Español
PDFs by language
Our 24/7 cancer helpline provides information and answers for people dealing with cancer. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear.
Chat live online
Select the Live Chat button at the bottom of the page
Call us at 1-800-227-2345
Available any time of day or night
Our highly trained specialists are available 24/7 via phone and on weekdays can assist through online chat. We connect patients, caregivers, and family members with essential services and resources at every step of their cancer journey. Ask us how you can get involved and support the fight against cancer. Some of the topics we can assist with include:
For medical questions, we encourage you to review our information with your doctor.
After someone is diagnosed with adrenal cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how far the cancer has spread in the body. It helps determine how serious the cancer is and how best to treat it. The stage is one of the most important factors in deciding how to treat the cancer and determining how successful treatment might be.
To determine the cancer’s stage after an adrenal cancer diagnosis, doctors try to answer these questions:
The stage of adrenal cancer is based on the results of physical exams, biopsies, and imaging tests (CT or MRI scan, x-rays, PET scan, etc.), which are described in Tests for Adrenal Cancer, as well as the results of surgery.
The adrenal cancer stages range from stages I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced cancer. Cancers with similar stages tend to have a similar outlook and are often treated in much the same way.
A staging system is a standard way for the cancer care team to describe how far a cancer has spread. Two major staging systems used for adrenal cancer are the American Joint Committee on Cancer (AJCC) TNM staging system and the ENSAT (European Network for the Study of Adrenal Tumors) staging system. Both are based on the same TNM categories, which are based on 3 key pieces of information:
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, usually after surgery, this information is combined in a process called stage grouping to assign an overall stage (numbered I through IV).
The staging system in the table below uses the pathologic stage. It is based on the results of physical exam, biopsy, imaging tests, and the results of surgery. This is likely to be more accurate than clinical staging, which only takes into account the tests done before surgery.
Adrenal cancer staging can be complex. If you have any questions about your stage, please ask your doctor to explain it to you in a way you understand.
ENSAT stage | AJCC Stage |
Stage grouping |
Stage description |
I | I |
T1 N0 M0 |
The tumor is 5 cm (about 2 inches) or less in size and it has not grown into tissues outside the adrenal gland (T1). It has not spread to nearby lymph nodes (N0) or distant sites (M0). |
II | II |
T2 N0 M0 |
The tumor is greater than 5 cm (2 inches) in size and it has not grown into tissues outside the adrenal gland (T2). It has not spread to nearby lymph nodes (N0) or distant sites (M0). |
III | III |
T1 N1 M0 |
The tumor is 5 cm (about 2 inches) or less in size and it has not grown into tissues outside the adrenal gland (T1). The cancer has spread to nearby lymph nodes (N1) but not to distant sites (M0). |
OR | |||
T2 N1 M0 |
The tumor is greater than 5 cm (2 inches) in size and it has not grown into tissues outside the adrenal gland (T2). The cancer has spread to nearby lymph nodes (N1) but not to distant sites (M0). |
||
OR | |||
T3 Any N M0 |
The tumor is growing in the fat that surrounds the adrenal gland. The tumor can be any size (T3). It might or might not have spread to nearby lymph nodes (Any N0). It has not spread to distant sites (M0). |
||
OR | |||
T4 Any N M0 |
The tumor is growing into nearby organs, such as the kidney, pancreas, spleen, and liver or large blood vessels (renal vein or vena cava). The tumor can be any size (T4). It may or may not have spread to nearby lymph nodes (Any N). It has not spread to distant organs (M0). |
||
IV | IV |
Any T Any N M1 |
The cancer has spread to distant sites like the liver or lungs (M1). It can be any size (Any T) and may or may not have spread to nearby tissues (Any T) or lymph nodes (Any N). |
The following additional categories are not listed on the table above:
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Adrenal Cortical. In: AJCC Cancer Staging Manual. 8th ed. New York: Springer. 2017:911-918.
Last Revised: December 8, 2017
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.
If this was helpful, donate to help fund patient support services, research, and cancer content updates.