After a diagnosis of appendix cancer, healthcare professionals perform tests to learn how far the disease has spread. This process is called staging. Knowing the stage helps your healthcare team design the best treatment plan for your specific type of tumor.
Tests used for staging may include blood work and imaging scans. These pictures show the size and location of the tumor and whether it has spread to lymph nodes or other organs. Sometimes, surgery is needed to see exactly how much of the appendix and nearby tissue is affected.
How appendix cancer is staged
Appendix cancer is often staged using the American Joint Committee on Cancer TNM system. This system looks at three key areas:
- T (tumor). How deeply the tumor has grown into the wall of the appendix or surrounding tissue.
- N (nodes). Whether the cancer has spread to nearby lymph nodes.
- M (metastasis). Whether the cancer has spread to distant organs, such as the liver or lungs.
Stage 1
The cancer has grown into the deeper layers of the appendix wall but hasn't reached nearby lymph nodes or other organs. It is still localized and can usually be treated successfully with surgery, sometimes followed by closer monitoring.
Stage 2
The tumor has grown through the appendix wall and may involve nearby tissue, but it hasn't spread to lymph nodes or distant sites. Treatment often includes a larger surgery, such as a right hemicolectomy, to ensure complete removal.
Stage 3
The cancer has spread to nearby lymph nodes but not to distant parts of the body. It's considered regional disease. Surgery to remove the appendix and nearby lymph nodes is standard, and chemotherapy may be added to reduce the risk of recurrence.
Stage 4
This is the most advanced stage. The cancer has spread to distant organs, such as the liver, lungs or the lining of the abdomen, called the peritoneum. Treatment may include cytoreductive, also called debulking, surgery. It also may include hyperthermic intraperitoneal chemotherapy (HIPEC) and traditional chemotherapy to control growth and relieve symptoms. Hyperthermic is also known as heated chemotherapy.
Understanding a cancer's grade
Staging describes where the cancer is in the body, while grade describes how aggressive the cancer cells look under a microscope. Grade gives healthcare professionals a sense of how fast the tumor is likely to grow. Low-grade tumors tend to grow slowly, while high-grade tumors grow faster and are more likely to spread.
Looking ahead
Understanding your stage and grade helps your care team recommend the most effective treatment and follow-up plan. Many people with early-stage or low-grade appendix cancer do very well after surgery. Even with more-advanced disease, new treatments such as HIPEC have improved outcomes and quality of life.
Dec. 30, 2025