Nasopharyngeal carcinoma staging

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

Overview

The staging of nasopharyngeal carcinoma is based on the TNM staging system.

Staging

The staging of nasopharyngeal carcinoma is based on the TNM staging system.

TNM staging

Primary tumor

• Tx: primary tumor cannot be assessed
• T0: no evidence of primary tumor
• Tis: carcinoma in situ
• T1: tumor is confined to the nasopharynx
• T2: tumor extends to soft tissues of the oropharynx and/or nasal fossa
  • T2a: without extension to the parapharyngeal region
  • T2b: with extension to the parapharyngeal region
• T3: invasion of adjacent bony structures and/or paranasal sinuses
• T4: invasion of any one or more of the following
  • intracranial content
  • cranial nerves
  • infratemporal fossa/masticator space
  • hypopharynx
  • orbit

Nodal status

• Nx: nodes cannot be assessed
• N0: no evidence of nodal involvement
• N1: unilateral nodal involvement <6cm maximal diameter above supraclavicular fossa
• N2: bilateral nodal involvement <6cm maximal diameter above supraclavicular fossa
• N3
  • N3a: >6 cm maximal diameter (unilateral or bilateral)
  • N3b: involvement of the supraclavicular fossa

Metastases

• Mx: presence of metastases cannot be assessed
• M0: no evidence of metastases
• M1: distant metastases present

Stages of Nasopharyngeal carcinoma

Stage	T	N	M
0	Tis	N0	M0
I	T1	N0	M0
II	T2a	N0	M0
II	T2b	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	AnyT	N3	M0
	T4b	AnyN	M0
IVC	AnyT	AnyN	M1

References

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