TNM Staging Guide 5th Edition eBook

Subglottis T1

Tumor limited to the subglottis T2 Tumor extends to the vocal cord(s) with normal or impaired mobility. T3 Tumor imited to the larynx with vocal fold fixation. T4a Moderately advanced local disease Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of the neck including deep extrinsic muscles of the tongue, strap muscles, thyroid, or esophagus) Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures D. Hypopharynx The hypopharynx includes the pyriform sinuses, the lateral and posterior hypopharyngeal walls, and the postcricoid region. Tumor limited to one subsite of the hypopharynx and is 2 cm or less in greatest dimension T2 Tumor invades more than one subsite of the hypopharynx or an adjacent site, or measures more than 2 cm but not more than 4 cm in greatest dimension without fixation of the hemilarynx or extension to the esophagus T3 Tumor more than 4 cm in greatest dimension or with fixation of the hemilarynx or extension to the esophagus T4a Moderately advanced local disease Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, esophagus, or central compartment soft tissue* T4b Very advanced local disease Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures *Note: Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat. T4b Very advanced local disease PRIMARY TUMOR (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ T1

18 TNM Staging of Head and Neck Cancer and Neck Dissection Classification

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