TNM Grading

For the staging of laryngeal cancer, the TNM system (T - tumour, N - node, M - metastasis), established by the International Union Against Cancer (UICC) is widely used [340]. Stage remains the most significant predictor of survival. The size of the tumour and the presence of regional and distant metastases are independent predictors of survival.

An important parameter ignored in the TNM system is extracapsular spread. Several studies have shown that the presence of extracapsular spread in the lymph nodes is strongly associated with both regional recurrence and distant metastases, resulting in decreased survival [71, 116, 157, 344]. Some studies, on the contrary, have not confirmed the independent prognostic significance of extracapsular spread [225, 292].

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