Oral cavity squamous cell cancer (SCC) TNM

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Clinical and Radiological TNM Classification of Malignant Tumours (8th Edition, UICC, 2017)

 

Primary Tumour (T)

Tx        Primary tumour cannot be assessed

T0        No evidence of primary tumour

Tis       Carcinoma in situ

T1        Tumour ≤2 cm and depth of invasion (DOI) ≤5mm*

T2        Tumour ≤2 cm and DOI >5 but ≤10mm; OR Tumour >2cm but ≤4cm and DOI ≤10mm

T3        Tumour >4cm; OR any tumour with DOI >10mm

T4a      (Lip) Tumour invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin (of the chin or the nose)

T4a      (Oral cavity) Tumour invades through the cortical bone of the mandible or maxillary sinus, or invades the skin of the face

T4b      (Lip and oral cavity) Tumour invades masticator space, pterygoid plates, or skull base, or encases internal carotid artery

 

Note:   * Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to classify a tumour as T4a.

 

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 of the Lip and Oral Cavity (8th Edition, UICC, 2017)

 

Primary Tumour (pT)

pTx      Primary tumour cannot be assessed

pT0      No evidence of primary tumour

pTis     Carcinoma in situ

pT1      Tumour ≤2 cm and  depth of invasion (DOI) ≤5mm*

pT2      Tumour ≤2 cm and DOI >5 but ≤10mm; OR Tumour >2cm but ≤4cm and DOI ≤10mm

pT3      Tumour >4cm; OR any tumour with DOI >10mm

pT4a    (Lip) Tumour invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin (of the chin or the nose)

pT4a    (Oral cavity) Tumour invades through the cortical bone of the mandible or maxillary sinus, or invades the skin of the face

pT4b    (Lip and oral cavity) Tumour invades masticator space, pterygoid plates, or skull base, or encases internal carotid artery

 

Note:   * Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to classify a tumour as T4a.

 

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

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

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

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

N3b      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+

Midline nodes are considered ipsilateral nodes.

 

 Distant Metastasis (M)

pM1     Distant metastasis