Anal cancer staging

[Maforce]

If you have a left positive inguinal LN and a right positive iliac LN, do you consider this N2 or N3? AJCC 7th statement is a bit confusing. The Radiation Oncology Study Guide addresses this, but I would like to get a consensus on the topic. Thanks

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[Gfunk6]

N2. But even if you consider it N3, it would not change the Stage (IIIB).

 

[Palex80]

In theory this is an N2. In practice, I would consider this an N3 and treatment/prognosis is in my opinion the same as with a typical N3.

 

[ramsesthenice]

In theory this is an N2. In practice, I would consider this an N3 and treatment/prognosis is in my opinion the same as with a typical N3.

Huge point. Staging is important in as much as it dictates treatment. The art of practice is deciding what factors impact your treatment plan and often it's not the exact TNM stage.