Nasopharyngeal Cancer Staging
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The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classifications and prognostic stage groups for nasopharyngeal cancers are provided below. [1]
Table 1. TNM classification (Open Table in a new window)
Primary tumor (T)
TX
Primary tumor cannot be assessed
T0
No tumor ifentified, but EBV-positive cervical node(s) involvement
Tis
Carcinoma in situ
T1
Tumor confined to the nasopharynx, or extenion to oropharynx and/or nasal cavity without parapharyngeal involvement
T2
Tumor with extension to parapharyngeal space, and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles)
T3
Tumor with infiltration of bony structures at skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4
Tumor with intracranial extension, involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle
Regional lymph nodes (N)
NX
Regional nodes cannot be assessed
N0
No regional lymph node metastasis
N1
Unilateral metastasis in cervical lymph node(s) and/or unilateral or bilateral metastasis in retropharyngeal lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N2
Bilateral metastasis in cervical lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N3
Unilateral or bilateral metastasis in cervical lymph node(s), larger than 6 cm in greatest dimension, and/or extension below the caudal border of cricoid cartilage
Distant metastasis (M)
cM0
No distant metastasis
cM1
Distant metastasis
Table 2. Prognostic stage groups (Open Table in a new window)
Stage
T
N
M
0
Tis
N0
M0
I
T1
N0
M0
II
T0–T1
N1
M0
T2
N0–N1
M0
III
T0–T3
N2
M0
T3
N1–N2
M0
IVA
T4
N0–N2
M0
T Any
N3
M0
IVB
T Any
N Any
M1
Head and Neck. American Joint Committee on Cancer. AJCC Cancer Staging Manual. 8th edition. New York, NY: Springer; 2016.
Primary tumor (T)
TX
Primary tumor cannot be assessed
T0
No tumor ifentified, but EBV-positive cervical node(s) involvement
Tis
Carcinoma in situ
T1
Tumor confined to the nasopharynx, or extenion to oropharynx and/or nasal cavity without parapharyngeal involvement
T2
Tumor with extension to parapharyngeal space, and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles)
T3
Tumor with infiltration of bony structures at skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4
Tumor with intracranial extension, involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle
Regional lymph nodes (N)
NX
Regional nodes cannot be assessed
N0
No regional lymph node metastasis
N1
Unilateral metastasis in cervical lymph node(s) and/or unilateral or bilateral metastasis in retropharyngeal lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N2
Bilateral metastasis in cervical lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N3
Unilateral or bilateral metastasis in cervical lymph node(s), larger than 6 cm in greatest dimension, and/or extension below the caudal border of cricoid cartilage
Distant metastasis (M)
cM0
No distant metastasis
cM1
Distant metastasis
Stage
T
N
M
0
Tis
N0
M0
I
T1
N0
M0
II
T0–T1
N1
M0
T2
N0–N1
M0
III
T0–T3
N2
M0
T3
N1–N2
M0
IVA
T4
N0–N2
M0
T Any
N3
M0
IVB
T Any
N Any
M1
Marvaretta M Stevenson, MD Assistant Professor, Division of Medical Oncology, Duke University Medical Center
Disclosure: Nothing to disclose.
Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital; Medical Director, Deaconess Hospital Outpatient Infusion Centers; Chairman, Deaconess Hospital Cancer Committee
Christopher D Braden, DO is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology
Disclosure: Nothing to disclose.
Guy J Petruzzelli, MD, PhD, MBA, FACS Physician-in-Chief and Vice President of Oncology Programs, Curtis and Elizabeth Anderson Cancer Institute at Memorial University Medical Center; Professor of Surgery-Head, Neck, and Endocrine Surgery, Mercer University School of Medicine-Savannah Campus
Guy J Petruzzelli, MD, PhD, MBA, FACS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for the Advancement of Science, American Association of Clinical Anatomists, American College of Surgeons, American Head and Neck Society, American Medical Association, American Society of Clinical Oncology, Chicago Medical Society, Georgia Society of Otolaryngology-Head and Neck Surgery, International Academy of Oral Oncology, International Head and Neck Scientific Group, North American Skull Base Society, Society of Surgical Oncology, Society of University Otolaryngologists-Head and Neck Surgeons, SWOG
Disclosure: Nothing to disclose.
Nasopharyngeal Cancer Staging
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