Staging and risk scores

UK reports stage against the UICC 8th edition, whose anatomic groups these are; the Royal College of Pathologists dataset in force (G148 version 3, November 2024) reprints it and advises against substituting AJCC TNM 8, because the AJCC edition also defines prognostic stage groups that move tumours up or down by grade, ER, PR and HER2 status and, for T1-2 N0 HR-positive HER2-negative disease, a low-risk genomic assay result. The UICC 9th edition, recommended from 1 January 2026, leaves the breast classification unchanged and clarifies only the post-treatment yp classification, basing ypT on the largest continuous focus of residual invasive cancer and recommending that residual cancer burden be reported beside it.

Stage	Definition	Standard of care on the cancer page
0	Tis (DCIS).	Ductal carcinoma in situ
IA / IB	T1 (2 cm or smaller) N0 / T0-1 N1mi (micrometastases 0.2-2 mm).	Early disease, all types, Fertility and early menopause, decided before treatment starts
IIA / IIB	T0-1 N1 or T2 (2-5 cm) N0 / T2 N1 or T3 (over 5 cm) N0.	Early disease, all types, Fertility and early menopause, decided before treatment starts
IIIA / IIIB / IIIC	T0-2 N2 or T3 N1-2 / T4 (chest wall, skin, inflammatory) N0-2 / any T N3 (10 or more axillary nodes, infraclavicular, internal mammary plus axillary, supraclavicular).	-
IV	M1: distant metastases.	-

HER2-positive breast cancer

Breast cancer TNM, 8th edition: anatomic stage groups

UK reports stage against the UICC 8th edition, whose anatomic groups these are; the Royal College of Pathologists dataset in force (G148 version 3, November 2024) reprints it and advises against substituting AJCC TNM 8, because the AJCC edition also defines prognostic stage groups that move tumours up or down by grade, ER, PR and HER2 status and, for T1-2 N0 HR-positive HER2-negative disease, a low-risk genomic assay result. The UICC 9th edition, recommended from 1 January 2026, leaves the breast classification unchanged and clarifies only the post-treatment yp classification, basing ypT on the largest continuous focus of residual invasive cancer and recommending that residual cancer burden be reported beside it.

Stage	Definition	Standard of care on the cancer page
0	Tis (DCIS).	-
IA / IB	T1 (2 cm or smaller) N0 / T0-1 N1mi (micrometastases 0.2-2 mm).	Stage I (≤2-3 cm, node-negative), Stage II-III, neoadjuvant
IIA / IIB	T0-1 N1 or T2 (2-5 cm) N0 / T2 N1 or T3 (over 5 cm) N0.	Stage II-III, neoadjuvant, Post-neoadjuvant, pathologic complete response, Post-neoadjuvant, residual invasive disease
IIIA / IIIB / IIIC	T0-2 N2 or T3 N1-2 / T4 (chest wall, skin, inflammatory) N0-2 / any T N3 (10 or more axillary nodes, infraclavicular, internal mammary plus axillary, supraclavicular).	Stage II-III, neoadjuvant, Post-neoadjuvant, pathologic complete response, Post-neoadjuvant, residual invasive disease
IV	M1: distant metastases.	Metastatic, first line, Metastatic, second line, Metastatic, later lines

HR-positive / HER2-negative breast cancer

Breast cancer TNM, 8th edition: anatomic stage groups

UK reports stage against the UICC 8th edition, whose anatomic groups these are; the Royal College of Pathologists dataset in force (G148 version 3, November 2024) reprints it and advises against substituting AJCC TNM 8, because the AJCC edition also defines prognostic stage groups that move tumours up or down by grade, ER, PR and HER2 status and, for T1-2 N0 HR-positive HER2-negative disease, a low-risk genomic assay result. The UICC 9th edition, recommended from 1 January 2026, leaves the breast classification unchanged and clarifies only the post-treatment yp classification, basing ypT on the largest continuous focus of residual invasive cancer and recommending that residual cancer burden be reported beside it.

Stage	Definition	Standard of care on the cancer page
0	Tis (DCIS).	-
IA / IB	T1 (2 cm or smaller) N0 / T0-1 N1mi (micrometastases 0.2-2 mm).	Early stage, deciding on chemotherapy, Early stage, adjuvant endocrine therapy, Early stage, high risk: adjuvant CDK4/6
IIA / IIB	T0-1 N1 or T2 (2-5 cm) N0 / T2 N1 or T3 (over 5 cm) N0.	Early stage, deciding on chemotherapy, Early stage, adjuvant endocrine therapy, Early stage, high risk: adjuvant CDK4/6
IIIA / IIIB / IIIC	T0-2 N2 or T3 N1-2 / T4 (chest wall, skin, inflammatory) N0-2 / any T N3 (10 or more axillary nodes, infraclavicular, internal mammary plus axillary, supraclavicular).	-
IV	M1: distant metastases.	Metastatic, first line, Metastatic, molecular progression on first line, Metastatic, second line by genotype

Triple-negative breast cancer (TNBC)

Breast cancer TNM, 8th edition: anatomic stage groups

UK reports stage against the UICC 8th edition, whose anatomic groups these are; the Royal College of Pathologists dataset in force (G148 version 3, November 2024) reprints it and advises against substituting AJCC TNM 8, because the AJCC edition also defines prognostic stage groups that move tumours up or down by grade, ER, PR and HER2 status and, for T1-2 N0 HR-positive HER2-negative disease, a low-risk genomic assay result. The UICC 9th edition, recommended from 1 January 2026, leaves the breast classification unchanged and clarifies only the post-treatment yp classification, basing ypT on the largest continuous focus of residual invasive cancer and recommending that residual cancer burden be reported beside it.

Stage	Definition	Standard of care on the cancer page
0	Tis (DCIS).	-
IA / IB	T1 (2 cm or smaller) N0 / T0-1 N1mi (micrometastases 0.2-2 mm).	Stage I (T1a-b N0), Stage II-III, Germline BRCA1 or BRCA2 carriers: early-stage choices
IIA / IIB	T0-1 N1 or T2 (2-5 cm) N0 / T2 N1 or T3 (over 5 cm) N0.	Stage II-III, Choice of neoadjuvant backbone: the platinum debate, Germline BRCA1 or BRCA2 carriers: early-stage choices
IIIA / IIIB / IIIC	T0-2 N2 or T3 N1-2 / T4 (chest wall, skin, inflammatory) N0-2 / any T N3 (10 or more axillary nodes, infraclavicular, internal mammary plus axillary, supraclavicular).	Choice of neoadjuvant backbone: the platinum debate
IV	M1: distant metastases.	Metastatic, first line, PD-L1 CPS ≥10, Metastatic, first line, PD-L1 negative or PD-1 ineligible, Metastatic, later lines

Glioma & glioblastoma

Louis et al., Neuro-Oncology 2021

WHO CNS5 (2021) classification of adult diffuse gliomas

Diagnosis is molecular first: IDH and 1p/19q status define the tumour type; grade is then assigned within the type. IDH-wild-type diffuse astrocytoma with TERT promoter mutation, EGFR amplification or +7/−10 is glioblastoma regardless of histology.

