Part of Cancer staging guidance sheets
Lip and oral cavity (ICD10 C00, C02-C06)
Introduction
This is the data sheet for TNM 8th edition staging of the lip and oral cavity (ICD10 C00, C02-C06).
For more detailed information regarding TNM staging, please see pages 6, 8 & 19-21 of the UICC TNM 8 book or visit the Wiley and UICC website.
Stage groupings
|
Stage Group |
T stage |
N stage |
M stage |
|---|---|---|---|
|
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 |
TNM clinical classification
T - primary tumour
| T value | Description |
|---|---|
|
TX |
Primary tumour cannot be assessed |
|
T0 |
No evidence of primary tumour |
|
Tis |
Carcinoma in situ |
|
T1 |
Tumour 2 cm or less in greatest dimension and 5mm or less depth of invasion* |
|
T2 |
Tumour 2 cm or less in greatest dimension and more than 5mm depth of invasion or, Tumour more than 2 cm but not more than 4 cm in greatest dimension and depth of invasion no more than 10mm |
|
T3 |
Tumour more than 2 cm but not more than 4 cm in greatest dimension and depth of invasion more than 10 mm or |
|
Tumour more than 4 cm in greatest dimension and not more than 10 mm depth of invasion |
|
|
T4a |
Lip: Tumour invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin (of the chin or the nose) |
|
|
Oral Cavity: Tumour more than 4 cm in greatest dimension and more than 10 mm depth of invasion or |
|
|
Tumour invades through the cortical bone of the mandible or maxillary sinus, or invades the skin of the face |
|
T4b |
Lip & Oral cavity: Tumour invades masticator space, pterygoid plates, or skull base, or encases internal carotid artery |
Note:
*Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to classify a tumour as T4
N - regional lymph nodes
| N value | Description |
|---|---|
|
NX |
Regional lymph nodes cannot be assessed |
|
N0 |
No regional lymph node metastasis |
|
N1 |
Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension without extranodal extension* |
|
N2 |
N2a - Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension without extranodal extension |
|
N2b - Metasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension without extranodal extension |
|
|
|
N2c - Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension without extranodal extension |
|
N3a |
Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension |
|
N3b |
Metastasis in a single or multiple lymph node with clinical extranodal extension** |
Notes:
*Midline nodes are considered ipsilateral nodes.
**The presence of skin involvement or soft tissue invasion with deep fixation/tethering to underlying muscle or adjacent structures or clinical signs of nerve involvement is classified as clinical extranodal extension.
M - distant metastasis
| M value | Description |
|---|---|
|
M0 |
No distant metastasis |
|
M1 |
Distant Metastasis |
Note:
The MX category is considered to be inappropriate as clinical assessment of metastasis can be based on physical examination alone. (The use of MX may result in exclusion from staging.)
TNM pathological classification
pT - primary tumour
The pT categories correspond to the T categories as per above.
pN - regional lymph nodes
Histological examination of a selective neck dissection specimen will ordinarily include 10 or more lymph nodes. Histological examination of a radical or modified radical neck dissection specimen will ordinarily include 15 or more lymph nodes.
| pN value | Description |
|---|---|
|
pNX |
Regional lymph nodes cannot be assessed |
|
pN0 |
No regional lymph node metastasis |
|
pN1 |
Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension without extranodal extension* |
|
pN2 |
pN2a - Metastasis in a single ipsilateral lymph node, 3cm or less in greatest dimension with extranodal extension or more than 3 cm but not more than 6 cm in greatest dimension without extranodal extension |
|
|
pN2b - Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, without extranodal extension |
|
|
pN2c - Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension without extranodal extension |
|
pN3 |
pN3a - Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension pN3b - Metastasis in a lmyph node more than 3cm in greatest dimension with extranodal extension OR, multiple ipsilateral, or any contralateral or bilateral node(s) without extranodal extension. |
pM - distant metastasis*
| pM value | Description |
|---|---|
|
M1 |
Distant Metastasis |
Note:
*pM0 and pMX are not valid categories
Last edited: 28 December 2023 11:34 am
