Nasopharyngeal carcinoma staging
Dr Yuranga Weerakkody and Dr Frank Gaillard et al.
Nasopharyngeal carcinoma is staged using the TNM staging system with derived stage groupings.
TNM staging
Primary tumour (T)
- 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 (N)
- 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 (M)
- 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
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