Stage	Definition	Standard of care on the cancer page
Astrocytoma, IDH-mutant, grade 2	IDH1/2-mutant, 1p/19q intact, ATRX loss; low mitotic activity.	IDH-mutant grade 2, IDH-mutant grade 2 glioma, Paediatric low-grade glioma
Astrocytoma, IDH-mutant, grade 3	As above with anaplasia and mitotic activity.	IDH-mutant grade 2, IDH-mutant grade 2 glioma, Oligodendroglioma grade 3 / astrocytoma grade 3
Astrocytoma, IDH-mutant, grade 4	As above with necrosis, microvascular proliferation or CDKN2A/B homozygous deletion.	IDH-mutant grade 2, IDH-mutant grade 2 glioma
Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 2-3	Codeletion defines the type; grade 3 with anaplasia.	Oligodendroglioma grade 3 / astrocytoma grade 3, Paediatric low-grade glioma
Glioblastoma, IDH-wild-type, grade 4	IDH-wild-type with necrosis or microvascular proliferation, or TERT promoter mutation, EGFR amplification or +7/−10.	Glioblastoma, Glioblastoma, newly diagnosed, Glioblastoma, recurrent

Colorectal cancer

Colorectal cancer TNM, 8th edition: stage groups

Stage	Definition	Standard of care on the cancer page
0	Tis: carcinoma in situ or intramucosal.	-
I	T1-2 (submucosa or muscularis propria) N0.	Stage I and low-risk stage II colon cancer, High-risk stage II colon cancer, Stage III colon cancer, mismatch-repair proficient
IIA / IIB / IIC	T3 N0 (through muscularis) / T4a N0 (visceral peritoneum) / T4b N0 (adjacent organs).	Stage I and low-risk stage II colon cancer, High-risk stage II colon cancer, Stage III colon cancer, mismatch-repair proficient
IIIA / IIIB / IIIC	Any node-positive disease without metastasis: IIIA T1-2 N1 or T1 N2a; IIIB T3-4a N1, T2-3 N2a, T1-2 N2b; IIIC T4a N2a, T3-4a N2b, T4b N1-2.	Stage III colon cancer, mismatch-repair proficient, Stage III colon cancer, mismatch-repair deficient, Locally advanced rectal cancer: radiotherapy and total neoadjuvant therapy
IVA / IVB / IVC	M1a one organ or site / M1b more than one / M1c peritoneal metastasis with or without organ involvement.	Metastatic disease, mismatch-repair deficient or MSI-high, first line, Metastatic disease, RAS and BRAF wild-type, left-sided, first line, Metastatic disease, RAS-mutant or right-sided, first line

Hepatocellular carcinoma

Reig et al., J Hepatol 2022

BCLC staging for hepatocellular carcinoma (2022 update)

Stage	Definition	Standard of care on the cancer page
0 (very early)	Single tumour 2 cm or smaller, preserved liver function, ECOG 0.	Early, Very early / early (BCLC 0-A)
A (early)	Single tumour, or up to 3 nodules each 3 cm or smaller, preserved liver function, ECOG 0.	Early, Very early / early (BCLC 0-A)
B (intermediate)	Multinodular, preserved liver function, ECOG 0; subclassified by transplant candidacy and tumour burden.	Intermediate, Intermediate (BCLC B)
C (advanced)	Portal invasion or extrahepatic spread, preserved liver function, ECOG 1-2.	Advanced, Advanced (BCLC C), first line, Advanced, second line and beyond
D (terminal)	End-stage liver function or ECOG 3-4: best supportive care.	-

Child-Pugh score

Bilirubin
Albumin
INR
Ascites
Encephalopathy

Score

5 / 15

Class A (5-6)

Class and what it means for treatment

Preserved function: eligible for resection, ablation, TACE and the systemic trials (IMbrave150, HIMALAYA enrolled Child-Pugh A only).

Standard of care: Advanced, Advanced (BCLC C), first line, Advanced, second line and beyond

Class A (5-6) 5-6: Preserved function: eligible for resection, ablation, TACE and the systemic trials (IMbrave150, HIMALAYA enrolled Child-Pugh A only).Class B (7-9) 7-9: Decompensating: systemic therapy on a case-by-case basis; sorafenib and lenvatinib have B7 data; transplant if within criteria.Class C (10-15) 10-15: Decompensated: transplant assessment or best supportive care; anticancer therapy is usually harmful.(minimum score 5)

ALBI grade (albumin and bilirubin only) is a more objective alternative used in trials.

Source: Pugh et al., Br J Surg 1973. Outcomes are those of the published cohort and do not account for treatments since.

Bladder & urothelial cancer

EAU guidelines on non-muscle-invasive bladder cancer

Non-muscle-invasive bladder cancer risk groups

Stage	Definition	Standard of care on the cancer page
Low risk	Primary, solitary, Ta, low grade, under 3 cm, no CIS.	NMIBC, Low / intermediate-risk NMIBC, High-risk NMIBC, BCG-naive
Intermediate risk	Ta low-grade tumours that are recurrent, multiple or 3 cm or larger, without high-risk features.	NMIBC, Low / intermediate-risk NMIBC, High-risk NMIBC, BCG-naive
High risk	T1, high grade, or CIS.	NMIBC, Low / intermediate-risk NMIBC, High-risk NMIBC, BCG-naive
Very high risk	Combinations such as T1 high grade with CIS, multiple large recurrent T1 high grade, variant histology or lymphovascular invasion; early cystectomy is discussed.	BCG-unresponsive NMIBC (CIS ± papillary), After cystectomy (no perioperative IO)

Localised prostate cancer, high and very high risk

Localised prostate cancer: the Cambridge Prognostic Groups (NICE)

The five-tier model NICE recommends for everyone with newly diagnosed localised or locally advanced prostate cancer, assigned by the urological cancer MDT. It replaced the three-tier D'Amico model in the 2021 amendment because that model could not separate Gleason 3+4 from 4+3. PSA is in micrograms per litre, which is the same number as nanograms per millilitre. NICE's treatment recommendations are written in these group numbers.

