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TNM classification of carcinomas of the nasal cavity and paranasal sinuses

TNM classification1,2

TNM classification of carcinomas of the nasal cavity and sinuses # T - Primary tumour

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

Maxillary sinus

T1 Tumour limited to the antral mucosa with no erosion or destruction of bone

T2 Tumour causing bone erosion or destruction, including extension into hard palate and/or middle nasal meatus, except extension to posterior antral 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, clivus

Nasal cavity and ethmoid sinus

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, clivus

N - Regional lymph nodes 3

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 greatest 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

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