Nasopharyngeal Cancer Staging 

Updated: Feb 06, 2018
  • Author: Marvaretta M Stevenson, MD; Chief Editor: Guy J Petruzzelli, MD, PhD, MBA, FACS  more...
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TNM Classification for Nasopharyngeal Cancers

The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classifications and prognostic stage groups for nasopharyngeal cancers are provided below. [1]

Table 1. TNM classification (Open Table in a new window)

Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No tumor ifentified, but EBV-positive cervical node(s) involvement
Tis Carcinoma in situ
T1 Tumor confined to the nasopharynx, or extenion to oropharynx and/or nasal cavity without parapharyngeal involvement
T2 Tumor with extension to parapharyngeal space, and/or adjacent soft tissue involvement (medial pterygoid, lateral pterygoid, prevertebral muscles)
T3 Tumor with infiltration of bony structures at skull base, cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4 Tumor with intracranial extension, involvement of cranial nerves, hypopharynx, orbit, parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle 
Regional lymph nodes (N)
NX Regional nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Unilateral metastasis in cervical lymph node(s) and/or unilateral or bilateral metastasis in retropharyngeal lymph node(s), 6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N2 Bilateral metastasis in cervical lymph node(s),  6 cm or smaller in greatest dimension, above the caudal border of cricoid cartilage
N3 Unilateral or bilateral metastasis in cervical lymph node(s),  larger than 6 cm in greatest dimension, and/or extension below the caudal border of cricoid cartilage
Distant metastasis (M)
cM0 No distant metastasis
cM1 Distant metastasis
pM1 Distant metastasis, microscopically confirmed

Table 2. Prognostic stage groups (Open Table in a new window)

Stage T N M
0 Tis N0 M0
I T1 N0 M0
II T0–T1 N1 M0
T2 N0–N1 M0
III T0–T3 N2 M0
T3 N1–N2 M0


T4 N0–N2 M0
T Any N3 M0
IVB T Any N Any M1