Larynx Cancer Staging


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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
thyroid cartilage, into the
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.

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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