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Staging of oral cancer

Oral cancer is separated into lateral tumors and midline tumors.

  • Lateral tumors – bucca, gingiva and retromolar space with a minimum of 1 cm distance to the midline without spreading to contralateral lymph nodes.
  • Midline tumors – tongue, floor of the mouth and hard palate. Tumors growing toward the midline have a tendency for bilateral lymph node spreading.

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

T classification

The T classification represents the extent of the primary tumor.

  • T1 – small tumors ≤ 2 cm of greatest diameter
  • T2 – tumors 2–4 cm of greatest diameter

 

  • T3 – Tumors > 4 cm, < 6 cm
  • T4 – Advanced tumors with invasion of neigboring organs, muscle, bone, and skin (2).

 

N classification

The N classification represents spreading to regional cervical lymph nodes measured in greatest diameter.

  • 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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