Salivary gland tumor staging: Difference between revisions
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{{Salivary gland tumor}} | {{Salivary gland tumor}} | ||
{{CMG}}{{AE}}{{Simrat}} | |||
==Overview== | |||
According to the [[TNM]] staging system by the American Joint Committee on Cancer, there are four stages of salivary gland cancers based on the [[tumor]] size, [[lymph nodes]] involved, and [[metastasis]].<ref name="NIH"> Salivary gland cancer. National cancer institute(2015) http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq#section/_13 Accessed on November 8, 2015</ref> | |||
==Staging== | |||
*The American Joint Committee on Cancer (AJCC) has designated staging by [[TNM]] classification to define salivary gland cancer. In general, tumors of the major salivary glands are staged according to size, extraparenchymal extension, [[lymph node]] involvement (in [[parotid]] [[tumors]], whether or not the [[facial nerve]] is involved), and presence of [[metastases]]. | |||
*Tumors arising in the minor salivary glands are staged according to the anatomic site of origin (e.g., [[oral cavity]] and [[sinuses]]). Clinical stage, particularly tumor size, may be the critical factor to determine the outcome of salivary gland cancer and may be more important than histologic grade. Diagnostic imaging studies may be used in staging. With excellent spatial resolution and superior soft tissue contrast, magnetic resonance imaging (MRI) offers advantages over computed tomographic scanning in the detection and localization of [[head]] and [[neck]] tumors. Overall, [[MRI]] is the preferred modality for evaluation of suspected neoplasms of the salivary glands.<ref name="NIH"> Salivary gland cancer. National cancer institute(2015) http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq#section/_13 Accessed on November 8, 2015</ref> | |||
===Primary tumor (T)=== | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 800px" align=center | |||
|valign=top| | |||
|+ | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|T Classification}} | |||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Thickness}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:TX | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Primary tumor cannot be assessed | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:T0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |No evidence of a primary tumor | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:T1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor ≤2 cm in greatest dimension without extraparenchymal extension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:T2 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor >2 cm but ≤4 cm in greatest dimension without extraparenchymal extension'''<sup><nowiki>*</nowiki></sup>''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:T3 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor >4 cm and/or tumor having extraparenchymal extension'''<sup><nowiki>*</nowiki></sup>''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | |||
:T4a | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Moderately advanced disease. | |||
*Tumor invades skin, mandible, ear canal, and/or facial nerve | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | |||
:T4b | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Very advanced disease | |||
*Tumor invades skull base and/or pterygoid plates and/or encases carotid artery | |||
|- | |||
|} | |||
'''<sup><nowiki>*</nowiki></sup>'''Extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues. Microscopic evidence alone does not constitute extraparenchymal extension for classification purposes. | |||
===Regional Lymph Nodes (N)=== | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 800px" align=center | |||
|valign=top| | |||
|+ | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|N classification}} | |||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Nodal Mass}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:NX | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Regional lymph nodes cannot be assessed | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |No regional lymph node metastasis | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis in a single ipsilateral lymph node, ≤3 cm in greatest dimension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N2 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Metastasis in a single ipsilateral lymph node, >3 cm but ≤6 cm in greatest dimension | |||
*Metastases in multiple ipsilateral lymph nodes, ≤6 cm in greatest dimension | |||
*Metastases in bilateral or contralateral lymph nodes, ≤6 cm in greatest dimension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N2a | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Metastasis in a single ipsilateral lymph node, >3 cm but ≤6 cm in greatest dimension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N2b | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Metastases in multiple ipsilateral lymph nodes, ≤6 cm in greatest dimension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N2c | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Metastases in bilateral or contralateral lymph nodes, ≤6 cm in greatest dimension | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:N3 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Metastases in bilateral or contralateral lymph nodes, ≤6 cm in greatest dimension | |||
|- | |||
|} | |||
===Distant Metastasis (M)=== | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 300px" align=center | |||
|valign=top| | |||
|+ | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|M Classification}} | |||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Definition}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:M0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |No distant metastasis | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:M1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Distant metastasis | |||
|- | |||
|} | |||
===Anatomic Stage/Prognostic Groups=== | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center | |||
|valign=top| | |||
|+ | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''Stage'''}} | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''T'''}} | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''N'''}} | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''M'''}} | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:Stage 1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*T1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*N0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M0 | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:Stage II | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*T2 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*N0 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M0 | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:Stage III | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*T3 | |||
*T1 | |||
*T2 | |||
*T3 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*N0 | |||
*N1 | |||
*N1 | |||
*N1 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M0 | |||
*M0 | |||
*M0 | |||
*M0 | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:Stage IVA | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*T4a | |||
*T4a | |||
*T1 | |||
*T2 | |||
*T3 | |||
*T4a | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*N0 | |||
*N1 | |||
*N2 | |||
*N2 | |||
*N2 | |||
*N2 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M0 | |||
*M0 | |||
*M0 | |||
*M0 | |||
*M0 | |||
*M0 | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | |||
:Stage IVB | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*T4b | |||
*Any T | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Any N | |||
*N3 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M0 | |||
*M0 | |||
|- | |||
| style="text-align: center;padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | |||
:Stage IVC | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Any T | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Any N | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*M1 | |||
|- | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Latest revision as of 15:28, 27 November 2017
Salivary gland tumor Microchapters |
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Case Studies |
Salivary gland tumor staging On the Web |
American Roentgen Ray Society Images of Salivary gland tumor staging |
Risk calculators and risk factors for Salivary gland tumor staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
According to the TNM staging system by the American Joint Committee on Cancer, there are four stages of salivary gland cancers based on the tumor size, lymph nodes involved, and metastasis.[1]
Staging
- The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define salivary gland cancer. In general, tumors of the major salivary glands are staged according to size, extraparenchymal extension, lymph node involvement (in parotid tumors, whether or not the facial nerve is involved), and presence of metastases.
- Tumors arising in the minor salivary glands are staged according to the anatomic site of origin (e.g., oral cavity and sinuses). Clinical stage, particularly tumor size, may be the critical factor to determine the outcome of salivary gland cancer and may be more important than histologic grade. Diagnostic imaging studies may be used in staging. With excellent spatial resolution and superior soft tissue contrast, magnetic resonance imaging (MRI) offers advantages over computed tomographic scanning in the detection and localization of head and neck tumors. Overall, MRI is the preferred modality for evaluation of suspected neoplasms of the salivary glands.[1]
Primary tumor (T)
T Classification | Thickness |
---|---|
|
Primary tumor cannot be assessed |
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No evidence of a primary tumor |
|
Tumor ≤2 cm in greatest dimension without extraparenchymal extension |
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Tumor >2 cm but ≤4 cm in greatest dimension without extraparenchymal extension* |
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Tumor >4 cm and/or tumor having extraparenchymal extension* |
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*Extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues. Microscopic evidence alone does not constitute extraparenchymal extension for classification purposes.
Regional Lymph Nodes (N)
N classification | Nodal Mass |
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Regional lymph nodes cannot be assessed |
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No regional lymph node metastasis |
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Metastasis in a single ipsilateral lymph node, ≤3 cm in greatest dimension |
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Distant Metastasis (M)
M Classification | Definition |
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No distant metastasis |
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Distant metastasis |
Anatomic Stage/Prognostic Groups
Stage | T | N | M |
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References
- ↑ 1.0 1.1 Salivary gland cancer. National cancer institute(2015) http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq#section/_13 Accessed on November 8, 2015