Oral cancer classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Oral cancer can be classified into several subtypes such as squamous cell carcinoma, verrucous carcinoma, minor salivary gland carcinoma, lymphomas, benign oral cancer and oropharyngeal tumors, leukoplakia, and erythroplakia.

Classification

Oral cancer can be classified into several subtypes:

  • Squamous cell carcinoma

Squamous cell carcinoma account for more than 90% of cancers that occur in the oral cavity and oropharynx.

  • Verrucous carcinoma
  • Minor salivary gland carcinomas
    • Adenoid cystic carcinoma
    • Mucoepidermoid carcinoma
    • Polymorphous low-grade adenocarcinoma.
  • Lymphomas
    • Oral cancers that develop in lymph tissue, are known as lymphomas.
      • Hodgkin lymphoma
      • Non-Hodgkin lymphoma
  • Benign oral cavity and oropharyngeal tumors

Several types of non-cancerous tumors and tumor-like conditions can arise in the oral cavity and oropharynx.

  • Leukoplakia and erythroplakia

A premalignant (or precancerous) lesion is defined as "a benign, morphologically altered tissue that has a greater than normal risk of malignant transformation." There are several different types of premalignant lesion that occur in the mouth. Some oral cancers begin as white patches (leukoplakia), red patches (erythroplakia) or mixed red and white patches (erythroleukoplakia or "speckled leukoplakia").





The process used to find out if cancer has spread within the oral cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose oral cavity cancer are also used to stage the disease.

  • The following stages are used for lip and oral cavity cancer:
    • Stage 0 (Carcinoma in Situ)
    • Stage I
    • Stage II
    • Stage III
    • Stage IV
Name Description
Stage 0 In stage 0, abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I In stage I, cancer has formed and the tumor is 2 centimeters or smaller. Cancer has not spread to the lymph nodes.
Stage II In stage II, the tumor is larger than 2 centimeters but not larger than 4 centimeters, and cancer has not spread to the lymph nodes.
Stage III In stage III, the tumor:

may be any size and has spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the tumor; or is larger than 4 centimeters.

Stage IV Stage IV is divided into stages IVA, IVB, and IVC.
Stage IVA In stage IVA, the tumor:
  • has spread through tissue in the lip or oral cavity into nearby tissue and/or bone (jaw, tongue, floor of mouth, maxillary sinus, or skin on the chin or nose);cancer may have spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the tumor; or
  • is any size or has spread through tissue in the lip or oral cavity into nearby tissue and/or bone (jaw, tongue, floor of mouth, maxillary sinus, or skin on the chin or nose), and cancer has spread:
    • to one lymph node on the same side of the neck as the tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters; or
    • to more than one lymph node on the same side of the neck as the tumor and the lymph nodes are not larger than 6 centimeters; or
    • to lymph nodes on the opposite side of the neck as the tumor or on both sides of the neck, and the lymph nodes are not larger than 6 centimeters.
Stage IVB In stage IVB, the tumor:
  • may be any size and has spread to one or more lymph nodes that are larger than 6 centimeters; or
  • has spread further into the muscles or bones in the oral cavity, or to the base of the skull and/or the carotid artery. Cancer may have spread to one or more lymph nodes anywhere in the neck.
Stage IVC In stage IVC, the tumor has spread beyond the lip or oral cavity to distant parts of the body, such as the lungs. The tumor may be any size and may have spread to the lymph nodes.

References

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