Stage	Definition	Standard of care on the cancer page
CPG 1	Gleason score 6 (grade group 1) and PSA under 10 and stage T1 to T2. Active surveillance is offered first (NG131 1.3.8).	-
CPG 2	Gleason 3+4=7 (grade group 2) or PSA 10 to 20, with stage T1 to T2. Active surveillance, radical prostatectomy and radical radiotherapy are offered as a choice (NG131 1.3.9).	-
CPG 3	Gleason 3+4=7 (grade group 2) and PSA 10 to 20 and stage T1 to T2, or Gleason 4+3=7 (grade group 3) at stage T1 to T2. Radical treatment is offered; active surveillance is considered only for people who decline it (NG131 1.3.10).	-
CPG 4	Any one of: Gleason score 8 (grade group 4), PSA above 20, stage T3. Active surveillance is not offered (NG131 1.3.11).	High risk, Very high risk and node-positive
CPG 5	Two or more of Gleason score 8 (grade group 4), PSA above 20 and stage T3; or Gleason 9 to 10 (grade group 5); or stage T4.	High risk, Very high risk and node-positive

Localised prostate cancer, intermediate risk

Localised prostate cancer: the Cambridge Prognostic Groups (NICE)

The five-tier model NICE recommends for everyone with newly diagnosed localised or locally advanced prostate cancer, assigned by the urological cancer MDT. It replaced the three-tier D'Amico model in the 2021 amendment because that model could not separate Gleason 3+4 from 4+3. PSA is in micrograms per litre, which is the same number as nanograms per millilitre. NICE's treatment recommendations are written in these group numbers.

Stage	Definition	Standard of care on the cancer page
CPG 1	Gleason score 6 (grade group 1) and PSA under 10 and stage T1 to T2. Active surveillance is offered first (NG131 1.3.8).	-
CPG 2	Gleason 3+4=7 (grade group 2) or PSA 10 to 20, with stage T1 to T2. Active surveillance, radical prostatectomy and radical radiotherapy are offered as a choice (NG131 1.3.9).	Favourable intermediate risk, Unfavourable intermediate risk
CPG 3	Gleason 3+4=7 (grade group 2) and PSA 10 to 20 and stage T1 to T2, or Gleason 4+3=7 (grade group 3) at stage T1 to T2. Radical treatment is offered; active surveillance is considered only for people who decline it (NG131 1.3.10).	Favourable intermediate risk, Unfavourable intermediate risk
CPG 4	Any one of: Gleason score 8 (grade group 4), PSA above 20, stage T3. Active surveillance is not offered (NG131 1.3.11).	-
CPG 5	Two or more of Gleason score 8 (grade group 4), PSA above 20 and stage T3; or Gleason 9 to 10 (grade group 5); or stage T4.	-

Localised prostate cancer, very low and low risk

Localised prostate cancer: the Cambridge Prognostic Groups (NICE)

The five-tier model NICE recommends for everyone with newly diagnosed localised or locally advanced prostate cancer, assigned by the urological cancer MDT. It replaced the three-tier D'Amico model in the 2021 amendment because that model could not separate Gleason 3+4 from 4+3. PSA is in micrograms per litre, which is the same number as nanograms per millilitre. NICE's treatment recommendations are written in these group numbers.

Stage	Definition	Standard of care on the cancer page
CPG 1	Gleason score 6 (grade group 1) and PSA under 10 and stage T1 to T2. Active surveillance is offered first (NG131 1.3.8).	Very low and low risk, preferred, Low risk, men who prefer treatment
CPG 2	Gleason 3+4=7 (grade group 2) or PSA 10 to 20, with stage T1 to T2. Active surveillance, radical prostatectomy and radical radiotherapy are offered as a choice (NG131 1.3.9).	-
CPG 3	Gleason 3+4=7 (grade group 2) and PSA 10 to 20 and stage T1 to T2, or Gleason 4+3=7 (grade group 3) at stage T1 to T2. Radical treatment is offered; active surveillance is considered only for people who decline it (NG131 1.3.10).	-
CPG 4	Any one of: Gleason score 8 (grade group 4), PSA above 20, stage T3. Active surveillance is not offered (NG131 1.3.11).	-
CPG 5	Two or more of Gleason score 8 (grade group 4), PSA above 20 and stage T3; or Gleason 9 to 10 (grade group 5); or stage T4.	-

Prostate cancer

Localised prostate cancer: NCCN risk groups

NCCN Prostate Cancer

Stage	Definition	Standard of care on the cancer page
Very low	cT1c, Grade Group 1, PSA under 10 ng/mL, fewer than 3 positive cores with 50% or less cancer in each, PSA density under 0.15.	Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet
Low	cT1-T2a, Grade Group 1, PSA under 10.	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
Favourable intermediate	One intermediate factor (cT2b-c, Grade Group 2-3, or PSA 10-20), Grade Group 1-2, under 50% of cores positive.	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
Unfavourable intermediate	Two or more intermediate factors, or Grade Group 3, or 50% or more cores positive.	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
High	cT3a, or Grade Group 4-5, or PSA over 20.	Localised and locally advanced prostate cancer, CPG 4 to 5 (high risk): radiotherapy with long androgen deprivation
Very high	cT3b-T4, or primary Gleason pattern 5, or 2-3 high-risk features, or more than 4 cores Grade Group 4-5.	Localised and locally advanced prostate cancer, CPG 4 to 5 (high risk): radiotherapy with long androgen deprivation

Localised prostate cancer: the Cambridge Prognostic Groups (NICE)

Epstein et al., Am J Surg Pathol 2016 (ISUP 2014 consensus)

The five-tier model NICE recommends for everyone with newly diagnosed localised or locally advanced prostate cancer, assigned by the urological cancer MDT. It replaced the three-tier D'Amico model in the 2021 amendment because that model could not separate Gleason 3+4 from 4+3. PSA is in micrograms per litre, which is the same number as nanograms per millilitre. NICE's treatment recommendations are written in these group numbers.

