Appendix Cancer Stages

Staging is used to evaluate the extent of a patient’s appendix (appendiceal) cancer and help determine a prognosis. Like many other cancers, appendix cancer is staged using the American Joint Committee on Cancer’s (AJCC) TNM system. This system takes into account three key aspects of a patient’s appendix cancer, including:  

• The tumor’s (T) size and location within the appendix
• Lymph node (N) involvement, if the cancer has traveled to nearby lymph nodes
• If and how far the cancer has metastasized (M), or spread, to other areas of the body

What are the stages of appendix cancer?

Following the TNM system, appendix cancer is staged from 0 to 4, with stage 4 indicating the most advanced disease. Here is a brief overview of each stage and what it describes:  

Stage 0

Also known as cancer in situ, stage 0 appendix cancer is confined to one area and has not invaded other tissues.

Stage 1  

Stage 1 appendix cancer has grown deeper into the appendix, but has not spread to nearby lymph nodes or distant areas of the body.

Stage 2  

Stage 2 appendix cancer can be divided into three sub-categories:

• Stage 2A – The cancer has grown into fatty or connective tissues by the appendix, but has not spread to lymph nodes or distant areas of the body.
• Stage 2B – The cancer has grown through the appendiceal lining, but has not traveled to lymph nodes or distant areas of the body.
• Stage 2C – The cancer has spread to nearby organs, such as the colon, but has not reached lymph nodes or distant areas of the body.

Stage 3

Stage 3 appendix cancer can also be broken down into three sub-categories: 

• Stage 3A – The cancer has grown into deep layers of appendix tissue and has reached one to three lymph nodes, but has not traveled to distant areas of the body.
• Stage 3B – The cancer has grown through the lining of the appendix and has reached one to three lymph nodes, but has not traveled to distant areas of the body.
• Stage 3C – The cancer has spread to four or more lymph nodes, but not to distant areas of the body. 

Stage 4 

The most advanced phase, stage 4 appendix cancer also involves three sub-categories:

• Stage 4A – The cancer has reached other parts of the stomach cavity, but the cancer cells are well-differentiated and have not spread to regional lymph nodes.  
• Stage 4B – The cancer has spread to other parts of the stomach cavity and may be in regional lymph nodes. Cancer cells may be poorly differentiated.
• Stage 4C – The cancer has metastasized and is present in distant areas of the body, such as the lungs.

Our approach

Staging and treating an uncommon malignancy like appendix cancer requires the expertise of experienced specialists, such as those in Moffitt Cancer Center’s highly regarded Gastrointestinal Oncology Program. You can promptly be connected with a Moffitt cancer expert by completing a new patient registration form online or by calling 1-888-663-3488.