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TNM Staging Assistant

Clinical (imaging) staging for chest, abdomen and pelvis. Enter what the study shows; the tool assigns cT, cN, cM and the stage group, and writes a report block.

Why does each cancer use a different version? AJCC has retired the old model of a single numbered edition that changed every site at once. It now revises staging one site at a time, publishing each as a "Version" that replaces that site's 8th-edition content on its own effective date. Thoracic sites (lung, thymus, pleural mesothelioma) already run on the 9th-edition system — the IASLC 9th edition, adopted by AJCC/UICC and in clinical use since 1 January 2025. Other sites have followed as Version 9 (e.g., anus; salivary gland and HPV-associated oropharynx as of 1 January 2026), while most abdominopelvic sites (bladder, colon and rectum, esophagus) remain on the 8th edition until their Version 9 is released. That is why two tumors staged on the same CT can carry different versions — so each block this tool writes names the system and version it used, because a stage statement without one cannot be audited later.

Clinical (imaging) staging only. Use alongside the AJCC manual, not in place of it.

Primary site

staging system and version shown on each

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Stage

Choose a primary site, then answer the T, N and M questions.

Report block

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One line (for the impression)

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What this tool does and does not do

Clinical staging only

Everything here is cTNM — the stage assignable from imaging before resection. It is not pTNM. Depth-of-invasion categories that require microscopy (bladder T2a vs T2b, T3a vs T3b; colon T1 vs T2) cannot be resolved on CT or MRI, and the tool says so rather than guessing. Where the unresolvable split changes the stage group, a range is reported instead of a single stage.

Nodal categories are imaging surrogates

AJCC N categories are defined by the number of histologically positive nodes. On imaging we substitute size, shape and morphology, which systematically under-calls small-volume disease and over-calls reactive nodes. A cN category is a prediction, not a count.

Version labeling

AJCC moved from numbered editions to per-site Versions; Version 9 protocols became effective 1 January 2026 for the sites released so far, while most abdominopelvic sites remain on the 8th edition. Every block this tool writes names the system and version used, because a staging statement without one cannot be audited later.

Sources

Category definitions are paraphrased from the CAP Cancer Protocols (which publish the AJCC definitions under permission) and cross-checked against the AJCC Cancer Staging System. Imaging-specific criteria and adjuncts are drawn from the radiology literature cited on each site. Nothing here reproduces an AJCC table.