2010ajcchn.docVIP

AJCC Staging of HN Cancer 2010 AJCC Staging of Head Neck Cancer 2010 Lip Oral Cavity Nasopharynx Oropharynx Hypopharynx Larynx Supraglottis Glottis Subglottis Nasal Cavity/Paranasal Sinus Maxillary Sinus Nasal Cavity/Ethmoid Sinus Salivary Gland Thyroid by @pawinpawin Nasopharynx T Staging T1 Confined to NP or extends to oropharynx and/or nasal cavity without parapharyngeal extension T2 Parapharyngeal extension T3 Invades bony structures of skull base and/or PNS T4 Intracranial and/or cranial nerves, infratemporal fossa, hypopharynx, orbit, masticator space N Staging N staging in nasopharynx is different from other HN cancer N1 Unilateral CLN = 6 cm, above supraclavicular, and/or retropharyngeal LN = 6 cm N2 Bilateral CLN = 6 cm above supraclavicular N3 CLN 6 cm N3a 6 cm N3b Extension to supraclav Supraclav = Triangular region of (1) superior margin sternal end clavicle (2) superior margin lateral end clavicle (3) point where the neck meets the shoulder Oropharynx T Staging T1 =2 cm T2 2 - =4 cm T3 4 cm or extension to lingual surface of epiglottis T4 ? T4a Invades larynx, exterinsic m of tongue, medial pterygoid, hard palate, mandible T4b Invades lateral pterygoid, pterygoid plates, lateral nasopharynx, skull base, encase carotid N Staging N1 Single ipsilat =3 cm N2 ? N2a Single ipsilat 3 cm 6 cm N2b Multiple ipsilat 6 cm N2c Bilat/contralat 6 cm N3 6 cm Stage Grouping T1 T2 T3 T4a T4b N0 I II N1 III N2 IVA N3 IVB Any T, Any N, M1 = IVC ? Lip Oral Cavity T Staging T1 =2 cm T2 2 - =4 cm T3 4 cm T4 ? T4a LIPS: invades cortical bone, inf alveolar n, FOM, skin of face (chin/nose) OC: invades cortical bone to deep m of tongue (genioglossus / hyoglossus / palatoglossus / styloglossus), maxillary sinus, skin of face T4b Invades masticator space, pterygoid plates, skull base, ICA N Staging N1 Single ipsilat =3 cm N2 ? N2a Single ipsilat 3 cm 6 cm N2b Multiple ipsilat 6 cm N2c Bilat/contralat 6 cm