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Staging of laryngeal cancer

Epithelial tumors are classified according to the guidelines set by the International Union Against Cancer (UICC) (3,4).

T classification

The T classification represents the extent of the primary tumor.


  • T1 – Tumor is limited to one side of the supraglottis with normal mobility of the vocal cord(s). 
  • T2 – Tumor invades the vocal cord without fixation of the larynx. 


  • T3 – Tumor is limited to the larynx with fixation of the vocal cord and/or infiltration of the postcricoid area, pre-epiglottic tissues or most likely erosion of thyroid cartilage. 
  • T4a – Tumor invades through thyroid cartilage or down into the trachea and soft tissue contents of the neck.
  • T4b – Tumor invades prevertebral space, mediastinal structures or encases carotid artery.


  • T1 – Tumor limited to vocal cord(s) with normal mobility. 
    • a - Tumor limited to one vocal cord.
    • b - Tumor involves both vocal cords.
  • T2 – Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility.
  • T3 – Tumor limited to larynx with vocal cord fixation and/or invades paraglottic space or with probable thyroid cartilage erosion.
  • T4a – Tumor invades through thyroid cartilage, the trachea, soft tissues of the neck/tongue. 
  • T4b – Tumor invades prevertebral space, mediastinal structures, or carotid artery.


Very rare.

N classification

The N classification represents spreading to regional lymph nodes on the neck. The widest diameter is measured.

  • N0 – no regional lymph node metastases
  • N1 – single ipsilateral lymph node metastasis ≤ 3 cm
  • N2
    • a – single ipsilateral lymph node metastasis > 3 cm ≤ 6 cm
    • b – multiple ipsilateral lymph node metastases ≤ 6 cm
    • c – bilateral or contralateral lymph node metastases ≤ 6 cm
  • N3 – lymph node metastases > 6 cm

M classification

The M classification represents distant metastases.

  • M0 – no distance metastases
  • M1 – distant metastases


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