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Hypopharyngeal SCC staging

Dr Yuranga Weerakkody and Dr Frank Gaillard et al.

Staging of hypopharyngeal squamous cell carcinoma is performed using the TNM staging system.

TNM staging

Primary tumour staging (T)

T1
- limited to 1 subsite AND
- tumour size ≤ 2 cm in greatest dimension
T2
- extends into adjacent subsite or area (larynx, oropharynx) AND / OR
- tumour size between 2 - 4 cm in greatest dimension
- clinically there must not be fixation of the hemilarynx
T3
- tumour size > 4 cm in greatest dimension OR
- clinical fixation of hemilarynx
T4
- T4a : direct invasion of one or more of the following:
  - thyroid cartilage / cricoid cartilage
  - hyoid bone
  - thyroid gland
  - oesophagus
  - central compartment
- T4b : direct invasion of one or more of the following:
  - mediastinal structures
  - prevertebral fascia
  - encases carotid artery

Nodal status (N)

Nodal staging is the same for SCCs of the oral cavity, oropharynx, hypopharynx and larynx.

Nx : nodes cannot be assessed
N0 : no regional nodal metastases
N1 : single ipsilateral node, ≤ 3cm
N2
- N2a : single ipsilateral node, 3 - 6 cm
- N2b : multiple ipsilateral nodes, < 6 cm
- N2c
  - bilateral nodal metastases OR
  - contralateral nodal metastases < 6 cm
N3 : any nodal metastasis > 6 cm