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

IVA

 

T4

N0–N2

M0

T Any

N3

M0

IVB

T Any

N Any

M1