Squamous cell carcinoma of the skin classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Raviteja Guddeti, M.B.B.S. [3]

Classification

Category	Criteria
T - Primary tumor
TX	Primary tumor cannot be assessed
Tis	Carcinoma in situ
T1	Tumor ≤ to 2 cm
T2	Tumor > 2 cm, and ≤ to 4 cm
T3	Tumor > 4 cm or minor bone erosion or perineural invasion or deep invasion
T4	Tumor with gross cortical bone/marrow, skull base invasion and/or skull base foramen invasion
T4a	Tumor with gross cortical bone/marrow invasion
T4b	Tumor with skull base invasion and/or skull base foramen involvement -	5	5
N - Regional lymph nodes
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single ipsilateral lymph node, tumor size ≤ 3 cm, and no extranodal extension
N2	* Metastasis in a single ipsilateral lymph node, tumor size ≤ 3 cm, and presence of extranodal extension; or Tumor size > 3 cm but ≤ 6 cm without extranodal extension; or Metastases in multiple ipsilateral lymph nodes, tumor size ≤ 6 cm without extranodal extension; or In bilateral or contralateral lymph node(s), tumor size ≤ 6 cm without extranodal extension
N2a	Metastasis in a single ipsilateral lymph node 3 cm or smaller in greatest dimension and ENE(+); or A single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–)
N2b	Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(–)
N2c	Metastases in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(–)
N3	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–); or In a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or Multiple ipsilateral, contralateral, or bilateral nodes, any with ENE(+); or A single contralateral node of any size and ENE(+)
N3a	Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–)
N3b	Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or Multiple ipsilateral, contralateral, or bilateral nodes, any with ENE(+); or A single contralateral node of any size and ENE(+)
M - Distant metastasis
MX	Distant metastasis cannot be assessed
M0	No distant metastasis
M1	Distant metastasis
M1a	Metastasis to one organ/site without peritoneal metastasis
M1b	Metastasis to two or more organs/sites without peritoneal metastasis
M1c	Metastasis to the peritoneal surface and/or metastasis to other organs/sites

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