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Staging the cancer is a uniform way of documenting
how big the cancer is and how far it has spread. Both prognosis and
treatment options will very depending upon the stage of the cancer. The
TNM Staging System describes (T) the local tumor size, (N) the spread to
regional nodes, and (M) distant metastasis or distant spread via blood or lymphatics to
bone, liver, brain etc. Below is the system for staging the most common
kind of larynx cancer :
Glottic
Cancer
:
Click on colored text for
word definitions !!
Stage Tis : Carcinoma in situ: The
cancer has not spread beyond the basement
membrane of the epithelium.
 Stage
TI : Cancer confined to the
true vocal cords
Stage T1a: Cancer confined to one
vocal cord
Stage T1b: Cancer on both vocal cords
( See right-
hand picture of a T1b cancer )
Stage T2 : Cancer extends to the
supraglottis
or
subglottis
Stage T3 : Cancer fixes the
true vocal cords
or invades into the
post-cricoid
post-cricoid area or
pre-epiglottic space.
Stage T4 : Cancer extends outside the
larynx
by invading through
the
thyroid cartilage,
into the
esophagus
or into the soft
tissues of the neck.
Regional Lymph nodes :
Stage N0 : No lymph nodes are involved
with cancer
Stage N1 : Single lymph node 3 centimeters or less in greatest
diameter
on the same side as the
larynx
cancer.
Stage N2 : Single lymph node greater than 3 centimeters in greatest
diameter
OR multiple lymph nodes or lymph nodes on the opposite side.
AND all lymph nodes are less than 6 centimeters in greatest diameter.
Stage N2a: Single lymph node on the same side
Stage N2b: Multiple lymph nodes all on the same side.
Stage N2c: Lymph nodes on the opposite site.
Stage N3 : Any lymph node 6 centimeters or greater in
diameter.
Distant Metastasis :
Stage MX : Distant Metastasis not
evaluated.
Stage M0 : No Distant Metastasis.
Stage M1 : Distant Metastasis Present.
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Using The TNM System the
Cancer can be Grouped into Stages
Stage 0
Tis, N0, M0
Stage I
T1, N0, M0
Stage II
T2, N0, M0
Stage III
T3, N0, M0
T1, N1, M0
T2, N1, M0
T3, N1, M0
Stage IVA
T4, N0, M0
T4, N1, M0
Any T, N2, M0
Stage IVB
Any T, N3, M0
Stage IVC
Any T, Any N, M1
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