Laryngeal squamous cell carcinoma (staging)

A.Prof Frank Gaillard et al.

Laryngeal squamous cell carcinoma staging uses the TNM staging system and actual staging is subsite (see laryngeal subsites) specific for T1-3. A rough approximation for all subsites is

  • T1: limited to one subsite and normal cord mobility
  • T2: more than one subsite and impaired cord mobility (but no fixation)
  • T3: limited to larynx with cord fixation
  • T4: extension into tissues beyond larynx

Staging

Primary tumour (T)
Tx, T0 and Tis

Tx, T0 and Tis are the same for all three subsites:

  • Tx: primary tumour cannot be assessed
  • T0: no evidence of primary tumour
  • Tis: carcinoma in situ
Supraglottic
  • T1: limited to supraglottis with normal cord mobility
  • T2: invades mucosa of adjacent subsite or area (e.g. base of tongue) with normal cord mobility
  • T3
    • limited to larynx with cord fixation
      invades one or more of:
      • postcricoid area
      • pre-epiglottic area
      • paraglottic space
      • minor (inner surface only) cartilage erosion
Glottic
  • T1
    • T1a: limited to unilateral vocal cord with normal cord mobility
    • T1b: bilateral vocal cord involvement with normal cord mobility
  • T2
    • invades mucosa of adjacent subsite (supraglottis or subglottis) and/or impaired cord mobility
  • T3
    • limited to larynx with cord fixation
      invades one or more of:
      • postcricoid area
      • pre-epiglottic area
      • paraglottic space
      • minor (inner surface only) cartilage erosion
Subglottis
  • T1: limited to subglottis
  • T2: invasion of adjacent subsite (i.e. vocal cords) with no cord fixation (cords may demonstrate abnormal mobility)
  • T3: limited to larynx with cord fixation
T4 lesions

T4 is the same for all three subsites

  • T4: same for all three subsites
    • T4a: any of the following:
      • invasion thorough thyroid cartilage
      • invasion of the trachea
      • invasion of the deep/extrinsic muscles of the tongue
      • invasion of the strap muscles
      • invasion of the thyroid gland
      • invasion of the oesophagus
    • T4b: any of the following:
      • invasion of the mediastinum
      • invasion of the prevertebral fascia
      • encases the 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, ≤ 3 cm
  • 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
Metastases (M)
  • Mx: presence of metastases cannot be assessed
  • M0: no evidence of metastases
  • M1: distant metastases present
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Article information

rID: 1567
Section: Staging
Synonyms or Alternate Spellings:
  • 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

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    Case 1: T4 disease
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    Case 2: T3N0
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