Stage	Definition	Standard of care on the cancer page
CPG 1	Gleason score 6 (grade group 1) and PSA under 10 and stage T1 to T2. Active surveillance is offered first (NG131 1.3.8).	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
CPG 2	Gleason 3+4=7 (grade group 2) or PSA 10 to 20, with stage T1 to T2. Active surveillance, radical prostatectomy and radical radiotherapy are offered as a choice (NG131 1.3.9).	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
CPG 3	Gleason 3+4=7 (grade group 2) and PSA 10 to 20 and stage T1 to T2, or Gleason 4+3=7 (grade group 3) at stage T1 to T2. Radical treatment is offered; active surveillance is considered only for people who decline it (NG131 1.3.10).	Localised prostate cancer: monitoring, surgery or radiotherapy, and what each one costs you, Localised prostate cancer, CPG 1 (low risk): the case for doing nothing yet, Localised prostate cancer, CPG 2 to 3 (intermediate risk): surgery or radiotherapy, and how many visits
CPG 4	Any one of: Gleason score 8 (grade group 4), PSA above 20, stage T3. Active surveillance is not offered (NG131 1.3.11).	Localised and locally advanced prostate cancer, CPG 4 to 5 (high risk): radiotherapy with long androgen deprivation
CPG 5	Two or more of Gleason score 8 (grade group 4), PSA above 20 and stage T3; or Gleason 9 to 10 (grade group 5); or stage T4.	Localised and locally advanced prostate cancer, CPG 4 to 5 (high risk): radiotherapy with long androgen deprivation

Gleason score and ISUP Grade Groups

Stage	Definition	Standard of care on the cancer page
Grade Group 1	Gleason 3+3 = 6. Only individual, well-formed glands.	-
Grade Group 2	Gleason 3+4 = 7. Predominantly well-formed glands with a lesser component of poorly formed, fused or cribriform glands.	-
Grade Group 3	Gleason 4+3 = 7. Predominantly poorly formed, fused or cribriform glands.	-
Grade Group 4	Gleason 8 (4+4, 3+5, 5+3).	-
Grade Group 5	Gleason 9-10. Lack of gland formation, necrosis, or both.	-

Renal cell carcinoma

IMDC (Heng) risk model for metastatic RCC

Heng criteria

Karnofsky performance status under 80%+1
Under 1 year from diagnosis to systemic treatment+1
Haemoglobin below the lower limit of normal+1
Corrected calcium above the upper limit of normal+1
Neutrophils above the upper limit of normal+1
Platelets above the upper limit of normal+1

Score

0 / 6

Favourable

Median overall survival on VEGF-targeted therapy (external validation, Heng 2013)

43.2 months

Standard of care: Metastatic, favourable risk, first line

Favourable 0: 43.2 monthsIntermediate 1-2: 22.5 monthsPoor 3-6: 7.8 months

Derived in the VEGF-TKI era; survival on immunotherapy combinations is longer in every group, but the groups still select first-line regimens (nivolumab-ipilimumab is approved for intermediate and poor risk).

Source: Heng et al., Lancet Oncology 2013 (validation); JCO 2009 (derivation). Outcomes are those of the published cohort and do not account for treatments since.

Cervical cancer

Bhatla et al., Int J Gynaecol Obstet 2019

FIGO 2018 staging of cervical cancer

The 2018 revision allows imaging and pathology to assign stage and adds IIIC for nodal disease (IIIC1 pelvic, IIIC2 para-aortic).

Stage	Definition	Standard of care on the cancer page
IA1 / IA2	Microscopic invasion under 3 mm / 3-5 mm.	-
IB1 / IB2 / IB3	Invasion 5 mm or more and largest dimension under 2 cm / 2-4 cm / 4 cm or more.	Stage IA1-IB1 (≤2 cm), Stage IB2-IIA (surgical candidates)
IIA1 / IIA2 / IIB	Upper two-thirds of vagina under 4 cm / 4 cm or more / parametrial involvement.	Locally advanced, Locally advanced (IB3, IIB-IVA), standard, Locally advanced, high risk (node-positive IB2-IIB, III-IVA)
IIIA / IIIB / IIIC1 / IIIC2	Lower third of vagina / pelvic wall or hydronephrosis / pelvic nodes / para-aortic nodes.	Locally advanced, Locally advanced (IB3, IIB-IVA), standard, Locally advanced, high risk (node-positive IB2-IIB, III-IVA)
IVA / IVB	Bladder or rectum invasion / distant metastasis.	Recurrent/metastatic, Persistent, recurrent, or metastatic, first line

Ovarian cancer

Prat et al., Int J Gynaecol Obstet 2014

FIGO 2014 staging of ovarian, fallopian tube and peritoneal cancer

Stage	Definition	Standard of care on the cancer page
I (IA-IC)	Confined to ovaries or tubes; IC for surgical spill, capsule rupture or positive washings.	Newly diagnosed stage I-II, Newly diagnosed stage III-IV: surgery and chemotherapy
II	Pelvic extension or primary peritoneal cancer confined to the pelvis.	Newly diagnosed stage III-IV: surgery and chemotherapy
III (IIIA1-IIIC)	Spread to the peritoneum outside the pelvis or retroperitoneal nodes: IIIA1 nodes only, IIIA2 microscopic, IIIB 2 cm or smaller, IIIC over 2 cm.	Newly diagnosed, Newly diagnosed stage I-II, Newly diagnosed stage III-IV: surgery and chemotherapy
IV (IVA-IVB)	Distant metastasis: IVA pleural effusion with positive cytology; IVB parenchymal or extra-abdominal metastases.	Newly diagnosed, Newly diagnosed stage I-II, Newly diagnosed stage III-IV: surgery and chemotherapy

Chronic lymphocytic leukaemia

Binet et al., Cancer 1981; Rai et al., Blood 1975

Binet and Rai staging of CLL

Staging decides when to treat (iwCLL active-disease criteria), not what to treat with; CLL-IPI (below) and TP53/IGHV status guide therapy choice.

Stage	Definition	Standard of care on the cancer page
Binet A	Fewer than 3 involved lymphoid areas, haemoglobin 100 g/L or above, platelets 100 × 10⁹/L or above (Rai 0-II).	Early stage, asymptomatic (Rai 0-II, Binet A-B)
Binet B	3 or more involved areas, counts preserved (Rai I-II).	Early stage, asymptomatic (Rai 0-II, Binet A-B)
Binet C	Haemoglobin under 100 g/L or platelets under 100 × 10⁹/L (Rai III-IV).	Early stage, asymptomatic (Rai 0-II, Binet A-B)

CLL-IPI

Score

0 / 10

Low

5-year overall survival (derivation, chemoimmunotherapy era)

93.2%

Standard of care: Early stage, asymptomatic (Rai 0-II, Binet A-B)

Low 0-1: 93.2%Intermediate 2-3: 79.3%High 4-6: 63.3%Very high 7-10: 23.3%

Outcomes predate BTK and BCL-2 inhibitors; with targeted therapy the survival gap between groups narrows but TP53 status still changes the regimen.

Source: International CLL-IPI working group, Lancet Oncology 2016. Outcomes are those of the published cohort and do not account for treatments since.

Diffuse large B-cell lymphoma

Lugano classification (modified Ann Arbor) for lymphoma

Limited stage is I-II; advanced stage is III-IV. B symptoms (fever, night sweats, weight loss over 10% in 6 months) are recorded for Hodgkin lymphoma only. Bulk is a single mass of 10 cm or over a third of the transthoracic diameter (Hodgkin) or per histology for NHL.

