Nasal cavity and ethmoid sinus carcinoma (staging)

Nasal cavity and ethmoid sinus carcinoma staging refers to TNM staging of epithelial cancers involving the nasal cavity or ethmoid air cells. Applicable histologies include squamous cell carcinoma, adenocarcinoma and its variants, and other rarer epithelial malignancies other than mucosal melanoma. The following article reflects the 8^th edition published by the American Joint Committee on Cancer, which is used for staging starting January 1, 2018 ^1,2.

Primary tumor (T)

• TX: primary tumor cannot be assessed

• Tis: carcinoma in situ

• T1: tumor limited to one subsite (septum, floor, lateral wall, or vestibule (edge of naris to mucocutaneous junction of nasal cavity); left or right ethmoid sinus)

• T2: tumor involving two subsites in one region or extending to involve an adjacent region in the nasoethmoidal complex

• T3: tumor invades any of the following:

  • medial wall or floor of orbit

  • maxillary sinus

  • palate

  • cribriform plate

• T4: moderately advanced or very advanced local disease

  • T4a: moderately advanced local disease in which tumor invades any of the following:

    • anterior orbital contents

    • skin of nose or cheek

    • minimal extension to anterior cranial fossa

    • pterygoid plates

    • sphenoid sinus

    • frontal sinus

  • T4b: very advanced local disease in which tumor invades any of the following:

    • orbital apex

    • middle cranial fossa

    • dura

    • brain

    • cranial nerves other than maxillary division of trigeminal nerve (V2)

    • nasopharynx

    • clivus

Regional lymph node (N)

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).

Distant metastases (M)

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 groups

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

  • [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

See also

• nasal cavity and ethmoid sinus carcinoma (staging)

• WHO classification of head and neck tumors

• cervical lymph node levels

• cervical lymph node staging