Stage Primary Tumor Lymph Node Metastasis
0 In situ primary tumor No regional lymph node metastasis No distant metastasis
IA Less than or equal to 2 cm maximum tumor dimension Nodes negative by pathologic exam No distant metastasis
IB Less than or equal to 2 cm maximum tumor dimension Nodes negative by clinical exam* (no pathologic node exam performed) No distant metastasis
IIA Greater than 2 cm tumor dimension Nodes negative by pathologic exam No distant metastasis
IIB Greater than 2 cm tumor dimension Nodes negative by clinical exam* (no pathologic node exam performed) No distant metastasis
IIC Primary tumor invades bone, muscle, fascia, or cartilage No regional lymph node metastasis No distant metastasis
IIIA Any size tumor (includes invading tumors) Micrometastasis** No distant metastasis
IIIB Any size tumor (includes invading tumors) Macrometastasis*** -OR- In transit metastasis**** No distant metastasis
IV Any size tumor (includes invading tumors) Any lymph node metastasis Metastasis beyond regional lymph nodes


* Clinical detection of nodal disease may be via inspection, palpation, and/or imaging.
** Micrometastases are diagnosed after sentinel or elective lymphadenectomy.
*** Macrometastases are defined as clinically detectable nodal metastases confirmed by therapeutic lymphadenectomy or needle biopsy.
**** In transit metastasis: a tumor distinct from the primary lesion and located either (1) between the primary lesion and the draining regional lymph nodes or (2) distal to the primary lesion.
(Adapted from AJCC’s Cancer Staging Manual 2009)