Laryngeal carcinoma (staging)

Laryngeal carcinoma staging refers to TNM staging of carcinomas involving the supraglottic, glottic, and subglottic larynx. The vast majority of but not all applicable cases are squamous cell carcinomas. The following article reflects the 8th edition published by the American Joint Committee on Cancer, which is used for staging starting January 1, 2018 1,2.

TX and Tis are the same for all three sites of the larynx:

  • TX: primary tumor cannot be assessed
  • Tis: carcinoma in situ

T1 through T3 are defined differently by laryngeal site:

  • T1: limited to vocal cord(s) with normal vocal cord mobility (may involve anterior or posterior commissure)
    • T1a: limited to one vocal cord
    • T1b: involves both vocal cords
  • T2: extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility
  • T3: limited to larynx with vocal cord fixation and/or invasion of paraglottic space and/or inner cortex of thyroid cartilage
  • T1: limited to subglottis
  • T2: extends to vocal cord(s) with normal or impaired vocal cord mobility (no cord fixation)
  • T3: limited to larynx with vocal cord fixation and/or invasion of paraglottic space and/or inner cortex of thyroid cartilage

T4 is the same for all three sites of the larynx:

Regional nodal status is defined the same as for cervical nodes in most other cancers of the head and neck.

NX, N0, and N1 have the same clinical and pathologic criteria:

  • NX: nodes cannot be assessed
  • N0: no regional node metastases
  • N1: metastasis in single ipsilateral node, ≤3 cm, and no extranodal extension (ENE(−))

The criteria for N2 and N3 differs between clinical and pathological assessment. Clinically overt ENE in a node measuring 3 cm or smaller is cN3b but pathologic ENE in a similarly sized node would be pN2a, reflecting the higher bar to demonstrate clinically overt ENE.

  • N2
    • N2a
      • cN2a: metastasis in single ipsilateral node, >3 cm and ≤6 cm, and ENE(−)
      • pN2a: metastasis in single ipsilateral node, >3 cm and ≤6 cm, and ENE(−); or metastasis in single ipsilateral node, ≤3 cm, and ENE(+)
    • N2b: metastasis in multiple ipsilateral nodes, all ≤6 cm, and ENE(−)
    • N2c: metastasis in bilateral or contralateral nodes, all ≤6 cm, and ENE(−)
  • N3
    • N3a: metastasis in a node, >6 cm, and ENE(−)
    • N3b
      • cN3b: metastasis in a node with clinically overt ENE(+)
      • pN3b: metastasis in single ipsilateral node, >3 cm, and ENE(+); or multiple ipsilateral, contralateral, or bilateral nodes any with ENE(+); or single contralateral node of any size and ENE(+)

The terms pM0 and MX are not valid TNM categories. The following categories may be used:

  • cM0: no evidence of metastases
  • cM1: distant metastasis
  • pM1: distant metastasis, microscopically confirmed
  • Stage 0
    • Tis, N0, M0
  • Stage I
    • T1, N0, M0
  • Stage II
    • T2, N0, M0
  • Stage III
    • T3, N0, M0
    • [T1, T2, T3], N1, M0
  • Stage IVA
    • T4a, [N0, N1], M0
    • [T1, T2, T3, T4a], N2, M0
  • Stage IVB
    • [Any T], N3, M0
    • T4b, [Any N], M0
  • Stage IVC
    • [Any T], [Any N], M1
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Article information

rID: 1567
Section: Staging
Synonyms or Alternate Spellings:
  • Larynx carcinoma staging
  • Larynx cancer staging
  • Laryngeal cancer staging
  • Staging of laryngeal SCC
  • Staging of laryngeal squamous cell carinoma
  • Staging of squamous cell carcinoma of the larynx
  • Staging of SCC of the larynx
  • Laryngeal SCC staging

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Cases and figures

  • Case 1: T4 disease
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  • Case 2: T3N0
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