TNM classification of carcinomas of the larynx

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TNM classification1,2

T - Primary tumour

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

Supraglottis

T1 Tumour limited to one subsite of supraglottis with normal vocal cord mobility

T2 Tumour invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynx T3 Tumour limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre-epiglottic tissues, paraglottic space, and/or with minor thyroid cartilage erosion (e.g. inner cortex) T4a Tumour invades through the thyroid cartilage and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglossus), strap muscles, thyroid, oesophagus T4b Tumour invades prevertebral space, mediastinal structures, or encases carotid artery

Glottis

T1 Tumour limited to vocal cord(s) (may involve anterior or posterior commissure) with normal mobility T1a Tumour limited to one vocal cord T1b Tumour involves both vocal cords

T2 Tumour extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility T3 Tumour limited to larynx with vocal cord fixation and/or invades paraglottic space, and/or with minor thyroid cartilage erosion (e.g. inner cortex)

T4a Tumour invades through the thyroid cartilage, or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglossus), strap muscles, thyroid, oesophagus T4b Tumour invades prevertebral space, mediastinal structures, or encases carotid artery

Subglottis

T1 Tumour limited to subglottis

T2 Tumour extends to vocal cord(s) with normal or impaired mobility T3 Tumour limited to larynx with vocal cord fixation T4a Tumour invades through cricoid or thyroid cartilage and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck includ ing deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus, and styloglossus), strap muscles, thyroid, oesophagus T4b Tumour invades prevertebral space, mediastinal structures, or encases 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

Stage 0 Stage I Stage II Stage III

Stage IVA

Stage IVB

Stage IVC

Tis T1 T2

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