Major salivary gland cancer (staging)

Major salivary gland cancer staging refers to TNM staging of malignant tumors of the major salivary glands (parotidsubmandibular, and sublingual glands). In contrast, tumors arising from minor salivary glands are staged according to their site of origin. 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: primary tumor cannot be assessed
  • T0: no evidence of primary tumor
  • Tis: carcinoma in situ
  • T1: tumor ≤2 cm in greatest dimension without extraparenchymal extension*
  • T2: tumor >2 cm and ≤4 cm without extraparenchymal extension*
  • T3
    • tumor >4 cm and/or
    • tumor with extraparenchymal extension*
  • T4: moderately or very advanced

*Extraparenchymal extension refers to clinical or macroscopic pathologic evidence of soft tissue invasion. Microscopic evidence does not suffice.

Regional nodal status is defined the same as for most other cancers of the head and neck. See the main article, cervical lymph node (staging).

The terms pM0 and MX are not valid TNM categories. The following categories may be used, either in the clinical classification (c) for patients with cancer identified before treatment and/or in the pathological classification (p) for patients for whom surgery is the first definitive therapy:

  • cM0: no evidence of metastases
  • cM1: distant metastasis
  • pM1: distant metastasis, microscopically confirmed

The prognostic stage groups are defined the same as for most other cancers of the head and neck:

  • Stage 0
    • Tis, N0, M0
  • Stage I
    • T1, N0, M0
  • Stage II
    • T2, N0, M0
  • Stage III
    • T3, N0, M0
    • [T0, T1, T2, T3], N1, M0
  • Stage IVA
    • T4a, [N0, N1], M0
    • [T0, T1, T2, T3, T4a], N2, M0
  • Stage IVB
    • [Any T], N3, M0
    • T4b, [Any N], M0
  • Stage IVC
    • [Any T], [Any N], M1

Compared to the prior edition, there has been no change in primary tumor category definitions, but regional lymph node categories have been updated as it has elsewhere in the head and neck to emphasize extranodal extension.

Share article

Article information

rID: 9453
System: Head & Neck
Section: Staging
Synonyms or Alternate Spellings:
  • Malignant salivary gland tumour staging
  • Salivary gland tumour staging
  • Staging of salivary gland tumour
  • Staging of malignant salivary gland tumors
  • Malignant salivary gland tumor staging
  • Salivary gland tumor staging
  • Staging of salivary gland tumor

Support Radiopaedia and see fewer ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.