Head and Neck Tumours

TNM 7 Classification

The following sites are included:

• Lip, Oral cavity
• Pharynx: Oropharynx, Nasopharynx, Hypopharynx
• Larynx
• Nasal Cavity and paranasal sinus
• Salivary glands
• Malignant Melanoma of Upper Aerodigestive Tract
• Thyroid gland

TNM 6 Classification

Abstract

The following sites are included:

• Lip, Oral cavity
• Pharynx: Oropharynx, Nasopharynx, Hypopharynx
• Larynx
• Nasal Cavity and paranasal sinus
• Salivary glands
• Thyroid gland

Carcinomas arising in minor salivary glands of the upper aerodigestive tract are classified according to the rules for tumours of their anatomic site of origin, e.g., oral cavity.

Each site is described under the following headings:

• Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment
• Anatomical sites and subsites where appropriate
• Definition of the regional lymph nodes
• TNM Clinical classification
• pTNM Pathological classification
• G Histopathological grading
• Stage grouping
• Summary

1. Introductory Notes

The following sites are included:

• Lip, Oral cavity
• Pharynx: Oropharynx, Nasopharynx, Hypopharynx
• Larynx
• Maxillary sinus
• Nasal Cavity and Ethmoid sinus
• Salivary glands
• Thyroid gland

Carcinomas arising in minor salivary glands of the upper aerodigestive tract are classified according to the rules for tumours of their anatomic site of origin, e.g., oral cavity.

Each site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

• Anatomical sites and subsites where appropriate
• Definition of the regional lymph nodes
• TNM Clinical classification
• pTNM Pathological classification
• G Histopathological grading
• Stage grouping
• Summary

2. Regional Lymph Nodes

The definitions of the N categories for all head and neck sites except nasopharynx and thyroid are the same. Midline nodes are considered ipsilateral nodes except in the thyroid.

3. Distant Metastasis

The definitions of the M categories for all head and neck sites are the same.
The categories M1 and pM1 may be further specified according to the following notation:

Pulmonary PUL Bone marrow MAR Osseous OSS Pleura PLE Hepatic HEP Peritoneum PER Brain BRA Adrenals ADR Lymph nodes LYM Skin SKI Others OTH

4. Histopathological Grading

The definitions of the G categories apply to all head and neck sites except thyroid. These are:

G - Histopathological Grading

GX. Grade of differentiation cannot be assessed
G1. Well differentiated
G2. Moderately differentiated
G3. Poorly differentiated
G4. Undifferentiated

5. TNM Clinical Classification

The following general definitions are used throughout:

5.1. T - Primary Tumour

TX. Primary tumour cannot be assessed
T0. No evidence of primary tumour
Tis. Carcinoma in situ
T1, T2, T3, T4. Increasing size and/or local extent of the primary tumour

5.2. N - Regional Lymph Nodes

NX. Regional lymph nodes cannot be assessed
N0. No regional lymph node metastasis
N1, N2, N3. Increasing involvement of regional lymph nodes

TNM 7 classification