Oral cancer staging
Oral cancer Microchapters
Oral cancer staging On the Web
American Roentgen Ray Society Images of Oral cancer staging
- The staging systems are all clinical and based on the best possible estimate of the extent of disease before treatment.
- Information from diagnostic imaging studies may be used in staging.
- Magnetic resonance imaging offers an advantage over computed tomographic scans in the detection and localization of head and neck tumors and in the distinction of lymph nodes from blood vessels.
- If a patient relapses, complete re-staging must be done to select the appropriate additional therapy.
- The stage of the disease depends on several factors:
- The tumor-node metastasis (TNM) classification of oral cancer is the most widely accepted system.
- This system has 3 basic clinical features:
T Categories for oral cavity cancers
- These measurements refer to the primary oral cancer tumor.
|TX||Primary tumor cannot be assessed|
|T0||No evidence of primary tumor|
|T1||Tumor ≤ 2 cm in greatest dimension|
|T2||Tumor > 2 cm but ≤ 4 cm in greatest dimension|
|T3||Tumor > 4 cm in greatest dimension|
|T4a||Moderately advanced local disease
(Oral cavity) Tumor invades adjacent structures only (e.g., through cortical bone [[[mandible]] or maxilla] into deep [extrinsic] muscle of tongue [[[genioglossus]], hyoglossus, palatoglossus, and styloglossus], maxillary sinus, or skin of face).
|T4b||Very advanced local disease|
N Categories for oral cavity cancers
|N Classification||Nodal Mass|
|NX||Regional lymph 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 ≤ 6 cm in greatest dimension|
|N2a||Metastasis in single ipsilateral lymph node, > 3 cm but ≤ 6 cm in greatest dimension|
|N2b||Metastases in multiple ipsilateral lymph nodes, none > 6 cm in greatest dimension|
|N2c||Metastases in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension|
|N3||Metastasis in a lymph node > 6 cm in greatest dimension.|
M Categories for Oral Cavity
|M0||No evidence of distant metastasis|
Stages of Oral cancer
Tumor grades of oral cancer
- Most head and neck cancers are of the squamous cell variety and may be preceded by various precancerous lesions.
- Minor salivary gland tumors are not uncommon in these sites.
- Specimens removed from the lesions may show the carcinomas to be non-invasive, in which case the term carcinoma in-situ is applied.
- An invasive carcinoma will be well-differentiated, moderately well-differentiated, poorly differentiated or undifferentiated.
Tumor grading is recommended using Broder classification (Tumor Grade [G]):
|Grade of Tumor(G)||Definition|