Oral cancer classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Classification

The process used to find out if cancer has spread within the oral cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose oral cavity cancer are also used to stage the disease.

• The following stages are used for lip and oral cavity cancer:
  • Stage 0 (Carcinoma in Situ)
  • Stage I
  • Stage II
  • Stage III
  • Stage IV

Name	Description
Stage 0	In stage 0, abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I	In stage I, cancer has formed and the tumor is 2 centimeters or smaller. Cancer has not spread to the lymph nodes.
Stage II	In stage II, the tumor is larger than 2 centimeters but not larger than 4 centimeters, and cancer has not spread to the lymph nodes.
Stage III	In stage III, the tumor: may be any size and has spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the tumor; or is larger than 4 centimeters.
Stage IV	Stage IV is divided into stages IVA, IVB, and IVC.
Stage IVA	In stage IVA, the tumor: has spread through tissue in the lip or oral cavity into nearby tissue and/or bone (jaw, tongue, floor of mouth, maxillary sinus, or skin on the chin or nose);cancer may have spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the tumor; or is any size or has spread through tissue in the lip or oral cavity into nearby tissue and/or bone (jaw, tongue, floor of mouth, maxillary sinus, or skin on the chin or nose), and cancer has spread: to one lymph node on the same side of the neck as the tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters; or to more than one lymph node on the same side of the neck as the tumor and the lymph nodes are not larger than 6 centimeters; or to lymph nodes on the opposite side of the neck as the tumor or on both sides of the neck, and the lymph nodes are not larger than 6 centimeters.
Stage IVB	In stage IVB, the tumor: may be any size and has spread to one or more lymph nodes that are larger than 6 centimeters; or has spread further into the muscles or bones in the oral cavity, or to the base of the skull and/or the carotid artery. Cancer may have spread to one or more lymph nodes anywhere in the neck.
Stage IVC	In stage IVC, the tumor has spread beyond the lip or oral cavity to distant parts of the body, such as the lungs. The tumor may be any size and may have spread to the lymph nodes.