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{{Laryngeal cancer}}
{{Laryngeal cancer}}
{{CMG}} {{AE}}{{Faizan}}
{{CMG}} {{AE}} {{OK}}
==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==
==Staging==
<ref>http://www.cancer.gov/types/head-and-neck/patient/laryngeal-treatment-pdq#section/_26</ref>
The following [[TNM staging system|TNM staging]] is used for laryngeal cancer: <ref name="pmid27841116">{{cite journal |vauthors=Jones TM, De M, Foran B, Harrington K, Mortimore S |title=Laryngeal cancer: United Kingdom National Multidisciplinary guidelines |journal=J Laryngol Otol |volume=130 |issue=S2 |pages=S75–S82 |date=May 2016 |pmid=27841116 |pmc=4873912 |doi=10.1017/S0022215116000487 |url=}}</ref>
 
{| class="wikitable"
==Stage 0==  
| colspan="1" rowspan="1" |'''Supraglottis'''
(Carcinoma in Situ)
| colspan="1" rowspan="1" |
 
|-
In stage 0, abnormal cells are found in the lining of the larynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
| colspan="1" rowspan="1" |T1
 
| colspan="1" rowspan="1" |[[Tumour|Tumor]] limited to one subsite of supraglottis with normal [[vocal fold]] [[mobility]]
==Stage I==
|-
 
| colspan="1" rowspan="1" |T2
In stage I, cancer has formed. Stage I laryngeal cancer depends on where cancer began in the larynx:
| colspan="1" rowspan="1" |[[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
 
|-
Supraglottis: Cancer is in one area of the supraglottis only and the vocal cords can move normally.
| colspan="1" rowspan="1" |T3
Glottis: Cancer is in one or both vocal cords and the vocal cords can move normally.
| colspan="1" rowspan="1" |[[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]])
Subglottis: Cancer is in the subglottis only.
|-
 
| colspan="1" rowspan="1" |T4a
==Stage II==
| colspan="1" rowspan="1" |[[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 of the neck|strap muscles]], [[thyroid]] and [[esophagus]]
 
|-
In stage II, cancer is in the larynx only. Stage II laryngeal cancer depends on where cancer began in the larynx:
| colspan="1" rowspan="1" |T4b
 
| colspan="1" rowspan="1" |[[Tumor]] invades pre-vertebral space, [[mediastinal]] structures or encases [[carotid artery]]
Supraglottis: Cancer is in more than one area of the supraglottis or surroundingtissues.
|-
Glottis: Cancer has spread to the supraglottis and/or the subglottis and/or the vocal cords cannot move normally.
| colspan="1" rowspan="1" |[[Glottis|'''Glottis''']]
Subglottis: Cancer has spread to one or both vocal cords, which may not move normally.
| colspan="1" rowspan="1" |
 
|-
==Stage III==
| colspan="1" rowspan="1" |T1
 
| colspan="1" rowspan="1" |[[Tumor]] limited to [[vocal fold]](s) (may involve anterior or posterior commissure) with normal [[mobility]]
Stage III laryngeal cancer depends on whether cancer has spread from the supraglottis,glottis, or subglottis.
T1a. [[Tumor]] limited to one [[vocal fold]] T1b. [[Tumor]] involves both vocal folds
 
|-
In stage III cancer of the supraglottis:
| colspan="1" rowspan="1" |T2
 
| colspan="1" rowspan="1" |T2a. [[Tumor]] extends to supraglottis and/or subglottis with normal [[vocal fold]] [[mobility]]
cancer is in the larynx only and the vocal cords cannot move, and/or cancer is intissues next to the larynx. Cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or
T2b. [[Tumor]] extends to supraglottis and/or subglottis with impaired [[vocal fold]] [[mobility]]
cancer is in one area of the supraglottis and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller and the vocal cords can move normally; or
|-
cancer is in more than one area of the supraglottis or surrounding tissues and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller.
| colspan="1" rowspan="1" |T3
 
| colspan="1" rowspan="1" |[[Tumor]] limited to [[larynx]] with [[vocal fold]] fixation and/or invades paraglottic space, and/or with minor [[thyroid cartilage]] erosion (e.g. inner [[cortex]])
In stage III cancer of the glottis:
|-
 
| colspan="1" rowspan="1" |T4a
cancer is in the larynx only and the vocal cords cannot move, and/or cancer is intissues next to the larynx; cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or
| colspan="1" rowspan="1" |[[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 of the neck|strap muscles]], [[thyroid]] and [[esophagus]]
cancer is in one or both vocal cords and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller and the vocal cords can move normally; or
|-
cancer has spread to the supraglottis and/or the subglottis and/or the vocal cords cannot move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller.
| colspan="1" rowspan="1" |T4b
 
| colspan="1" rowspan="1" |[[Tumor]] invades prevertebral space, [[mediastinal]] structures or encases [[carotid artery]]
In stage III cancer of the subglottis:
|-
 
| colspan="1" rowspan="1" |'''Subglottis'''
cancer is in the larynx and the vocal cords cannot move; cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or
| colspan="1" rowspan="1" |
cancer is in the subglottis and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller; or
|-
cancer has spread to one or both vocal cords, which may not move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller.
| colspan="1" rowspan="1" |T1
 
| colspan="1" rowspan="1" |[[Tumor]] limited to subglottis
==Stage IV==
|-
 
| colspan="1" rowspan="1" |T2
Stage IV is divided into stage IVA, stage IVB, and stage IVC. Each substage is the same forcancer in the supraglottis, glottis, or subglottis.
| colspan="1" rowspan="1" |[[Tumor]] extends to [[vocal fold]](s) with normal or impaired [[mobility]]
 
|-
In stage IVA:
| colspan="1" rowspan="1" |T3
 
| colspan="1" rowspan="1" |[[Tumor]] limited to [[larynx]] with [[vocal fold]] fixation
cancer has spread through the thyroid cartilage and/or has spread to tissuesbeyond the larynx such as the neck, trachea, thyroid, or esophagus. Cancer may have spread to one lymph node on the same side of the neck as the originaltumor and the lymph node is 3 centimeters or smaller; or
|-
cancer has spread to one lymph node on the same side of the neck as the original tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node anywhere in the neck with none larger than 6 centimeters. Cancer may have spread to tissues beyond the larynx, such as the neck, trachea, thyroid, or esophagus. Thevocal cords may not move normally.
| colspan="1" rowspan="1" |T4a
 
| colspan="1" rowspan="1" |[[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 of the neck|strap muscles]], [[thyroid]] and [[esophagus]]
In stage IVB:
|-
 
| colspan="1" rowspan="1" |T4b
cancer has spread to the space in front of the spinal column, surrounds thecarotid artery, or has spread to parts of the chest. Cancer may have spread to one or more lymph nodes anywhere in the neck and the lymph nodes may be any size; or
| colspan="1" rowspan="1" |[[Tumor]] invades prevertebral space, [[mediastinal]] structures or encases [[carotid artery]]
cancer has spread to a lymph node that is larger than 6 centimeters and may have spread as far as the space in front of the spinal column, around the carotid artery, or to parts of the chest. The vocal cords may not move normally.
|}
 
In stage IVC, cancer has spread to other parts of the body, such as the lungs, liver, or bone.
 
==References==


== References ==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Otolaryngology]]

Latest revision as of 06:18, 18 March 2019

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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.
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