Stage | Tumor (Maximum Penetration)* | Regional Lymph Node Metastasis† | Distant Metastasis‡ |
---|---|---|---|
I | T1 | N0 | M0 |
II | T2 | N0 | M0 |
III | T3 or | N0 | M0 |
T1–3 | N1 | M0 | |
IVA | T1–3 | N2 | M0 |
T4a | N0–2 | M0 | |
IVB | T4b | Any N | M0 |
Any T | N3 | M0 | |
IVC | Any T | Any N | M1 |
* Definition of Primary Tumor (T) | |||
T1 | Tumor ≤ 2 cm with DOI (depth of invasion, not tumor thickness) ≤ 5 mm | ||
T2 | Tumor ≤ 2 cm with DOI > 5 mm OR tumor > 2 cm and ≤ 4 cm with DOI ≤ 10 mm | ||
T3 | Tumor > 2 cm and ≤4 cm with DOI > 10 mm OR tumor > 4 cm with DOI ≤ 10 mm | ||
T4a | Moderately advanced local disease Lip: Tumor invades through cortical bone or involves the inferior alveolar nerve, floor of mouth, or skin of face (eg, chin or nose) Oral cavity: Tumor > 4 cm with DOI > 10 mm OR tumor invades adjacent structures only (eg, through cortical bone of the mandible or maxilla, or involves the maxillary sinus or skin of the face) Note: Superficial erosion of bone/tooth socket (alone) by a gingival primary is not sufficient to classify a tumor as T4. | ||
T4b | Very advanced local disease Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery | ||
† Definition of Regional Lymph Node (N) | |||
N1 | Metastasis in a single ipsilateral node ≤ 3 cm and no extranodal extension | ||
N2 | Metastasis in single ipsilateral node > 3 cm but ≤ 6 cm and no extranodal extension; OR in multiple ipsilateral nodes ≤ 6 cm and no extranodal extension; OR in bilateral or contralateral nodes ≤ 6 cm and no extranodal extension | ||
N3 | Metastasis in a node > 6 cm and no extranodal extension; OR in any nodes and extranodal extension | ||
‡ Definition of Distant Metastasis (M) | |||
M0 | No distant metastasis | ||
M1 | Distant metastasis | ||
Data from Amin MB, Edge S, Greene F, Byrd DR, et al: American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 8th edition. New York, Springer, 2017; AJCC Cancer Staging Form Supplement, 2018. For a comparison of the 7th and 8th edition, see Cramer JD, Reddy A, Ferris RL, et al: Comparison of the seventh and eighth edition American Joint Committee on Cancer oral cavity staging systems. Laryngoscope, 128(10):2351-2360, 2018. doi: 10.1002/lary.27205 |