Stage	Definition	Standard of care on the cancer page
I	One node or group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE).	Limited stage (I-II, non-bulky), Limited stage (I to II), non-bulky, low risk: four cycles, and often no radiotherapy
II	Two or more nodal groups on the same side of the diaphragm; or stage I-II by nodal extent with limited contiguous extranodal involvement (IIE).	Limited stage (I-II, non-bulky), Limited stage (I to II), non-bulky, low risk: four cycles, and often no radiotherapy
II bulky	Stage II with bulky disease; treated as limited or advanced by histology and prognostic factors.	Limited stage (I-II, non-bulky), Advanced stage, IPI 0-1, Advanced stage, IPI 2-5
III	Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement.	Advanced stage, IPI 0-1, Advanced stage, IPI 2-5, Advanced stage, IPI 0 to 1: R-CHOP for six cycles
IV	Additional non-contiguous extralymphatic involvement (marrow, liver, lung, CNS).	Advanced stage, IPI 0-1, Advanced stage, IPI 2-5, Advanced stage, IPI 0 to 1: R-CHOP for six cycles

International Prognostic Index (IPI) with R-IPI groups

IPI · R-IPI

Score

0 / 5

Very good (R-IPI)

4-year overall survival, rituximab era (R-IPI, Sehn 2007)

94% (4-year PFS 94%)

Very good (R-IPI) 0: 94% (4-year PFS 94%)Good (R-IPI) 1-2: 79% (4-year PFS 80%)Poor (R-IPI) 3-5: 55% (4-year PFS 53%)

Original IPI groups: low 0-1, low-intermediate 2, high-intermediate 3, high 4-5 with 5-year OS 73%, 51%, 43% and 26% before rituximab (Shipp 1993). NCCN-IPI (Zhou 2014) refines age and LDH bands.

Source: Sehn et al., Blood 2007 (R-IPI); Shipp et al., NEJM 1993 (IPI). Outcomes are those of the published cohort and do not account for treatments since.

Follicular lymphoma

Lugano classification (modified Ann Arbor) for lymphoma

Limited stage is I-II; advanced stage is III-IV. B symptoms (fever, night sweats, weight loss over 10% in 6 months) are recorded for Hodgkin lymphoma only. Bulk is a single mass of 10 cm or over a third of the transthoracic diameter (Hodgkin) or per histology for NHL.

Stage	Definition	Standard of care on the cancer page
I	One node or group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE).	Limited stage (I-II), Stage I and contiguous stage II follicular lymphoma: radiotherapy with curative intent
II	Two or more nodal groups on the same side of the diaphragm; or stage I-II by nodal extent with limited contiguous extranodal involvement (IIE).	Limited stage (I-II), Stage I and contiguous stage II follicular lymphoma: radiotherapy with curative intent
II bulky	Stage II with bulky disease; treated as limited or advanced by histology and prognostic factors.	Advanced, low burden, asymptomatic, Advanced, high burden (GELF criteria), Advanced follicular lymphoma with no symptoms: watch and wait, or rituximab alone
III	Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement.	Advanced, low burden, asymptomatic, Advanced, high burden (GELF criteria), Advanced follicular lymphoma with no symptoms: watch and wait, or rituximab alone
IV	Additional non-contiguous extralymphatic involvement (marrow, liver, lung, CNS).	Advanced, low burden, asymptomatic, Advanced, high burden (GELF criteria), Advanced follicular lymphoma with no symptoms: watch and wait, or rituximab alone

FLIPI

Follicular Lymphoma International Prognostic Index

Score

0 / 5

Low

10-year overall survival (derivation cohort, pre-rituximab)

71%

Standard of care: Advanced follicular lymphoma with no symptoms: watch and wait, or rituximab alone

Low 0-1: 71%Intermediate 2: 51%High 3-5: 36%

FLIPI2 (Federico 2009) uses β2-microglobulin, node over 6 cm, marrow involvement, haemoglobin and age; PRIMA-PI uses β2-microglobulin and marrow alone.

Source: Solal-Céligny et al., Blood 2004. Outcomes are those of the published cohort and do not account for treatments since.

Hodgkin lymphoma

Lugano classification (modified Ann Arbor) for lymphoma

Limited stage is I-II; advanced stage is III-IV. B symptoms (fever, night sweats, weight loss over 10% in 6 months) are recorded for Hodgkin lymphoma only. Bulk is a single mass of 10 cm or over a third of the transthoracic diameter (Hodgkin) or per histology for NHL.

Stage	Definition	Standard of care on the cancer page
I	One node or group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE).	Early stage, favourable (I-II), Early stage, unfavourable (I-II bulky or risk factors)
II	Two or more nodal groups on the same side of the diaphragm; or stage I-II by nodal extent with limited contiguous extranodal involvement (IIE).	Early stage, favourable (I-II), Early stage, unfavourable (I-II bulky or risk factors)
II bulky	Stage II with bulky disease; treated as limited or advanced by histology and prognostic factors.	Advanced stage, Early stage, unfavourable (I-II bulky or risk factors), Advanced stage (III-IV), age ≤60
III	Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement.	Advanced stage, Advanced stage (III-IV), age ≤60, Advanced stage, age >60
IV	Additional non-contiguous extralymphatic involvement (marrow, liver, lung, CNS).	Advanced stage, Advanced stage (III-IV), age ≤60, Advanced stage, age >60

Mantle cell lymphoma

Lugano classification (modified Ann Arbor) for lymphoma

Limited stage is I-II; advanced stage is III-IV. B symptoms (fever, night sweats, weight loss over 10% in 6 months) are recorded for Hodgkin lymphoma only. Bulk is a single mass of 10 cm or over a third of the transthoracic diameter (Hodgkin) or per histology for NHL.

Stage	Definition	Standard of care on the cancer page
I	One node or group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE).	-
II	Two or more nodal groups on the same side of the diaphragm; or stage I-II by nodal extent with limited contiguous extranodal involvement (IIE).	-
II bulky	Stage II with bulky disease; treated as limited or advanced by histology and prognostic factors.	-
III	Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement.	-
IV	Additional non-contiguous extralymphatic involvement (marrow, liver, lung, CNS).	-

Simplified MIPI

MIPI · Mantle Cell Lymphoma International Prognostic Index

Age
ECOG performance status 2-4+2
LDH / upper limit of normal
White cell count (× 10⁹/L)

Score

0 / 11

Low

Median overall survival (derivation, Hoster 2008)

Not reached (5-year OS 60%)

Low 0-3: Not reached (5-year OS 60%)Intermediate 4-5: 51 monthsHigh 6-11: 29 months

Ki-67 of 30% or more adds independent risk (MIPI-c). Outcomes predate BTK inhibitors and cytarabine-based induction.

