Oral Cancer and Complications of Cancer Therapies _ _____________________________________________
OVERVIEW OF TNM CLASSIFICATION OF ORAL CANCER
Classification
Assessment
Primary Tumor (T) TX
Primary tumor unassessable
T0
Primary tumor is not evident
Tis
Carcinoma in situ
T1, T2, T3
Size of primary tumor may range from less than 2 cm to greater than 4 cm
T4a (lip or oral cavity) T4b (lip and oral cavity) Regional Lymph Node (N) NX
Primary tumor has invaded deeper and/or surrounding tissue, including nerve, cartilage, muscle, skin, sinus, bone, and skull
Regional lymph node metastasis cannot be assessed
N0 N1
No metastasis to the regional lymph node(s)
Metastasis to only one lymph node 3 cm or less in greatest dimension
N2a
Metastasis of one ipsilateral lymph node greater than 3 cm but less than 6 cm
N2b
Metastasis to multiple ipsilateral lymph nodes less than 6 cm
N2c
Metastasis to bilateral lymph nodes less than 6 cm
N3
Lymph node metastasis is greater than 6 cm
Distant Metastasis (M) MX
Distant metastasis unassessable
M0 M1
Distant metastasis is not evident
Distant metastasis is evident
Source: [27; 28; 29]
Table 3
CANCER STAGING CRITERIA
Stage
General Description
Associated Classifications
0
Carcinoma in situ; lesion affects only the epithelial tissue
T0N0M0 TisN0M0 T1N0M0 T2N0M0 T1N1M0 T2N1M0 T3N0M0 T3N1M0
I
Tumor size is small; there is no metastasis to the regional lymph nodes or other organs Tumor size is larger; no metastasis to regional lymph nodes or other organs Any tumor concomitant with lymph node metastasis; there is no distant metastasis
II
III
IV(A, B, C)
Invasive tumor without metastasis to lymph nodes or other organs Any tumor concomitant with considerable lymph node metastasis Any tumor with any lymph node metastasis concomitant with distant metastasis
T(1–3)N2M0 T4aN(any)M0 T(any)N3M0 T4bN(any)M0 T(any)N(any)M1
Source: [28; 29; 30]
Table 4
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