Adrenal Cancer Stages

A cancer’s stage refers to how large the primary tumor is and how far the cancer has spread in the patient’s body. Knowing the stage helps the care team understand the disease and develop an appropriate treatment plan. It also impacts the patient’s prognosis, or chance for a successful treatment.

TNM stages

The TNM staging system is used for most cancers.

TNM staging describes cancer based on three main factors:

• The size of the primary tumor (T) and whether it has invaded nearby tissues.
• The cancer’s spread to nearby lymph nodes (N).
•  Whether the cancer has metastasized (M), or spread, to distant parts of the body.

Each TNM factor is assigned a number that reflects the extent of the cancer. Tumors (T) are scored between 1-4, nodes (N) 1-3, and metastasis (M) 0-1.

After all diagnostic and staging procedures are performed, your doctor should know the TNM stage of your cancer and be able to explain how this stage impacts your treatment and prognosis.

0 to IV stages

Often, TNM staging can be simplified into stages four stages (I-IV). For some cancers, there is also a stage 0. Larger numbers mean the cancer is more advanced and is generally more difficult to treat.

• Stage 0 reflects the presence of abnormal cells that have not spread to tissue that is immediately nearby. Stage 0 is considered precancerous, though it could become cancer in the future. This stage is also called “in-situ,” which means “in its original place.” Not all cancers have a stage 0.
• Stage I cancers are typically small and confined to the area where they began.
• Stage II and Stage III cancers have spread to nearby tissue and/or lymph nodes.
• Stage IV cancer has spread to distant areas of the body. This is also called metastatic cancer. Stage IV cancer often cannot be cured, but frequently can be managed like a chronic disease.

Adrenocortical carcinoma I-IV stages

Adrenocortical carcinoma is the most common type adrenal gland cancer. 

Source: National Cancer Institute

Stage I adrenocortical carcinoma

In stage I, the tumor is 5 centimeters or smaller and is found in the adrenal gland only.

Stage II adrenocortical carcinoma

In stage II, the tumor is larger than 5 centimeters and is found in the adrenal gland only.

Stage III adrenocortical carcinoma

In stage III, the tumor is any size and has spread:

• to nearby lymph nodes; or
• to nearby tissues or organs (kidney, diaphragm, pancreas, spleen, or liver) or to large blood vessels (renal vein or vena cava) and may have spread to nearby lymph nodes.

Stage IV adrenocortical carcinoma

In stage IV, the tumor is any size, may have spread to nearby lymph nodes, and has spread to other parts of the body, such as the lung, bone, or peritoneum.