All staging is based on the AJCC 8th Edition Cancer Staging unless otherwise stated
SupraglottisGlottisSubglottisLarynx clinical nodeDistant metastasis
- T1 - Tumor limited to one subsite of supraglottis with normal vocal cord mobility
- T2 - Tumor invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynx
- T3 - Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, preepiglottic space, paraglottic space, and/or inner cortex of thyroid cartilage
- T4 - Moderately advanced or very advanced
- T4a - Tumor invades through the outer cortex of the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid or esophagus
- T4b - Very advanced local disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures
- T1 - Tumor limited to the vocal cord(s) (may involve anterior or posterior commissure) with normal mobility
- T1a Tumor limited to one vocal cord
- T1b Tumor involves both vocal cords
- T2 - Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility
- T3 - Tumor limited to the larynx with vocal cord fixation and/or invasion of paraglottic space, and/or inner cortex of thyroid cartilage
- T4 - Moderately advanced or very advanced
- T4a - Tumor invades through the outer cortex of the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of the tongue, strap muscles, thyroid or esophagus
- T4b - Very advanced local disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures
- T1 - Tumor limited to the subglottis
- T2 Tumor extends to vocal cord(s) with normal or impaired mobility
- T3 - Tumor limited to larynx with vocal cord fixation and/or invasion of paraglottic space and/or inner cortex of the thyroid cartilage
- T4 - Moderately advanced or very advanced
- T4a - Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond
the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscles of the tongue, strap muscles, thyroid or esophagus)
- T4b - Very advanced local disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures
- Nx - Regional lymph nodes cannot be assessed
- N0 - No regional lymph node metastasis
- N1 - Single ipsilateral lymph node ≤ 3cm and ENE -ve
- N2 - Lymph node ≤ 6 cm in greatest dimension
- N2a - Single ipsilateral lymph node > 3 cm but ≤ 6 cm and ENE -ve
- N2b - Multiple ipsilateral lymph nodes ≤ 6 cm in greatest dimension and ENE -ve
- N2c - Bilateral or contralateral lymph nodes ≤ 6 cm in greatest dimension and ENE -ve
- N3 Lymph node > 6 cm in greatest dimension
- N3a Lymph node > 6 cm in greatest dimension and ENE -ve
- N3b Any lymph node(s) with clinically overt ENE +ve
- Mx - Distant metastasis cannot be assessed
- M0 - No distant metastasis
- M1 - Distant metastasis
Oropharynx (HPV -ve)HypopharynxRegional clinical nodesDistant metastasis
- Tx - Primary tumour cannot be assessed
- Tis - Carcinoma in situ
- T1 - Tumour ≤2 cm in greatest dimension
- T2 - Tumour >2 cm and ≤4 cm
- T3 - Tumour >4 cm or extension to lingual surface of epiglottis
- T4 - Moderately advanced or very advanced
- T4a - Tumor invades the larynx, deep/extrinsic muscle of the tongue, medial pterygoid, hard palate, or mandible
- T4b - Tumor invades the lateral pterygoid muscle, pterygoid plates, lateral
nasopharynx, or skull base, or encases the carotid artery
-
Tx - Primary tumour cannot be assessed
-
T1 - Tumor limited to one subsite of hypopharynx and/or ≤2 cm in greatest dimension
-
T2 - Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures >2 cm but ≤4 cm in greatest dimensión without fixation of hemilarynx
-
T3 - Tumour >4 cm or with fixation of hemilarynx or extensión to esophagus
-
T4 - Moderately advanced or very advanced
- T4a - Moderately advanced local disease Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, or central compartment soft tissue
- T4b - Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures
- Nx - Regional lymph nodes cannot be assessed
- N0 - No regional lymph node metastasis
- N1 - Single ipsilateral lymph node ≤ 3cm and ENE -ve
- N2 - Lymph node ≤ 6 cm in greatest dimension
- N2a - Single ipsilateral lymph node > 3 cm but ≤ 6 cm and ENE -ve
- N2b - Multiple ipsilateral lymph nodes ≤ 6 cm in greatest dimension and ENE -ve
- N2c - Bilateral or contralateral lymph nodes ≤ 6 cm in greatest dimension and ENE -ve
- N3 Lymph node > 6 cm in greatest dimension
- N3a Lymph node > 6 cm in greatest dimension and ENE -ve
- N3b Any lymph node(s) with clinically overt ENE +ve
- Mx - Distant metastasis cannot be assessed
- M0 - No distant metastasis
- M1 - Distant metastasis
Oropharynx (HPV +ve)Oropharynx clinical nodes (HPV +ve)Distant metastasis
- Tx - Primary tumour cannot be assessed
- T1 - Tumour ≤2 cm in greatest dimension
- T2 - Tumour >2 cm and ≤4 cm
- T3 - Tumour >4 cm, or extension to lingual surface of epiglottis
- T4 - Moderately advanced or very advanced
- T4a - Tumor invades the larynx, deep/extrinsic muscle of the tongue, medial pterygoid, hard palate, or mandible
- T4b - Tumor invades the lateral pterygoid muscle, pterygoid plates, lateral
nasopharynx, or skull base, or encases the carotid artery
- Nx - Regional lymph nodes cannot be assessed
- N0 - No regional lymph node metastasis
- N1 - Single ipsilateral lymph node ≤ 6cm
- N2 - Bilateral or contralateral lymph node ≤ 6 cm in greatest dimension
- N3 - Lymph node > 6 cm in greatest dimension
- Mx - Distant metastasis cannot be assessed
- M0 - No distant metastasis
- M1 - Distant metastasis