Tongue cancer staging

Tongue cancer Microchapters
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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]

Staging

T Categories for tongue cancer

T Classification	Thickness
TX	Primary tumor cannot be assessed
T0	No evidence of a primary tumor
Tis	Carcinoma in situ
T1	Tumor ≤2 cm in greatest dimension
T2	Tumor >2 cm but ≤4 cm in greatest dimension
T3	Tumor >4 cm in greatest dimension
T4a	Moderately advanced local disease (Lip) Tumor invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin of face, that is, chin or nose (Oral cavity) Tumor invades adjacent structures only (e.g., through cortical bone [mandible or maxilla] into deep [extrinsic] muscle of tongue [genioglossus, hyoglossus, palatoglossus, and styloglossus], maxillary sinus, or skin of face) b
T4b	Very advanced local disease. Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery

b Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of larynx.

N Categories for Oral Cavity b

N Classification	Nodal Mass
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, ≤3 cm in greatest dimension
N2	Metastasis in a single ipsilateral lymph node, >3 cm but ≤6 cm in greatest dimension Metastases in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension Metastases in bilateral or contralateral lymph nodes, none >6 cm in greatest dimension
N2a	Metastasis in single ipsilateral lymph node, >3 cm but ≤6 cm in greatest dimension
N2b	Metastases in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension
N2c	Metastases in bilateral or contralateral lymph nodes, none >6 cm in greatest dimension
N3	Metastasis in a lymph node >6 cm in greatest dimension

b Metastases at level VII are considered regional lymph node metastases

M Categories for Oral Cavity

M Classification	Definition
M0	No distant metastasis
M1	Distant metastasis