Staging Flashcards
Oral cavity T stating
T1: Tumor =< 2 cm or DOI =< 0.5 cm
T2: Tumor 2-4 cm or DOI =< 1 cm
T3: Tumor > 4 cm or DOI > 1cm
T4a: DOI > 1 cm, Bone erosion (through cortical bone of the mandible or maxilla, or involves the maxillary sinus or skin of the face), + Maxillary sinus involvement
T4b: + masticator space, pterygoid plates, skull base, encases carotid
Oropharynx T staging (HPV+)
T1: =< 2 cm
T2: 2 - 4 cm
T3: > 4 cm or onto lingual surface of epiglottis
T4: Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible or beyond
Oral cavity N staging
N1: single ipsilateral LN, =< 3cm , no ENE
N2a: single ipsilateral LN, 3-6 cm, no ENE
N2b: multiple ipsilateral LN, =< 6 cm, no ENE
N2c: bilateral or contralateral LN, =< 6 cm, no ENE
N3a: any LN > 6 cm, no ENE
N3b: any LN with clinical ENE (physical exam: skin, CN+ support by imaging)
Oropharynx N clinical staging for HPV+
N1: ipsi, =< 6 cm
N2: contra/bilateral, =< 6 cm
N3: LN(s) > 6 cm
Oropharynx N pathologic staging for HPV+
pN0: no LN met
pN1: =< 4 LN(s)
pN2: > 4 LN(s)
Oropharynx HPV+ Clinical Group Staging
T0-2, N0-1: Stage I
T0-2, N2: Stage II
T3, N0-2: Stage II
T0-4, N3: Stage III
T4, N0-3: Stage III
Oropharynx HPV+ Pathological Group Staging
T0-2, N0-1: Stage I
T0-2, N2: Stage II
T3-4, N0-1: Stage II
T3-4, N2: Stage III
Clinical group staging for T3N2 is?
Stage II
Pathological group stating for T3N2 is?
Stage III
Oropharynx T staging (HPV-)
T1: =< 2 cm
T2: 2 - 4 cm
T3: > 4 cm or onto lingual surface of epiglottis
T4a: Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, mandible
T4b: Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery
T stage for Supraglottic larynx cancer
T1: Tumor limited to one subsite of supraglottis with normal VC mobility
T2: Extends to mucosa of > 1 adjacent subsite of supraglottis or glottis w/o fixation of larynx
T3: Limited to larynx with VC fixation or invades the postcricoid area, pre-epiglottic tissues, paraglottic space, and/or minor thyroid cartilage erosion (inner cortex)
T4a: Invades through thyroid cartilage, and/or invades beyond larynx
T4b: Invades prevertebral space, encases the carotid artery, or invades mediastinal structures
T stage for glottis
T1a: Tumor limited to one VC with normal mobility
T1b: Involves both VCs with normal mobility. Includes anterior commissure.
T2: Extends to supraglottis and/or subglottis +/- impaired VC mobility
T3: Limited to larynx with VC fixation and/or invades paraglottic space, and/or minor thyroid cartilage erosion (inner cortex of the thyroid cartilage)
T4a: Invades through thyroid cartilage and/or invades tissues beyond larynx
T4b: Invades prevertebral space, encases carotid artery, or invades mediastinal structures
T stage for subglottis
T1: Tumor limited to subglottis
T2: Extends to VCs with normal or impaired mobility
T3: Limited to larynx with VC fixation
T4a: Invades cricoid or thyroid cartilage and/or invades tissue beyond larynx
T4b: Invades prevertebral space, encases carotid artery, or invades mediastinal structures
N stage for Larynx & Hypopharynx
N1: Single ipsi LN =< 3cm and no ENE
N2a: Single ipsi LN > 3cm and =< 6 cm, no ENE
N2b: Multiple ipsi LN =< 6 cm, no ENE
N2c: Bilateral or Contralateral LN =< 6 cm, no ENE
N3a: > 6 cm, no ENE
N3b: Any clinical overt + ENE
T stage for hypopharynx
T1: Tumor limited to 1 subsite and/or =< 2 cm
T2: Tumor involves > 1 subsite and/or and adjacent site or measured > 2 cm but not more than 4 cm, no fixation of the hemilarynx
T3: Tumor > 4 cm and/or with fixation of the hemilarynx or extension to the esophagus
T4a: Tumor invades thyroid or cricoid cartilage, hyoid bone, thyroid gland, or central compartment soft tissue (parapharyngeal strap muscles, subcutaneous fat)
T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures
T stage for nasopharyngeal cancer
T1: Confined to nasopharynx or extends to oropharynx and/or nasal cavity without parapharyngeal involvement
T2: Extends to parapharyngeal space and/or adjacent soft tissue (eg - medial/lateral pterygoid, prevertebral muscles)
T3: Infiltrates bony structures of skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4: Intracranial extension; involvement of
