TNM Staging for Cancer of the Nasopharynx

Description

A cancer of the nasopharynx can be staged using the TNM staging criteria of the American Joint Committee on Cancer (AJCC).

Anatomic extent of the nasopharynx:

(1) postero-superior wall: junction of the hard and soft palate to the base of the skull

(2) lateral wall: fossa of Rosenmuller

(3) inferior wall: superior surface of the soft palate

TNM	Finding	Designation
T	primary tumor cannot be assessed	TX
	no evidence of primary tumor	T0
	carcinoma in situ	Tis
	tumor confined to the nasopharynx	T1
	tumor extends to the oropharynx and/or nasal cavity without parapharyngeal extension (posterolateral invasion beyond the pharyngobasilar fascia)	T2a
	any tumor with parapharyngeal extension (postero-lateral invasion beyond the pharyngobasilar fascia)	T2b
	tumor involves bony structures and/or paranasal sinuses	T3
	tumor with intracranial extension and/or involvement of the cranial nerves, infratemporal fossa, hypopharynx, orbit, or masticator space	T4
N	regional lymph nodes cannot be assessed	NX
	no regional lymph node metastasis	N0
	unilateral metastasis in lymph nodes <= 6 cm in greatest dimension, above the supraclavicular fossa	N1
	bilateral metastasis in lymph nodes <= 6 cm in greatest dimension, above the supraclavicular fossa	N2
	metastasis in lymph node > 6 cm in diameter	N3a
	metastasis to a lymph node residing wholly or in part in the supraclavicular fossa	N3b
M	presence of distant metastases cannot be assessed	MX
	no distant metastasis	M0
	distant metastasis present	M1

where:

• T4a lesions are potentially resectable while T4b are unresectable.

• Midline lymph nodes are considered ipsilateral nodes.

• The supraclavicular fossa is a triangular region with apices (1) superior margin of the sternal end of the clavicle, (2) the superior margin of the lateral end of the clavicle, (3) the point where the neck meets the shoulder.

TNM Groups	Stage
Tis, N0, M0	0
T1, N0, M0	I
T2a, N0, M0	IIA
T1, N1, M0 T2a, N1, M0 T2b, N0, M0 T2b, N1, M0	IIB
T1, N2, M0 T2a, N2, M0 T2b, N2, M0 T3, N0, M0 T3, N1, M0 T3, N2, M0	III
T4, N0 , M0 T4, N1, M0 T4, N2, M0	IVA
any T, N3, M0	IVB
any T, any N, M1	IVC

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TNM Staging for Cancer of the Nasopharynx

Description

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