Source: Hoster et al., Blood 2008. Outcomes are those of the published cohort and do not account for treatments since.

Multiple myeloma

Palumbo et al., JCO 2015 (R-ISS)

Myeloma ISS and R-ISS staging

ISS uses β2-microglobulin and albumin only. R-ISS adds interphase FISH (del(17p), t(4;14), t(14;16)) and LDH. R2-ISS (2022) further weights 1q gain. Use the interactive R-ISS scorer below.

Stage	Definition	Standard of care on the cancer page
ISS I	β2-microglobulin under 3.5 mg/L and albumin 35 g/L or above.	-
ISS II	Neither I nor III.	-
ISS III	β2-microglobulin 5.5 mg/L or above.	-
R-ISS I	ISS I, standard-risk cytogenetics and normal LDH.	Newly diagnosed, Newly diagnosed, transplant-eligible, Newly diagnosed, transplant-ineligible
R-ISS II	Not R-ISS I or III.	Newly diagnosed, Newly diagnosed, transplant-eligible, Newly diagnosed, transplant-ineligible
R-ISS III	ISS III with either high-risk cytogenetics or raised LDH.	Newly diagnosed, High-risk smouldering myeloma, Newly diagnosed, transplant-eligible

R-ISS (Revised International Staging System)

ISS stage
High-risk FISH: del(17p), t(4;14) or t(14;16)+1
LDH above normal+1

Score

0 / 5

R-ISS I

5-year overall survival (Palumbo 2015 pooled trials)

82%

R-ISS I 0: 82%R-ISS II 1-3: 62%R-ISS III 4-5: 40%

Points here are a device to reproduce the R-ISS rules: stage III needs ISS III plus at least one of high-risk FISH or raised LDH; stage I needs ISS I with neither. Median OS was not reached, 83 months and 43 months.

Source: Palumbo et al., JCO 2015. Outcomes are those of the published cohort and do not account for treatments since.

Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)

Lugano classification (modified Ann Arbor) for lymphoma

Limited stage is I-II; advanced stage is III-IV. B symptoms (fever, night sweats, weight loss over 10% in 6 months) are recorded for Hodgkin lymphoma only. Bulk is a single mass of 10 cm or over a third of the transthoracic diameter (Hodgkin) or per histology for NHL.

Stage	Definition	Standard of care on the cancer page
I	One node or group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE).	-
II	Two or more nodal groups on the same side of the diaphragm; or stage I-II by nodal extent with limited contiguous extranodal involvement (IIE).	-
II bulky	Stage II with bulky disease; treated as limited or advanced by histology and prognostic factors.	-
III	Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement.	-
IV	Additional non-contiguous extralymphatic involvement (marrow, liver, lung, CNS).	-

Non-small-cell lung cancer

Detterbeck et al., Chest 2017 (IASLC 8th edition)

Lung cancer TNM, 8th edition: stage groups

Stage	Definition	Standard of care on the cancer page
IA1-IA3	T1a-c (3 cm or smaller) N0 M0; IA1 up to 1 cm, IA2 1-2 cm, IA3 2-3 cm.	Stage I-II resectable, Stage III unresectable
IB	T2a (3-4 cm, or main bronchus or visceral pleura) N0.	Stage I-II resectable, Stage III unresectable
IIA	T2b (4-5 cm) N0.	Stage I-II resectable, Stage III unresectable
IIB	T1-2 N1, or T3 (5-7 cm, chest wall, separate nodule same lobe) N0.	Stage I-II resectable, Stage III unresectable
IIIA	T1-2 N2, T3 N1, or T4 (over 7 cm, mediastinal invasion, nodule in another ipsilateral lobe) N0-1.	Stage III unresectable
IIIB	T1-2 N3, or T3-4 N2.	Stage III unresectable
IIIC	T3-4 N3.	Stage III unresectable
IVA	M1a (pleural or pericardial spread, contralateral lung nodule) or M1b (single extrathoracic metastasis).	Metastatic, EGFR exon 19 del / L858R, Metastatic, EGFR exon 20 insertion, Metastatic, ALK-rearranged
IVB	M1c: multiple extrathoracic metastases.	Metastatic, EGFR exon 19 del / L858R, Metastatic, EGFR exon 20 insertion, Metastatic, ALK-rearranged

Small-cell lung cancer

Kalemkerian et al., NCCN Small Cell Lung Cancer; VALG two-stage system

Small-cell lung cancer: limited versus extensive stage

Stage	Definition	Standard of care on the cancer page
Limited stage	Confined to one hemithorax and regional nodes, encompassable in a tolerable radiotherapy field (roughly TNM I-III without malignant effusion); about a third of patients.	Very limited stage (T1-2 N0, ~5%), Limited stage
Extensive stage	Beyond one hemithorax, malignant pleural or pericardial effusion, or distant metastases (TNM IV); about two-thirds.	Extensive stage, first line

Advanced cutaneous squamous cell carcinoma

Royal College of Pathologists appendix A, version 3, 6 November 2025: UICC TNM 9 pathological staging of primary cutaneous carcinoma

Carcinoma of the skin: UICC TNM 9 (the system UK reports use)

UK skin carcinoma reports stage against UICC, not the American AJCC: the Royal College of Pathologists assessed both and chose UICC because AJCC 8 covers only the head and neck while UICC covers the whole body surface, and because UICC TNM is the version favoured by NCRAS. The table combines the UICC head-and-neck and carcinoma-of-the-skin chapters and covers basal cell, squamous cell and adnexal carcinoma; it excludes Merkel cell carcinoma and carcinomas of the eyelid, vulva, penis, non-hair-bearing lip and non-hair-bearing perianal skin. Most people with a keratinocyte cancer are never given a stage at all, because it would not change what is done; the words that decide care in Britain are low risk and high risk.

