Primary tumor (T) | |||
T category | T criteria | ||
TX | Primary tumor cannot be assessed | ||
Tis | Carcinoma in situ | ||
T1 | Tumor 2 cm or smaller in greatest dimension | ||
T2 | Tumor larger than 2 cm but not larger than 4 cm in greatest dimension | ||
T3 | Tumor larger than 4 cm in greatest dimension or extension to lingual surface of epiglottis | ||
T4 | Moderately advanced or very advanced local disease | ||
T4a | Moderately advanced local disease. Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible.* | ||
T4b | Very advanced local disease. Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery. | ||
* Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of the larynx. | |||
Regional lymph nodes (N) | |||
Clinical N (cN) | |||
N category | N criteria | ||
NX | Regional lymph nodes cannot be assessed | ||
N0 | No regional lymph node metastasis | ||
N1 | Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(–) | ||
N2 | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–); or Metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–); or In bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–) | ||
N2a | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–) | ||
N2b | Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(–) | ||
N2c | Metastases in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–) | ||
N3 | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–); or Metastasis in any node(s) and clinically overt ENE(+) | ||
N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–) | ||
N3b | Metastasis in any node(s) and clinically overt ENE(+) | ||
NOTE: A designation of "U" or "L" may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(–) or ENE(+). | |||
Distant metastasis (M) | |||
M category | M criteria | ||
M0 | No distant metastasis | ||
M1 | Distant metastasis | ||
Prognostic stage groups | |||
When T is... | And N is... | And M is... | Then the stage group is... |
Tis | N0 | M0 | 0 |
T1 | N0 | M0 | I |
T2 | N0 | M0 | II |
T3 | N0 | M0 | III |
T1, T2, T3 | N1 | M0 | III |
T4a | N0, N1 | M0 | IVA |
T1, T2, T3, T4a | N2 | M0 | IVA |
Any T | N3 | M0 | IVB |
T4b | Any N | M0 | IVB |
Any T | Any N | M1 | IVC |
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