Clinical Staging of Oral Cancers:

Staging is based on the TNM system and the American Joint Committee on Cancer (AJCC)

Tumour (T)

  • T1: Tumours are 2 cm or smaller in greatest dimension.
  • T2: Tumours are larger than 2 cm but not larger than 4 cm in greatest dimension.
  • T3: Tumours are larger than 4 cm in dimension.
  • T4: Tumours involve adjacent structures.
    • T4a: Tumour invades adjacent structures (cortical bone, deep [extrinsic] muscle of tongue [genioglossus, hyoglossus, palatoglossus, styloglossus], or facial skin).
    • T4b: Tumour invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery.

Node (N)

  • N0: No nodal metastasis is present.
  • N1: A single ipsilateral node is smaller than 3 cm in greatest dimension.
  • N2a: Metastasis in a single ipsilateral lymph node that is larger than 3 cm but not larger than 6 cm in dimension.
  • N2b: Multiple ipsilateral nodes are smaller than 6 cm in greatest dimension.
  • N2c: Bilateral or contralateral nodes are smaller than 6 cm in greatest dimension. N3: Any node is larger than 6 cm in greatest dimension.

Staging:

 

T1

T2

T3

T4

N0

I

II

III

IV

N1

III

III

III

IV

N2

IV

IV

IV

IV

N3

IV

IV

IV

IV

*Obtained from eMedicine, Gosselin, B.J., Malignant Tumors of the Mobile Tongue, May, 2006

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