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N denotes the presence, or absence, and extent of lymph node metastases. Recognized adverse prognostic factors include tumors located in the anal canal as opposed to anal margin or perianal skin cancers, locally advanced tumors including tumors greater than 5 cm (t3), tumors of any size that invade adjacent organ such as the vagina, urethra, or bladder (t4), lymph node involvement, and probably being hiv-positive, particularly for patients with cd4 lymphocyte. Anal cancer sometimes spreads to nearby lymph nodes (bean-sized collections of immune system cells). Swollen lymph nodes in the groin can be a sign that cancer has spread. Biopsies may be needed to check for cancer spread to nearby lymph nodes. Whether you or someone you love has cancer, knowing what to expect can help you cope. From basic information about cancer and its causes to in-depth information on specific cancer types including risk factors, early detection, diagnosis, and treatment options youll find it here. A lymph node, or lymph gland is a kidney-shaped organ of the lymphatic system, and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that include b and t cells.