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Appendix cancer stages

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was updated on June 8, 2022.


The stage of appendix cancer is determined by the tumor’s size and how far it has progressed. The National Cancer Institute says that appendix cancer stages may also be described as:

Localized: Cancer is found in the appendix, colon, rectum, small intestine and/or stomach only.

Regional: Cancer has spread from the appendix, colon, rectum, stomach and/or small intestine to nearby tissues or lymph nodes.

Metastatic: Cancer has spread to other parts of the body.

Carcinoid tumors and carcinomas are staged differently. Treatment for gastrointestinal carcinoid tumors is not based on the stage of the cancer, but instead on whether the tumor may be removed by surgery and whether the tumor has spread.

Stage 0: The cancer is found in only one location and has not spread. This stage is also known as appendix cancer in situ.

Stage 1 appendix cancer: The cancer has spread to the inner layers of appendix tissue but not to the regional lymph nodes or other parts of the body.

Stage 2 appendix cancer: There are three subcategories of stage 2 appendix cancer: 2A, 2B and 2C. The categories differ by the extent to which the cancer has spread:

  • Stage 2A: The cancer has grown into the connective or fatty tissue next to the appendix but has not spread to the regional lymph nodes or other parts of the body.
  • Stage 2B: The cancer has grown through the lining of the appendix but has not spread to the regional lymph nodes or other parts of the body.
  • Stage 2C: The appendix tumor has grown into other organs, such as the colon or rectum, but has not spread to the regional lymph nodes or other parts of the body.

Stage 3 appendix cancer: Stage 3 is also divided into three subcategories:

  • Stage 3A: The cancer has spread to the inner layers of the appendix tissue and to one to three regional lymph nodes but has not spread to other parts of the body.
  • Stage 3B: The cancer has grown into nearby tissues of the appendix, or through the lining of the appendix, and to one to three regional lymph nodes but has not spread to other areas of the body.
  • Stage 3C: The cancer has spread to four or more regional lymph nodes but not to other areas of the body.

Stage 4 appendix cancer: The most advanced stage of appendix cancer has three sub-categories:

  • Stage 4A: The cancer has spread to other areas in the abdomen, but not to the regional lymph nodes, and the cancer cells are well-differentiated.
  • Stage 4B: The cancer is diagnosed at this stage if one of these characteristics groups applies:
  • Stage 4C: The cancer has spread outside the abdominal area to distant parts of the body, such as the lungs.

Next topic: How is appendix cancer diagnosed?

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