TMN classification of head & neck cancer

Classification: TX: primary tumor cannot be assessed T0: no evidence of primary tumor Tis: carcinoma in situ T1: lip, oral cavity, oropharynx: 0-2 cm hypopharyx, nasopharynx 1 site larynx: 1 site or limited to vocal cords T2: lip, oral cavity, oropharynx: 2.1-4 cm hypopharynx: > 1 site, no vocal cord fixation nasopharyx: > 1 site larynx: > 1 site or impaired vocal cord mobility T3: lip, oral cavity, oropharynx: > 4 cm hypopharynx: vocal cord paralysis nasopharynx: extension to nasal cavity or oropharynx larynx: vocal cord paralysis T4: lip, oral cavity: > 4 cm with massive invasion oropharynx, hypopharynx, nasopharynx, larynx -> massive soft tissue, bone or cartilage invasion Regional lymph nodes (N) NX: regional lymph nodes cannot be assessed N0: no regional lymph node metastases N1: metastasis in a single ipsilateral lymph node =< 3 cm in dimension N2: N2a: metastasis in a single ipsilateral lymph node, >= 3 cm & =< 6 cm in greatest dimension N2b: metastases in multiple ipsilateral lymph nodes =< 6 cm N2c: bilateral or contralateral lymph nodes =< 6 cm N3: metastasis in a lymph node > 6 cm in greatest dimension Distant metastases (M) MX: presence of distant metastases cannot be assessed M0: No distant metastases M1: distant metastases Stage grouping: Stage T T M Stage 0: Tis NO M0 Stage 1: T1 N0 M0 Stage 2: T2 N0 M0 Stage 3: T3 N0 M0 - T1 N1 M0 - T2 N1 M0 - T3 N1 M0 Stage 4: T4 N0 M0 - T4 N1 M0 - any T N2 M0 - any T N3 M0 - any T any N M1

References

Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 551