TNM Staging Guide 5th Edition eBook

III. American Joint Committee on Cancer Tumor Staging—Nasopharynx, Thyroid, andMucosal Melanoma

A. Nasopharynx The nasopharynx includes the vault, the lateral walls, the posterior walls, and the superior surface of the soft palate.

PRIMARY TUMOR (T) TX Primary tumor cannot be assessed T0

No evidence of primary tumor but there is evidence of cancer in a cervical node that is EBV(+)

Tis Carcinoma in situ T1

Tumor confined to the nasopharynx or tumor extends to the oropharynx and/or nasal cavity without parapharyngeal extension T2 Tumor with parapharyngeal extension and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles) T3 Tumor involves bony structures of skull base, cervical vertebra, pterygoid plates and/or paranasal sinuses T4 Tumor with intracranial extension and/or involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or with extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle

REGIONAL LYMPH NODES (N) This site is different from other head and neck sites. NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1

Unilateral cervical metastasis or retropharyngeal lymph nodes (unilateral or bilateral), each 6 cm or less in greatest dimension, above the supraclavicular fossa** N2 Bilateral metastases in cervical lymph nodes, 6 cm or less in greatest dimension, above the supraclavicular fossa** N3a Metastasis in cervical lymph node(s) >6 cm in size, above the supraclavicular fossa**

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