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Staging of cancer of the nasal cavity and paranasal sinuses

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

T classification

The T classification represents the extent of the tumor.

Maxillary Sinus

  • T1 – Tumor is confined to mucosa without erosion or infiltration of bone.  
  • T2 – Tumor causes erosion of bone and extends into hard palate and/or to the medial wall of the maxillary sinus. 

  • T3 –Tumor invades any of the following: bone of posterior wall of maxillary sinus, subcutaneous tissue, floor of medial wall of orbit, ethmoid sinuses. 
  • T4a – Tumor invades any of the following: anterior orbital contents, skin of cheek, infratemporal fossa, pterygoid plates, cribriform plate, sphenoid or frontal sinuses. 
  • T4b – Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary nerve.

 

Nasal Cavity and Ethmoidal Sinus

  • T1 – Tumor is confined to one site of the nasal cavity or ethmoid sinus with or without invasion of bone. 
  • T2 – Tumor involves two localizations in close proximity within the nasoethmoidal complex, with or without invasion of bone. 
  • T3 – Tumor extends to invade the medial wall or floor of the orbit, maxillary sinus, palate, or cribriform plate. 
  • T4a – Tumor invades any of the following: anterior orbital contents, skin of nose or cheek. 
  • T4b – Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary nerve.

It is often difficult to define the exact origin of infiltrating tumors.

N classification

The N classification represents the absence or presence and extent of regional lymph node metastasis on the neck.

  • 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 distant metastases
  • M1 – distant metastases

 

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