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Cancer Staging Systems

Staging of lip and oral cancer

Last Update: Sunday January 4th, 2004 7:15 PM GMT

TNM definition

Primary tumor (T)

  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: Carcinoma in situ
  • T1: Tumor 2 cm or less in greatest dimension
  • T2: Tumor more than 2 cm but not more than 4 cm in greatest dimension
  • T3: Tumor more than 4 cm in greatest dimension
  • T4: (lip) Tumor invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin of face, i.e., chin or nose
    • T4a: (oral cavity) Tumor invades adjacent structures (e.g., through cortical bone, into deep [extrinsic] muscle of tongue [genioglossus, hyoglossus, palatoglossus, and styloglossus], maxillary sinus, skin of face)
    • T4b: Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery

Regional lymph nodes (N)

  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
  • N2: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
    • N2a: Metastasis in a single ipsilateral lymph node more than 3 cm but not more than 6 cm in dimension
    • N2b: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
    • N2c: Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
  • N3: Metastasis in a lymph node more than 6 cm in greatest dimension

Distant metastasis (M)

  • MX: Distant metastasis cannot be assessed
  • M0: No distant metastasis
  • M1: Distant metastasis

Stage grouping

Stage 0

  • Tis, N0, M0

Stage I

  • T1, N0, M0

Stage II

  • T2, N0, M0

Stage III

  • T3, N0, M0
  • T1, N1, M0
  • T2, N1, M0
  • T3, N1, M0

Stage IVA

  • T4a, N0, M0
  • T4a, N1, M0
  • T1, N2, M0
  • T2, N2, M0
  • T3, N2, M0
  • T4a, N2, M0

Stage IVB

  • Any T, N3, M0
  • T4b, any N, M0

Stage IVC

  • Any T, any N, M1

References

  1. Lip and oral cavity. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 23-32. 

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