| Primary Tumor (T) | |
| Regional Lymph Nodes (N) | |
| Distant Metastasis (M) | |
This view displays the TNM formula. Please select appropriate value from the list for T/N/M variables. The result will be displayed, based on your selection of variables.
Definition of Primary Tumor (T)
| T Category | T Criteria |
|---|---|
| TX | Primary tumor cannot be assessed |
| Tis | Carcinoma in situ |
| T1 | Tumor less than or equal to 2 cm, less than or equal to 5 mm depth of invasion (DOI) DOI is depth of invasion and not tumor thickness. |
| T2 | Tumor less than or equal to 2 cm, DOI greater than 5 mm and less than or equal to 10 mm or tumor greater than 2 cm but less than or equal to 4 cm, and less than or equal to 10 mm DOI |
| T3 | Tumor greater than 4 cm or any tumor greater than 10 mm DOI |
| T4 | Moderately advanced or very advanced local disease |
| T4a | Moderately advanced local disease (lip) Tumor invades through cortical bone or involves the inferior alveolar nerve, floor of mouth, or skin of face (i.e., chin or nose) (oral cavity) Tumor invades adjacent structures only (e.g., through cortical bone of the mand ible or maxilla, or involves the maxillary sinus or skin of the face) Note: Superficial erosion of bone/tooth socket (alone) by a gingival primary is not sufficient to classify a tumor as T4. |
| T4b | Very advanced local disease Tumor invades masticator space, pterygoid plates, or skull base and /or encases the internal carotid artery |
Definition of Regional Lymph Node (N)
Clinical N (cN)| N Category | N Criteria |
|---|---|
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastasis |
| N1 | Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension ENE(-) |
| N2 | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(-); or in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension, and ENE(-) |
| N2a | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension, and ENE(-) |
| N2b | Metastasis in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension, and ENE(-) |
| N2c | Metastasis in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension, and ENE(-) |
| N3 | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-); or metastasis in any node(s) and clinically overt ENE(+) |
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-) |
| N3b | Metastasis in any node(s) and clinically overt ENE(+) |
A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(-) or ENE(+).
| N Category | N Criteria |
|---|---|
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastasis |
| N1 | Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(-) |
| N2 | Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(-); or in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension, ENE(-) |
| N2a | Metastasis in single ipsilateral node 3 cm or smaller in greatest dimension and ENE(+); or a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-) |
| N2b | Metastasis in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(-) |
| N2c | Metastasis in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(-) |
| N3 | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-); or metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or multiple ipsilateral, contralateral or bilateral nodes any with ENE(+); or asingle contralateral node 3 cm or smaller and ENE (+) |
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-) |
| N3b | Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or multiple ipsilateral, contralateral or bilateral nodes any with ENE(+); or asingle contralateral node 3 cm or smaller and ENE (+) |
A designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(-) or ENE(+).
Definition of Distant Metastasis (M)
| M Category | M Criteria |
|---|---|
| M0 | No distant metastasis |
| M1 | Distant metastasis |