Laryngeal cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]

Overview

According to the TNM staging system, the stages of laryngeal cancer are based on the tumor size, lymph node involvement, and distant metastasis

Staging

The following TNM staging is used for laryngeal cancer: [1]

Supraglottis
T1 Tumor limited to one subsite of supraglottis with normal vocal fold mobility
T2 Tumor invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g. mucosa of base of tongue, vallecula, medial wall of piriform sinus) without fixation of the larynx
T3 Tumor limited to larynx with vocal fold fixation and/or invades any of the following: post-cricoid area, pre-epiglottic tissues, paraglottic space, and/or with minor thyroid cartilage erosion (e.g. inner cortex)
T4a Tumor invades through the thyroid cartilage and/or invades tissues beyond the larynx, e.g. trachea, soft tissues of neck, including deep/extrinsic muscle of tongue (e.g. genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid and esophagus
T4b Tumor invades pre-vertebral space, mediastinal structures or encases carotid artery
Glottis
T1 Tumor limited to vocal fold(s) (may involve anterior or posterior commissure) with normal mobility

T1a. Tumor limited to one vocal fold T1b. Tumor involves both vocal folds

T2 T2a. Tumor extends to supraglottis and/or subglottis with normal vocal fold mobility

T2b. Tumor extends to supraglottis and/or subglottis with impaired vocal fold mobility

T3 Tumor limited to larynx with vocal fold fixation and/or invades paraglottic space, and/or with minor thyroid cartilage erosion (e.g. inner cortex)
T4a Tumor invades through the thyroid cartilage or invades tissues beyond the larynx, e.g. trachea, soft tissues of neck, including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid and esophagus
T4b Tumor invades prevertebral space, mediastinal structures or encases carotid artery
Subglottis
T1 Tumor limited to subglottis
T2 Tumor extends to vocal fold(s) with normal or impaired mobility
T3 Tumor limited to larynx with vocal fold fixation
T4a Tumor invades through cricoid or thyroid cartilage and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid and esophagus
T4b Tumor invades prevertebral space, mediastinal structures or encases carotid artery

References

  1. Jones TM, De M, Foran B, Harrington K, Mortimore S (May 2016). "Laryngeal cancer: United Kingdom National Multidisciplinary guidelines". J Laryngol Otol. 130 (S2): S75–S82. doi:10.1017/S0022215116000487. PMC 4873912. PMID 27841116.