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Staging of pharynx cancer

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

T classification

The T classification represents the extent of the primary tumor.

  • T1 – small tumors ≤ 2 cm in largest diameter
  • T2 – tumor 2–4 cm in largest diameter

 

  • T3–4 – Advanced tumors with invasion of neighboring organs, soft tissue, bony structures or skin (2).

Nasopharynx

Tumors of the nasopharynx have a unique T classification.

  • T1 – Small tumors confined to nasopharynx
  • T2a – Tumor extends to soft tissue of oropharynx and/or nasal cavity without parapharyngeal extension
  • T2b – Tumor extends to soft tissue of oropharynx and/or nasal cavity with parapharyngeal extension
  • T3 – Tumor invades bony structures and/or paranasal sinuses
  • T4 – Tumor with intracranial extension and/or involvement of cranial nerves, infratemporal fossa, hypopharynx, orbit, or masticator space.

N classification

The N classification represents metastasis to regional lymph nodes in the neck. The greatest 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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