Quick Reference Guide to TNM Staging of Head and Neck Cancer and Neck Dissection Classification

*Note: A designation of “U” or “L” may be used for any N stage to indicate metastasis above the lower border of the cricoid cartilage (U) or below the lower border of the cricoid cartilage (L). PATHOLOGIC REGIONAL LYMPH NODE STAGING (pN), HPV-MEDIATED OROPHARYNGEAL CANCER pN0 No regional nodes metastasis

pN1* Metastasis in ≤ 4 cervical lymph nodes pN2* Metastasis in > 4 cervical lymph nodes

*Note: ENE is not included in the staging system for HPV-mediated Oropharyngeal Cancer. A designation of “U” or “L” may be used for any N stage to indicate metastasis above the lower border of the cricoid cartilage (U) or below the lower border of the cricoid cartilage (L).

DISTANT METASTASIS (M) MX

Distant metastasis cannot be assessed

M0

No distant metastasis Distant metastasis

M1

J. Group Staging for the Larynx, Oropharynx p16(-), Hypopharynx, Oral Cavity, Salivary Glands, Nonmelanoma skin and Paranasal Sinuses

Stage Grouping Stage 0

Tis T1 T2 T3 T1 T2 T3

N0 N0 N0 N0

M0 M0 M0 M0 M0 M0 M0 M0

Stage I Stage II Stage III

N1 N1 N1

Stage IVA

T4a

N0

24 TNM Staging of Head and Neck Cancer and Neck Dissection Classification