Part of Cancer staging guidance sheets
Nasal cavity and paranasal sinuses (ICD10 C30.0, C31.0, C31.1)
Introduction
This is the data sheet for TNM 8th edition staging of the nasal cavity and paranasal sinuses (ICD10 C30.0, C31.0, C31.1)
For more detailed information regarding TNM staging, please see pages 6, 8 & 36-39 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 |
T1, T2, T3 |
N2 |
M0 |
|
|
T4a |
N0, N1, N2 |
M0 |
|
Stage IVB |
T4b |
Any N |
M0 |
|
|
Any T |
N3 |
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 |
Maxillary Sinus
| T value | Description |
|---|---|
|
T1 |
Tumour limited to the mucosa with no erosion or destruction of bone |
|
T2 |
Tumour causing bone erosion or destruction, including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of maxillary sinus and pterygoid plates |
|
T3 |
Tumour invades any of the following: bone of posterior wall of maxillary sinus, subcutaneous tissues, floor or medial wall of orbit, pterygoid fossa, ethmoid sinuses |
|
T4a |
Tumour invades any of the following: anterior orbital contents, skin of cheek, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid or frontal sinuses |
|
T4b |
Tumour invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus |
Nasal Cavity and Ethmoid Sinus
| T value | Description |
|---|---|
|
T1 |
Tumour restricted to one subsite of nasal cavity or ethmoid sinus, with or without bony invasion |
|
T2 |
Tumour involves two subsites in a single site or extends to involve an adjacent site within the nasoethmoidal complex, with or without bony invasion |
|
T3 |
Tumour extends to invade the medial wall or floor of the orbit, maxillary sinus, palate, or cribriform plate |
|
T4a |
Tumour invades any of the following: anterior orbital contents, skin of nose or cheek, minimal extension to anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses |
|
T4b |
Tumour invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than V2, nasopharynx, or clivus |
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 |
Metastasis as described below: |
|
|
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 - Metastasis 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 nodes with clinical extranodal extension* |
Notes:
*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 extra nodal extension.
Midline nodes are considered ipsilateral nodes.
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 |
Metastasis as described below: |
|
|
pN2a - Metastasis in a single ipsilateral lymph node, 3 cm 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 |
|
pN3a |
Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension |
|
pN3b |
Metastasis in a lymph node more than 3 cm in greatest dimension with extranodal extension or multiple ipsilateral, or any contralateral or bilateral node(s) with extranodal extension |
pM - distant metastasis*
| pM value | Description |
|---|---|
|
pM1 |
Distant metastasis microscopically confirmed |
Note:
*pM0 and pMX are not valid categories
Last edited: 16 December 2022 1:14 pm
