Editing EAU & ASCO: Penile Cancer 2023 (section)

== TNM Staging ==

* Based on 8th edition of AJCC, last updated in 2017

=== Primary Tumor (T) ===

* '''TX: Primary tumour cannot be assessed'''
* '''T0: No evidence of primary tumour'''
* '''Tis: Carcinoma in situ (Penile Intraepithelial Neoplasia – PeIN)'''
* '''Ta: Non-invasive verrucous carcinoma'''
* '''<span style="color:#ff0000">T1: Tumour invades subepithelial connective tissue'''
** '''<span style="color:#ff0000">T1a: without lymphovascular invasion or perineural invasion and is not poorly differentiated'''
** '''<span style="color:#ff0000">T1b: with lymphovascular invasion or perineural invasion or is poorly differentiated'''
* '''<span style="color:#ff0000">T2: Tumour invades corpus spongiosum</span> with or without invasion of the urethra'''
* '''<span style="color:#ff0000">T3: Tumour invades corpus cavernosum</span> with or without invasion of the urethra'''
* '''<span style="color:#ff0000">T4: Tumour invades other adjacent structures'''

=== Regional Lymph Nodes (N) ===

* '''Clinical'''
** '''<span style="color:#ff0000">cN0: No palpable or visibly enlarged inguinal lymph nodes'''
** '''<span style="color:#ff0000">cN1: Palpable mobile unilateral inguinal lymph node'''
** '''<span style="color:#ff0000">cN2: Palpable mobile multiple or bilateral inguinal lymph nodes'''
** '''<span style="color:#ff0000">cN3: Fixed inguinal nodal mass or pelvic lymphadenopathy based on imaging, unilateral or bilateral'''
* Pathological
** pN0 No regional lymph node metastasis
** pN1 Metastasis in 1-2 inguinal lymph nodes
** pN2 Metastasis in >2 unilateral inguinal nodes or bilateral inguinal lymph nodes
** pN3 Metastasis in pelvic lymph node(s), unilateral or bilateral or extranodal extension of regional lymph node metastasis

=== Distant Metastasis (M) ===

* M0: No distant metastasis 
* M1: Distant metastasis