Adrenal gland
cancer

You are here: 

Staging adrenal gland cancer

Staging is a way to describe or classify a cancer based on the extent of cancer in the body. Extent includes the size of the tumour and where the cancer is in the body. Your healthcare team uses the stage to plan treatment and estimate your prognosis.

The staging system for adrenal gland cancer applies only to adrenocortical carcinomas (ACC) (cancerous tumours of the adrenal cortex). It does not apply to cancerous pheochromocytomas or other tumours of the adrenal gland.

The staging system used for ACC is the TNM system. Each stage is given a number from 1 to 4. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. Generally, the higher the number, the more the cancer has spread. In Canada, the TNM stage groupings of the Union for International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC) are usually used.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the adrenal gland and has not spread to other parts of the body. Regional means close to or around the adrenal gland. Distant means in a part of the body farther from the adrenal gland.

TNM

T describes the size of the primary tumour. It also describes if the tumour has grown into other parts of the adrenal gland or tissues around the adrenal gland. T is usually given as a number from 1 to 4. A higher number means that the tumour is larger. It may also mean that the tumour has grown into nearby tissues or organs.

N describes whether or not cancer has spread to lymph nodes around the adrenal gland. N0 means the cancer hasn’t spread to any nearby lymph nodes. N1 means cancer has spread to lymph nodes.

M describes whether or not the cancer has spread (metastasized) to other parts of the body. M0 means that cancer has not spread to other parts of the body. M1 means that it has spread to other parts of the body.

Stage I ACC

TNMDescription

T1

N0

M0

The tumour is 5 cm or smaller. It has not grown outside the adrenal gland.

Stage II ACC

TNMDescription

T2

N0

M0

The tumour is larger than 5 cm, but it has not grown outside the adrenal gland.

Stage III ACC

TNMDescription

T1 or T2

N1

M0

The tumour is any size, but it has not grown outside the adrenal gland.

The cancer has spread to nearby lymph nodes.

T3

N0

M0

The tumour has grown into the fat outside the adrenal gland.

Stage IV ACC

TNMDescription

T3

N1

M0

The tumour has grown into the fat outside of the adrenal gland.

The cancer has spread to nearby lymph nodes.

T4

any N

M0

The tumour has grown into nearby organs.

The cancer may have spread to nearby lymph nodes.

any T

any N

M1

The tumour is any size. It may have grown into nearby tissues or organs.

The cancer may have spread to nearby lymph nodes.

The cancer has spread to other parts of the body (distant sites).

Another staging classification that may be used for ACC is the European Network for the Study of Adrenal Tumors (ENSAT) groupings. The ENSAT classification is the same as UICC and AJCC for stages I and II, but stages III and IV are a little different.

ENSAT stage III ACC

TNMDescription

T3 or T4

N0

M0

The tumour has grown into the fat just outside the adrenal gland or into other nearby organs.

any T

N1

M0

The tumour is any size. It may have grown into nearby tissues or organs.

The cancer has spread to nearby lymph nodes.

ENSAT stage IV ACC

TNMDescription

any T

any N

M1

The tumour is any size. It may have grown into nearby tissues or organs.

The cancer may have spread to nearby lymph nodes.

The cancer has spread to other parts of the body (distant sites).

Recurrent adrenal gland cancer

Recurrent means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to the primary tumour, it’s called regional recurrence. It can also recur in another part of the body, which is called a distant metastasis, or a distant recurrence.

Stories

Dr Peter Dirks A driving force behind relapse in childhood brain cancer

Read more

Trusted online community of support

Illustration of computer

Cancerconnection.ca provides a trusted online community for cancer patients, their family and friends.

Learn more