Major Salivary Glands Cancer Staging 

Updated: Feb 22, 2016
  • Author: Marvaretta M Stevenson, MD; Chief Editor: Guy J Petruzzelli, MD, PhD, MBA, FACS  more...
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TNM Classification for Cancer of Major Salivary Glands (Parotid, Submandibular, and Sublingual)

The TNM classification for cancer of the major salivary glands (parotid, submandibular, and sublingual) is provided below, along with anatomic staging. [1]

Table. TNM classification (Open Table in a new window)

Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1 Tumor ≤2 cm in greatest dimension without extraparenchymal extension (clinical or macroscopic evidence of invasion of the soft tissues, not microscopic evidence)
T2 Tumor >2 cm but not more than 4 cm in greatest dimension without extraparenchymal extension
T3 Tumor >4 cm and/or tumor has extraparenchymal extension
T4a Moderately advanced disease
  • Tumor invades the skin, mandible, ear canal, and/or facial nerve
T4b Very advanced disease
  • Tumor invades skull base and/or pterygoid plates and/or encases carotid artery
Regional lymph nodes (N)
NX Regional nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in a single ipsilateral lymph node,  ≤3 cm in greatest dimension
N2 Metastasis in a single ipsilateral lymph node >3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension
N2a Metastasis in a single ipsilateral lymph node >3 cm but not more than 6 cm in greatest dimension
N2b Metastasis in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension
N2c Metastasis in bilateral or contralateral lymph nodes, none >6 cm in greatest dimension
N3 Metastasis in a lymph node >6 cm in greatest dimension
Distant metastasis (M)
M0 No distant metastasis
M1 Distant metastasis

Table. Anatomic stage/prognostic groups (Open Table in a new window)

Stage T N M
0 Tis N0 M0
I T1 N0 M0
II T2 N0 M0
III T3 N0 M0
T1 N1 M0
T2 N1 M0
T3 N1 M0
IVA T4a N0 M0
T4a N1 M0
T1 N2 M0
T2 N2 M0
T3 N2 M0
T4a N2 M0
IVB T Any N3 M0
T4b N Any M0
IVC T Any N Any M1