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

Nasopharyngeal carcinoma is staged using the TNM staging system with derived stage groupings.

Staging

Nasopharyngeal carcinoma is staged using the TNM staging system with derived stage groupings.

TNM staging

Primary tumor

  • Tx: primary tumour cannot be assessed
  • T0: no evidence of primary tumour
  • Tis: carcinoma in situ
  • T1: tumour is confined to the nasopharynx
  • T2: tumour 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 supracalvicular fossa
  • N2: bilateral nodal involvement <6cm maximal diameter above supracalvicular fossa
  • N3
    • N3a: >6 cm maximal diameter (unilateral or bilateral)
    • N3b: involvement of the supracalvicular fossa

Metastases

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

Stage groupings

  • Stage 0: Tis, N0, M0
  • Stage 1: T1, N0, M0
  • Stage 2a: T2a, N0, M0
  • Stage 2b: T2b, N0, M0 or T0-T2, N1, M0
  • Stage 3: T3, N0-2, M0 or T0-T2, N2, M0
  • Stage 4a: T4, N0-2, M0
  • Stage 4b: any T, N3, M0
  • Stage 4c: any T, any N, M1

References


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