Stage Information
TNM Definitions
The American Joint Committee on Cancer (AJCC) has designated staging by TNM
classification.[1]
TNM Definitions
There is no tumor classification (T) for occult primary cancer metastatic to
neck lymph nodes.
Regional lymph nodes (N)
- NX: Regional lymph nodes cannot be assessed
- N0: No regional lymph node metastasis
- 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*
* [Note: A designation of "U" or "L" may be used to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L).]
In clinical evaluation, the actual size of the nodal mass should be measured
and allowance should be made for intervening soft tissues. Most masses more than 3
cm in diameter are not single nodes but are confluent nodes or tumor in soft
tissues of the neck. There are three stages of clinically positive nodes: N1, N2,
and N3. The use of subgroups a, b, and c is not required but recommended.
Midline nodes are considered homolateral nodes.
Distant metastasis (M)
- MX: Distant metastasis cannot be assessed
- M0: No distant metastasis
- M1: Distant metastasis
There is no generally accepted Roman numeral staging system for this disease.
Untreated
Untreated metastatic squamous neck cancer with occult primary means that a
patient is newly diagnosed and has had no prior treatment except supportive
care.
References
-
Head and neck sites. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 17-88.
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