Stage	Definition	Standard of care on the cancer page
Stage 0	Tis N0 M0: carcinoma in situ, which in the skin usually means Bowen's disease.	-
Stage I	T1 N0 M0: tumour 20 mm or less in maximum dimension, usually the clinical measurement.	-
Stage II	T2 N0 M0: tumour over 20 mm and up to 40 mm.	-
Stage III	T3 N0 M0, or T1 to T3 with N1. T3 is over 40 mm, or minor bone erosion, or perineural invasion, or deep invasion (beyond the subcutaneous fat, or more than 6 mm from the granular layer of adjacent normal epidermis). N1 is a single ipsilateral node 30 mm or less.	Adjuvant after surgery and radiotherapy
Stage IV	T1 to T3 with N2 or N3, or any T4, or any M1. T4a is gross cortical or marrow invasion; T4b is axial skeleton invasion including the vertebral foramen and epidural space. Nodal categories differ between the head and neck, where extranodal extension subdivides them, and the trunk and limbs, where a contralateral node counts as distant metastasis.	Locally advanced or metastatic, first line

Cutaneous squamous cell carcinoma: the Brigham and Women's Hospital alternative

Jambusaria-Pahlajani et al., JAMA Dermatology 2013;149:402 to 410 (derivation); Karia et al., Journal of Clinical Oncology 2014;32:327 to 334 (validation)

Not a UK reporting standard and not used in UK pathology reports, which stage against UICC. It is included because it is the evidence behind the general agreement that the anatomical stage alone does not identify the dangerous tumours, and because American sources quote it. It counts four risk factors rather than measuring the tumour: poor differentiation, perineural invasion, diameter 2 cm or more, and invasion beyond the subcutaneous fat, with bone invasion automatically T3. The ten-year outcomes below come from 1,818 primary tumours at one American referral centre and are higher than an unselected population would show; the ranking rather than the percentage is what transfers. The Royal College of Pathologists has published its objection to the risk bands derived from this system.

Stage	Definition	Standard of care on the cancer page
T1	No risk factors. In the validation cohort, T1 and T2a together carried 10-year cumulative incidences of 1.4 percent local recurrence, 0.6 percent nodal metastasis and 0.2 percent death from the cancer.	-
T2a	One risk factor.	-
T2b	Two or three risk factors. In the derivation cohort T2b was 19 percent of cases but 72 percent of nodal metastases and 83 percent of deaths from the cancer.	Adjuvant after surgery and radiotherapy
T3	Four risk factors, or bone invasion. T2b and T3 together were 5 percent of the validation cohort and carried 60 percent of poor outcomes, with 10-year incidences of 24 percent local recurrence, 24 percent nodal metastasis and 16 percent death from the cancer.	Locally advanced or metastatic, first line

Basal cell carcinoma

Royal College of Pathologists appendix A, version 3, 6 November 2025: UICC TNM 9 pathological staging of primary cutaneous carcinoma

Carcinoma of the skin: UICC TNM 9 (the system UK reports use)

UK skin carcinoma reports stage against UICC, not the American AJCC: the Royal College of Pathologists assessed both and chose UICC because AJCC 8 covers only the head and neck while UICC covers the whole body surface, and because UICC TNM is the version favoured by NCRAS. The table combines the UICC head-and-neck and carcinoma-of-the-skin chapters and covers basal cell, squamous cell and adnexal carcinoma; it excludes Merkel cell carcinoma and carcinomas of the eyelid, vulva, penis, non-hair-bearing lip and non-hair-bearing perianal skin. Most people with a keratinocyte cancer are never given a stage at all, because it would not change what is done; the words that decide care in Britain are low risk and high risk.

Stage	Definition	Standard of care on the cancer page
Stage 0	Tis N0 M0: carcinoma in situ, which in the skin usually means Bowen's disease.	-
Stage I	T1 N0 M0: tumour 20 mm or less in maximum dimension, usually the clinical measurement.	-
Stage II	T2 N0 M0: tumour over 20 mm and up to 40 mm.	-
Stage III	T3 N0 M0, or T1 to T3 with N1. T3 is over 40 mm, or minor bone erosion, or perineural invasion, or deep invasion (beyond the subcutaneous fat, or more than 6 mm from the granular layer of adjacent normal epidermis). N1 is a single ipsilateral node 30 mm or less.	-
Stage IV	T1 to T3 with N2 or N3, or any T4, or any M1. T4a is gross cortical or marrow invasion; T4b is axial skeleton invasion including the vertebral foramen and epidural space. Nodal categories differ between the head and neck, where extranodal extension subdivides them, and the trunk and limbs, where a contralateral node counts as distant metastasis.	Locally advanced or metastatic

Bowen's disease (squamous cell carcinoma in situ)

Royal College of Pathologists appendix A, version 3, 6 November 2025: UICC TNM 9 pathological staging of primary cutaneous carcinoma

Carcinoma of the skin: UICC TNM 9 (the system UK reports use)

UK skin carcinoma reports stage against UICC, not the American AJCC: the Royal College of Pathologists assessed both and chose UICC because AJCC 8 covers only the head and neck while UICC covers the whole body surface, and because UICC TNM is the version favoured by NCRAS. The table combines the UICC head-and-neck and carcinoma-of-the-skin chapters and covers basal cell, squamous cell and adnexal carcinoma; it excludes Merkel cell carcinoma and carcinomas of the eyelid, vulva, penis, non-hair-bearing lip and non-hair-bearing perianal skin. Most people with a keratinocyte cancer are never given a stage at all, because it would not change what is done; the words that decide care in Britain are low risk and high risk.

Stage	Definition	Standard of care on the cancer page
Stage 0	Tis N0 M0: carcinoma in situ, which in the skin usually means Bowen's disease.	-
Stage I	T1 N0 M0: tumour 20 mm or less in maximum dimension, usually the clinical measurement.	-
Stage II	T2 N0 M0: tumour over 20 mm and up to 40 mm.	-
Stage III	T3 N0 M0, or T1 to T3 with N1. T3 is over 40 mm, or minor bone erosion, or perineural invasion, or deep invasion (beyond the subcutaneous fat, or more than 6 mm from the granular layer of adjacent normal epidermis). N1 is a single ipsilateral node 30 mm or less.	-
Stage IV	T1 to T3 with N2 or N3, or any T4, or any M1. T4a is gross cortical or marrow invasion; T4b is axial skeleton invasion including the vertebral foramen and epidural space. Nodal categories differ between the head and neck, where extranodal extension subdivides them, and the trunk and limbs, where a contralateral node counts as distant metastasis.	-

Cutaneous squamous cell carcinoma

Royal College of Pathologists appendix A, version 3, 6 November 2025: UICC TNM 9 pathological staging of primary cutaneous carcinoma

Carcinoma of the skin: UICC TNM 9 (the system UK reports use)

UK skin carcinoma reports stage against UICC, not the American AJCC: the Royal College of Pathologists assessed both and chose UICC because AJCC 8 covers only the head and neck while UICC covers the whole body surface, and because UICC TNM is the version favoured by NCRAS. The table combines the UICC head-and-neck and carcinoma-of-the-skin chapters and covers basal cell, squamous cell and adnexal carcinoma; it excludes Merkel cell carcinoma and carcinomas of the eyelid, vulva, penis, non-hair-bearing lip and non-hair-bearing perianal skin. Most people with a keratinocyte cancer are never given a stage at all, because it would not change what is done; the words that decide care in Britain are low risk and high risk.

