Nasopharyngeal carcinoma diagnostic study of choice

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

Overview

The staging of nasopharyngeal carcinoma is based on the TNM staging system.

Staging

American Joint Committee on Cancer (AJCC) Staging

The table below summarizes the TNM staging system for the diagnosis of nasopharyngeal carcinoma:

TNM	Description
TX	The primary tumor cannot be assessed
T0	No evidence of primary tumor, but EBV-positive cervical node(s) involvement
Tis	Carcinoma in situ
T1	Tumor confined to nasopharynx, or extension to oropharynx and/or nasal cavity without paraphartheyngeal involvement
T2	Tumor with extension to parapharyngeal space and/or infiltration of the medial pterygoid, lateral pterygoid, and/or prevertebral muscles
T3	Tumor invades bony structures of skull base cervical vertebra, pterygoid structures, and/or paranasal sinuses
T4	Tumor with intracranial extension and/or involvement of cranial nerves, hypopharynx, orbit, parotid gland and/or infiltration beyond the lateral surface of the lateral pterygoid muscle
Regional Lymph Nodes
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph nodes involved
N1	Unilateral metastasis, in cervical lymph node(s), and/or unilateral, or bilateral metastasis in retropharyngeal lymph nodes, 6 cm or less, above the caudal border of Cricoid cartilage
N2	Bilateral metastasis in cervical lymph node(s), 6 cm or less above the caudal border of Cricoid cartilage
N3	Metastasis in cervical lymph node(s) greater than 6 cm in dimension and/or extension below the caudal border of Cricoid cartilage
Distant Metastasis
M0	No distant metastasis
M1	Distant metastasis is present

Stage grouping
Stage	T	N	M
0	Tis	N0	M0
I	T1	N0	M0
II	T1	N0,N1	M0
	T2	N0,N1	M0
III	T0, T1, T2	N2	M0
	T3	N0, N1, N2	M0
IVA	T4	N0, N1, N2	M0
	Any T	N3	M0
IVB	Any T	Any N	M1