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TNM and Stage Groupings > Merkel Cell Carcinoma
Merkel Cell Carcinoma
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| Tis |
In situ primary tumor |
| T1 |
Less than or equal to 2 cm maximum tumor dimension |
| T2 |
Greater than 2 cm but not more than 5 cm maximum tumor dimension |
| T3 |
Over 5 cm maximum tumor dimension |
| T4 |
Primary tumor invades bone, muscle, fascia, or cartilage |
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph nodes cannot be assessed |
| N0 |
No regional lymph node metastasis |
| cN0 |
Nodes negative by clinical exam* (no pathologic node exam performed) |
| pN0 |
Nodes negative by pathologic exam |
| N1 |
Metastasis in regional lymph node(s) |
| N1a |
Micrometastasis** |
| N1b |
Macrometastasis*** |
| N2 |
In transit metastasis **** |
*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
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Metastasis beyond regional lymph nodes |
| M1a |
Metastasis to skin, subcutaneous tissues or distant lymph nodes |
| M1b |
Metastasis to lung |
| M1c |
Metastasis to all other visceral sites |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
| 0 |
Tis |
N0 |
M0 |
| IA |
T1 |
pN0 |
M0 |
| IB |
T1 |
cN0 |
M0 |
| IIA |
T2/T3 |
pN0 |
M0 |
| IIB |
T2/T3 |
cN0 |
M0 |
| IIC |
T4 |
N0 |
M0 |
| IIIA |
Any T |
N1a |
M0 |
| IIIB |
Any T |
N1b/N2 |
M0 |
| IV |
Any T |
Any N |
M1 |