Stage	Definition	Standard of care on the cancer page
Stage 0	Tis N0 M0: carcinoma in situ, which in the skin usually means Bowen's disease.	-
Stage I	T1 N0 M0: tumour 20 mm or less in maximum dimension, usually the clinical measurement.	Localised low- and high-risk
Stage II	T2 N0 M0: tumour over 20 mm and up to 40 mm.	Localised low- and high-risk
Stage III	T3 N0 M0, or T1 to T3 with N1. T3 is over 40 mm, or minor bone erosion, or perineural invasion, or deep invasion (beyond the subcutaneous fat, or more than 6 mm from the granular layer of adjacent normal epidermis). N1 is a single ipsilateral node 30 mm or less.	High-risk after surgery and radiotherapy, Follow-up, the lymph nodes, and the chance of a second one, Radiotherapy after surgery, and what not to add to it
Stage IV	T1 to T3 with N2 or N3, or any T4, or any M1. T4a is gross cortical or marrow invasion; T4b is axial skeleton invasion including the vertebral foramen and epidural space. Nodal categories differ between the head and neck, where extranodal extension subdivides them, and the trunk and limbs, where a contralateral node counts as distant metastasis.	Locally advanced or metastatic

Cutaneous squamous cell carcinoma: the Brigham and Women's Hospital alternative

Jambusaria-Pahlajani et al., JAMA Dermatology 2013;149:402 to 410 (derivation); Karia et al., Journal of Clinical Oncology 2014;32:327 to 334 (validation)

Not a UK reporting standard and not used in UK pathology reports, which stage against UICC. It is included because it is the evidence behind the general agreement that the anatomical stage alone does not identify the dangerous tumours, and because American sources quote it. It counts four risk factors rather than measuring the tumour: poor differentiation, perineural invasion, diameter 2 cm or more, and invasion beyond the subcutaneous fat, with bone invasion automatically T3. The ten-year outcomes below come from 1,818 primary tumours at one American referral centre and are higher than an unselected population would show; the ranking rather than the percentage is what transfers. The Royal College of Pathologists has published its objection to the risk bands derived from this system.

Stage	Definition	Standard of care on the cancer page
T1	No risk factors. In the validation cohort, T1 and T2a together carried 10-year cumulative incidences of 1.4 percent local recurrence, 0.6 percent nodal metastasis and 0.2 percent death from the cancer.	Localised low- and high-risk
T2a	One risk factor.	Localised low- and high-risk
T2b	Two or three risk factors. In the derivation cohort T2b was 19 percent of cases but 72 percent of nodal metastases and 83 percent of deaths from the cancer.	Follow-up, the lymph nodes, and the chance of a second one
T3	Four risk factors, or bone invasion. T2b and T3 together were 5 percent of the validation cohort and carried 60 percent of poor outcomes, with 10-year incidences of 24 percent local recurrence, 24 percent nodal metastasis and 16 percent death from the cancer.	Locally advanced or metastatic

Locally advanced and metastatic basal cell carcinoma

Royal College of Pathologists appendix A, version 3, 6 November 2025: UICC TNM 9 pathological staging of primary cutaneous carcinoma

Carcinoma of the skin: UICC TNM 9 (the system UK reports use)

UK skin carcinoma reports stage against UICC, not the American AJCC: the Royal College of Pathologists assessed both and chose UICC because AJCC 8 covers only the head and neck while UICC covers the whole body surface, and because UICC TNM is the version favoured by NCRAS. The table combines the UICC head-and-neck and carcinoma-of-the-skin chapters and covers basal cell, squamous cell and adnexal carcinoma; it excludes Merkel cell carcinoma and carcinomas of the eyelid, vulva, penis, non-hair-bearing lip and non-hair-bearing perianal skin. Most people with a keratinocyte cancer are never given a stage at all, because it would not change what is done; the words that decide care in Britain are low risk and high risk.

Stage	Definition	Standard of care on the cancer page
Stage 0	Tis N0 M0: carcinoma in situ, which in the skin usually means Bowen's disease.	-
Stage I	T1 N0 M0: tumour 20 mm or less in maximum dimension, usually the clinical measurement.	-
Stage II	T2 N0 M0: tumour over 20 mm and up to 40 mm.	-
Stage III	T3 N0 M0, or T1 to T3 with N1. T3 is over 40 mm, or minor bone erosion, or perineural invasion, or deep invasion (beyond the subcutaneous fat, or more than 6 mm from the granular layer of adjacent normal epidermis). N1 is a single ipsilateral node 30 mm or less.	Neoadjuvant, Radiotherapy and local options
Stage IV	T1 to T3 with N2 or N3, or any T4, or any M1. T4a is gross cortical or marrow invasion; T4b is axial skeleton invasion including the vertebral foramen and epidural space. Nodal categories differ between the head and neck, where extranodal extension subdivides them, and the trunk and limbs, where a contralateral node counts as distant metastasis.	Locally advanced, first line, Metastatic disease

Melanoma

Gershenwald et al., CA Cancer J Clin 2017

Melanoma AJCC 8th edition

Stage	Definition	Standard of care on the cancer page
IA	T1a (under 0.8 mm, no ulceration) or T1b (under 0.8 mm ulcerated, or 0.8-1.0 mm) N0.	Stage II-III, Stage I-II primary, Stage IIB-IIC (thick or ulcerated, node-negative)
IB	T2a (1.0-2.0 mm, no ulceration) N0.	Stage II-III, Stage I-II primary, Stage IIB-IIC (thick or ulcerated, node-negative)
IIA	T2b (1.0-2.0 mm ulcerated) or T3a (2.0-4.0 mm) N0.	Stage II-III, Stage IIB-IIC (thick or ulcerated, node-negative), Resectable stage III (macroscopic nodes)
IIB	T3b (2.0-4.0 mm ulcerated) or T4a (over 4 mm) N0.	Stage II-III, Stage IIB-IIC (thick or ulcerated, node-negative), Resectable stage III (macroscopic nodes)
IIC	T4b (over 4 mm, ulcerated) N0.	Stage II-III, Stage IIB-IIC (thick or ulcerated, node-negative), Resectable stage III (macroscopic nodes)
IIIA-IIID	Regional node or in-transit, satellite or microsatellite disease; substage by primary thickness and ulceration and by number and type (clinically occult versus detected) of nodes.	Resectable stage III (macroscopic nodes), Stage III after surgery (adjuvant), Unresectable or metastatic, first line
IV	M1a skin, soft tissue, distant nodes; M1b lung; M1c other visceral (not CNS); M1d CNS. Each with (0) normal or (1) raised LDH.	Metastatic first line, Unresectable or metastatic, first line, Metastatic uveal melanoma (HLA-A*02:01-positive)

Skin cancer (all types)