Chapter 084. Head and Neck Cancer (Part 4) pot

Head and Neck Cancer Part 4 Table 84-2 Definition of TNM–Nasopharynx Primary Tumor T Stage Grouping assessed Stage 0 T0 No evidence Stage I Tis Carcinoma in situ Stage IIA... T1 Tu

Chapter 084 Head and Neck Cancer

(Part 4)

Table 84-2 Definition of TNM–Nasopharynx

Primary Tumor (T) Stage Grouping

assessed

Stage

0

T0 No evidence Stage

I

Tis Carcinoma in situ Stage

IIA

T1 Tumor confined

to the nasopharynx

Stage IIB

T2 Tumor extends to

soft tissues

extends to the

oropharynx and/or nasal

parapharyngeal

extension

T2b Any tumor

with parapharyngeal

extension

T3 Tumor involves

bony structures and/or

paranasal sinuses

T4 Stage

III

Tumor with intracranial extension

and/or involvement of

cranial nerves,

infratemporal fossa,

hypopharynx, orbit, or

masticator space

Regional Lymph Nodes

(N)

The distribution and the

prognostic impact of regional

lymph node spread from

nasopharynx cancer, particularly of

the undifferentiated type, are

different from those of other head

and neck mucosal cancers and

justify the use of a different N

classification scheme

NX Regional lymph nodes

cannot be assessed

N0 No regional lymph node

metastasis

N1 Unilateral metastasis in

lymph node(s), ≤6 cm in greatest

dimension, above the

supraclavicular fossa

N2 Bilateral metastasis in

lymph node(s), ≤6 cm in greatest

dimension, above the

supraclavicular fossa

N3 Metastasis in lymph

node(s), >6 cm and/or to

supraclavicular fossa

N3a Greater than 6 cm in

dimension

T

N3b Extension to the

supraclavicular fossa

T

Any

N

M1

In patients with lymph node involvement and no visible primary, the diagnosis should be made by lymph node excision If the results indicate squamous cell carcinoma, a panendoscopy should be performed, with biopsy of all suspicious-appearing areas and directed biopsies of common primary sites, such as the nasopharynx, tonsil, tongue base, and pyriform sinus