Stage IV includes: IVA: T4, Any N, M0; IVB: Any T, Any N, M1. T4: Tumor has involved (biopsy-proven) the mucosa of the bladder or rectum, or has spread to adjacent organs. M0: No distant metastasis. M1: Distant metastasis including inguinal lymph nodes, lung, liver, bone, or intraperitoneal metastases. Metastases to pelvic or paraaortic lymph nodes, or vagina are excluded. (from AJCC 9th Ed.) [from NCI]