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TNM classification of carcinomas of the oral cavity and oropharynx

TNM classification of carcinomas of the lip and oral cavity 1,2

T - Primary tumour

TX Primary tumour cannot be assessed TO No evidence of primary tumour Tis Carcinoma in situ

T1 Tumour 2 cm or less in greatest dimension

T2 Tumour more than 2 cm but not more than 4 cm in greatest dimension

T3 Tumour more than 4 cm in greatest dimension

Tumour invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin (chin or nose) T4a (oral cavity)

Tumour invades through cortical bone, into deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglos-sus), maxillary sinus, or skin of face T4b (lip and 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##

NX Regional lymph nodes cannot be assessed

NO No regional lymph node metastasis

N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in great est dimension N2 Metastasis as specified in N2a, 2b, 2c below N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in a lymph node more than 6 cm in greatest dimension

Note: Midline nodes are considered ipsilateral nodes.

TNM classification of carcinomas of the oropharynx 12

T - Primary tumour

TX Primary tumour cannot be assessed TO No evidence of primary tumour Tis Carcinoma in situ

T1 Tumour 2 cm or less in greatest dimension T2 Tumour more than 2 cm but not more than 4 cm in greatest dimension T3 Tumour more than 4 cm in greatest dimension T4a Tumour invades any of the following: larynx, deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglos-sus), medial pterygoid, hard palate, and mandible T4b Tumour invades any of the following: lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, skull base; or encases the carotid artery

N - Regional lymph nodes##

NX Regional lymph nodes cannot be assessed

NO No regional lymph node metastasis

N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in great est dimension N2 Metastasis as specified in N2a, 2b, 2c below N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in a lymph node more than 6 cm in greatest dimension

Note: Midline nodes are considered ipsilateral nodes.

M - Distant metastasis MX Distant metastasis cannot be assessed MO No distant metastasis M1 Distant metastasis

Stage grouping are the cervical nodes.

M - Distant metastasis MX Distant metastasis cannot be assessed M0 No distant metastasis M1 Distant metastasis

Stage grouping

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