Primary tumor (T)* |
TX | Primary tumor cannot be assessed |
T0 | No evidence of primary tumor |
Tis | Carcinoma in situ |
T1 | Tumor 2 cm or less in greatest dimension with less than two high-risk features (see list of high-risk features below) |
T2 | Tumor greater than 2 cm in greatest dimension OR |
Tumor any size with two or more high-risk features |
T3 | Tumor with invasion of maxilla, mandible, orbit, or temporal bone |
T4 | Tumor with invasion of skeleton (axial or appendicular) or perineural invasion of skull base |
High-risk features for the primary tumor (T) staging |
Depth/invasion | >2 mm thickness |
Clark level ≥IV |
Perineural invasion |
Anatomic location | Primary site ear |
Primary site hair-bearing lip |
Differentiation | Poorly differentiated or undifferentiated |
Regional lymph nodes (N) |
NX | Regional lymph nodes cannot be assessed |
N0 | No regional lymph node metastases |
N1 | Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension |
N2 | Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension |
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 |
Distant metastasis (M) |
M0 | No distant metastases |
MI | Distant metastases |
Anatomic stage/prognostic groups¶ |
Stage 0 | Tis | N0 | M0 |
Stage I | T1 | N0 | M0 |
Stage II | T2 | N0 | M0 |
Stage III | T3 | N0 | M0 |
T1 | N1 | M0 |
T2 | N1 | M0 |
T3 | N1 | M0 |
Stage IV | T1 | N2 | M0 |
T2 | N2 | M0 |
T3 | N2 | M0 |
Any T | N3 | M0 |
T4 | Any N | M0 |
Any T | Any N | M1 |