NCIt definition : Stage IV includes: (T4, Any N, M0); (Any T, N3, M0); (Any T, Any N, M1). T4: Tumor
invades other adjacent structures. cN3: Palpable fixed inguinal nodal mass or pelvic
lymphadenopathy unilateral or bilateral. pN3: Extranodal extension of lymph node metastasis
or pelvic lymph node(s) unilateral or bilateral. M0: No distant metastasis. M1: Distant
metastasis (lymph node metastasis outside of the true pelvis in addition to visceral
or bone sites). (AJCC 7th ed.);
Alternative definition : NCI-GLOSS: Cancer has spread to tissues near the penis and may have spread to lymph
nodes in the groin or pelvis; or cancer has spread anywhere in or near the penis and
to one or more lymph nodes deep in the pelvis or groin; or cancer has spread to distant
parts of the body.;