| 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 |
|---|---|
| T0 | No evidence of primary tumor |
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 and 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, ENE(-) |
| N2a | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-) |
| N2b | Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(-) |
| N2c | Metastases 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) with clinically overt ENE(+) (ENEc) |
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-) |
| N3b | Metastasis in any node(s) with clinically overt ENE(+) (ENEc) |
Clinical N (cN) classification applies to patients who are treated with primary nonsurgical treatment without a cervical lymph node dissection.
Midline nodes are considered ipsilateral nodes.
ENEc is defined as invasion of skin, infiltration of musculature, dense tethering or fixation to adjacent structures, or cranial nerve, brachial plexus, sympathetic trunk, or phrenic nerve invasion with dysfunction.
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 single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-); or metastases in multiple ipsilaterallymph 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 and ENE(-) |
| N2a | Metastasis in a single ipsilateral node 3 cm or less 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 | Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(-) |
| N2c | Metastases 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 size and ENE(+) in any node; or a single contralateral node of any size and ENE(+) |
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-) |
| N3b | Metastasis in a single ipsilateralnode larger than 3 cm in greatest dimension and ENE(+);or multiple ipsilateral, contralateral, or bilateral nodes any size and ENE(+)in any node; or a single contralateral node of any size and ENE(+) |
Pathological N (pN) classification applies to patients who are treated surgically with a cervical lymph node dissection.
Midline nodes are considered ipsilateral nodes.
ENE detected on histopathologic examination is designated as ENEmi (microscopic ENE less than or equal to 2 mm) or ENEma (major ENE greater than 2 mm). Both ENEmi and ENEma qualify as ENE(+) for definition of pN.
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 |