Tongue cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2] Mohammed Abdelwahed M.D[3]

Overview

According to the TNM staging system by the American Joint Committee on Cancer, there are four stages of oral cancer based on the tumor size, lymph nodes involved, and metastasis.[1][2]

Staging

The TNM classification of oral cavity carcinoma is as follows:[3]

TNM Staging for Lip and Oral Cavity Cancers#
Tumor
TX Primary tumor cannot be assessed.
T0 Primary tumor cannot be assessed.
Tis Carcinoma in situ
T1 Tumor <2 cm or less in greatest dimension
T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension
T3 Tumor more than 4 cm in greatest dimension
T4 (lip) Tumor invades through cortical bone, inferior alveolar nerve, floor of the mouth, or skin of the face (e.g., chin or nose).
T4a (oral cavity) Tumor invades adjacent structures (e.g., through cortical bone into deep [extrinsic] muscle of the tongue [[[genioglossus]], hyoglossus, palatoglossus, and styloglossus], maxillary sinus, or skin of the face).
T4b Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid canal.
Regional Lymph Nodes (N)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension
N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
N3 Metastasis in a lymph node more than 6 cm in greatest dimension
Distant Metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis
M = Distant metastasis; N = regional lymph nodes; T= primary tumor; Tis = carcinoma in situ.

# = Staging system of the American Joint Committee on Cancer.

Staging of Oral Squamous Cell Carcinoma
Stage Description
0 Tis, N0, M0
I T1, N0, M0
II T2, N0, M0
III T3, N0, M0

T1, N1, M0

T2, N1, M0

T3, N1, M0

IVA T4a, N0, M0

T4a, N1, M0

T1, N2, M0

T2, N2, M0

T3, N2, M0

T4a, N2, M0

IVB Any T, N3, M0

T4b, any N, M0

IVC Any T, any N, M1
M = Distant metastasis; N = regional lymph nodes; T = primary tumor; Tis = carcinoma in situ.

References

  1. Sqamous cell carcinoma of the tongue. Radiopedia(2015) http://radiopaedia.org/articles/squamous-cell-carcinoma-of-the-tongue Accessed on November 17, 2015
  2. Staging of Sqamous cell carcinoma of the oral cavity. Radiopedia(2015) http://radiopaedia.org/articles/staging-of-squamous-cell-carcinoma-of-the-oral-cavity Accessed on November 17, 2015
  3. Sobin, L. H. (2009). TNM classification of malignant tumours. Chichester, West Sussex, UK Hoboken, NJ: Wiley-Blackwell. ISBN 9781444332414.

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