Oral Cavity Cancer Staging
The initial clinical evaluation, including physical examination and imaging, is used to determine the clinical staging. The AJCC Staging Manual, 7th Ed. defines four stages using the tumor/node/metastasis (TNM) system as described in the following tables:
| T (tumor) stage | Definition |
| 0 | No primary tumor |
| 1 | Tumor ≤ 2cm |
| 2 | Tumor >2 cm and ≤ 4cm |
| 3 | Tumor > 4cm |
| 4a | Tumor involves deep structures / cortical bone (specific to oral cavity subsite) e.g., mandible, skin, extrinsic tongue muscle |
| 4b | Tumor involves carotid artery, masticator space, skull base, or pterygoid plates |
| N (node) stage | Definition |
| 0 | No pathologic lymph nodes |
| 1 | Single ipsilateral cervical node ≤ 3cm |
| 2a | Single ipsilateral cervical node > 3cm and ≤ 6cm |
| 2b | Multiple ipsilateral nodes, ≤ 6cm |
| 2c | Bilateral or contralateral node, ≤ 6cm |
| 3 | Cervical node or conglomerate of matted nodes > 6cm |
| M (metastasis) stage | Definition |
| 0 | No distant metastasis |
| 1 | Distant metastasis |
|
N stage |
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| T stage | 0 | 1 | 2/3 |
| 1 | Stage I | Stage III | Stage IVa |
| 2 | Stage II | ||
| 3 | |||
| 4a | |||
The above table applies to T1-4a N0-3 M0 tumors.
Stage IVb: T4b, any N, M0
Stage IVc: any T, any N, M1
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