TNM Staging Guide 5th Edition eBook

HPV-Mediated Oropharyngeal Cancer PRIMARY TUMOR (T) TX Primary tumor cannot be assessed T0

No evidence of primary tumor but the cervical node is a p16(+) cancer

T1 T2 T3

Tumor 2 cm or less in greatest dimension

Tumor more than 2 cm but not more than 4 cm in greatest dimension Tumor more than 4 cm in greatest dimension or extension to lingual surface of epiglottis

T4 Moderately advanced local disease

Tumor invades the larynx, extrinsic muscle of tongue, medial ptery- goid, hard palate, or mandible or beyond 1 1 Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of the larynx. C. Larynx The larynx includes all laryngeal structures from the tip of the epiglottis to the cricoid cartilage inferiorly and is subdivided into three specific sites: supraglottis, glottis, and subglottis.

Sites of the Larynx Site

Subsite

Supraglottis

Suprahyoid epiglottis Infrahyoid epiglottis Aryepiglottic folds (laryngeal aspect) Arytenoids Ventricular bands (false vocal folds)

Glottis

True vocal folds, including anterior and posterior commissures; occupies a horizontal place 1 cm in thickness, extending inferiorly from the lateral margin of the ventricle Region extending from the lower boundary of the glottis to the lower margin of the cricoid cartilage

Subglottis

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