Hypopharyngeal squamous cell cancer (SCC) TNM

TNM Classification of Malignant Tumours (8^th Edition, UICC, 2017)

 

Primary Tumour (T)

 

T1        Tumour limited to one subsite of hypopharynx (left or right piriform sinuses, posterior hypopharyngeal wall, or post cricoid region) and/or

            Tumour ≤2cm in greatest dimension      

 

T2        Tumour extends into >1 adjacent subsite of hypopharynx or adjacent site (larynx, oropharynx) and/or

            Tumour >2cm and ≤4cm without fixation of hemilarynx

 

T3        Tumour >4cm or

            Clinical rixation of hemilarynx or

            Extension to oesophageal mucosa

 

T4a      Advanced local tumour with invasion into one or more of the following:

Thyroid cartilage, cricoid cartilage, hyoid bone, thyroid gland, oesophageal muscle, central compartment soft tissues (prelaryngeal strap muscles and subcutaneous fat)

 

T4b      Very advanced local tumour with invasion into one or more of the following:

            Mediastinal structures, Prevertebral fascia, encases carotid artery

 

Regional Lymph Nodes (N)

 

Nx        Regional lymph nodes cannot be assessed

N0        No regional lymph node metastasis

N1        Metastasis in a single ipsilateral lymph node, ≤3 cm and no extranodal extension (ENE)

N2a      Metastasis in a single ipsilateral lymph node, >3cm but ≤6cm, no ENE

N2b      Metastasis in multiple ipsilateral lymph nodes, all ≤6cm and no ENE

N2c      Metastasis in bilateral or contralateral lymph nodes, ≤6cm and no ENE

N3a      Metastasis in any lymph node >6cm with no ENE

N3b      Metastasis in any lymph node(s) with clinical ENE *

Notes:

* The presence of skin involvement or soft tissue invasion with deep fixation/tethering to underlying muscle or adjacent structures or clinical signs of nerve involvement is classified as clinical extranodal extension.

Midline nodes are considered ipsilateral nodes.

Distant Metastasis (M)

M0       No distant metastasis

M1       Distant metastasis

pTNM Pathological Classification of Malignant Tumours (8^th Edition, UICC, 2018)

 

Primary Tumour (T)

 

pT1      Tumour limited to one subsite of hypopharynx (left or right piriform sinuses, posterior hypopharyngeal wall, or post cricoid region) and/or

            Tumour ≤2cm in greatest dimension      

pT2      Tumour extends into >1 adjacent subsite of hypopharynx or adjacent site (larynx, oropharynx) and/or

            Tumour >2cm and ≤4cm without fixation of hemilarynx

pT3      Tumour >4cm or

            Clinical Fixation of hemilarynx or

            Extension to oesophageal mucosa

pT4a     Advanced local tumour with invasion into one or more of the following:

Thyroid cartilage, cricoid cartilage, hyoid bone, thyroid gland, oesophageal muscle, central compartment soft tissues (prelaryngeal strap muscles and subcutaneous fat)

pT4b     Very advanced local tumour with invasion into one or more of the following:

            Mediastinal structures, Prevertebral fascia, encases carotid artery

 

Pathological classification of Regional Lymph Nodes (pN)

Histological examination of a selective neck dissection specimen will ordinarily include 10 or more lymph nodes. Histological examination of a radical or modified radical neck dissection specimen will ordinarily include 15 or more lymph nodes.

pNx      Regional lymph nodes cannot be assessed

pN0      No regional lymph node metastasis

pN1      Metastasis in a single ipsilateral lymph node, ≤3cm, no ENE

pN2a    Metastasis in a single ipsilateral lymph node, ≤3cm With ENE+; OR single lymph node >3cm but ≤6cm and no ENE

pN2b    Metastasis in multiple ipsilateral lymph nodes, ≤6cm, no ENE

pN2c    Metastasis in bilateral or contralateral lymph nodes, ≤6cm, no ENE

pN3a    Metastasis in any lymph node >6cm, no ENE

pN3b    Metastasis in a single ipsilateral lymph node >3cm with ENE+; OR single contralateral node, any size with ENE+; OR multiple nodes, any size with ENE+

 

Note:    Midline nodes are considered ipsilateral nodes.

 

Distant Metastasis (M)

pM1      Distant metastasis