Cancer Staging

Staging describes the severity of a persons cancer

based on the size and/or extent of the primary tumor,
and whether or not cancer has spread in the body.

Staging is important for several reasons:

Helps the doctor plan the appropriate treatment
Estimating the patients prognosis
To identify possible clinical trials that may be a
suitable treatment option for a patient

TNM Staging
Oral malignancies are staged according to the TNM
system advocated by the American Joint Committee
on Cancer staging.

T = Tumor
N = Nodes
M = Metastases

T: Tumor
Describes the size of the primary tumor and whether
it has invaded nearby tissue
TX : tumor cannot be evaluated
Tis: carcinoma in situ
T0 : no evidence of primary tumor
T1: Tumor 2cm in greatest dimension
T2: Tumor > 2cm but 4cm in greatest dimension
T3: Tumor > 4cm in greatest dimension

T: Tumor
T4: (lip) Tumor invades through cortical bone,
inferior alveolar nerve, floor of mouth, or skin of
face, ie, chin or nosea

T4a: Moderately advanced local diseasea

T4b: Very advanced local disease
Tumor involves masticator space, pterygoid plates, or
skull base and/or encases internal carotid artery

N: Regional Lymph Nodes

N: describes the regional lymph nodes that are
involved

NX: Regional nodes cannot be assessed

N0: No regional LN metastasis
N1: Metastasis in a single ipsilateral LN, 3cm

N: Regional Lymph Nodes

N2:
N2a: Metastasis in a single ipsilateral LN, >3cm but
6cm in greatest dimension;
N2b: Metastasis in multiple ipsilateral LNs, none >
6cm in greatest dimension
N2c: Metastasis in bilateral LN, none > 6cm in
greatest dimension

N3: Metastasis in a LN, >6cm in greatest dimension

M: Distant Metastases
M0: No distant metastasis
M1: Distant metastasis

References
Edge SP, Byrd DR, Comp CC, et al (eds): AJCC Cancer
Staging Manual, 7th ed. New York, Springer, 2010.

Textbook of Guidelines to Oral & Maxillofacial Surgery &

Anaesthesia, 2nd ed.