Version May 2024
| Primary tumor (T) | |||
| T category | T criteria | ||
| TX | Primary tumor cannot be assessed | ||
| T0 | No evidence of primary tumor | ||
| Tis | Carcinoma in situ | ||
| T1 | Tumor 2 cm or smaller in greatest dimension without extraparenchymal extension* | ||
| T2 | Tumor larger than 2 cm but not larger than 4 cm in greatest dimension without extraparenchymal extension* | ||
| T3 | Tumor larger than 4 cm and/or tumor having extraparenchymal extension* | ||
| T4 | Moderately advanced or very advanced disease | ||
| T4a | Moderately advanced disease. Tumor invades skin, mandible, ear canal, and/or facial nerve. | ||
| T4b | Very advanced disease. Tumor invades skull base and/or pterygoid plates and/or encases carotid artery. | ||
| * Extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues. Microscopic evidence alone does not constitute extraparenchymal extension for classification purposes. | |||
| Regional lymph nodes (N) | |||
| Clinical N (cN) | |||
| N category | N criteria | ||
| NX | Regional lymph nodes cannot be assessed | ||
| N0 | No regional lymph node metastasis | ||
| N1 | Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(–) | ||
| N2 | Metastasis in a single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–); or Metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–); or In bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–) | ||
| N2a | Metastasis in 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 nodes, 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 Metastasis in any node(s) with clinically overt ENE(+) | ||
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–) | ||
| N3b | Metastases in any node(s) with clinically overt ENE(+) | ||
| NOTE: A designation of "U" or "L" may be used for any N category to indicate metastasis above the lower border of the cricoid (U) or below the lower border of the cricoid (L). Similarly, clinical and pathological ENE should be recorded as ENE(–) or ENE(+). | |||
| Distant metastasis (M) | |||
| M category | M criteria | ||
| M0 | No distant metastasis | ||
| M1 | Distant metastasis | ||
| Prognostic stage groups | |||
| When T is... | And N is... | And M is... | Then the stage group is... |
| Tis | N0 | M0 | 0 |
| T1 | N0 | M0 | I |
| T2 | N0 | M0 | II |
| T3 | N0 | M0 | III |
| T0, T1, T2, T3 | N1 | M0 | III |
| T4a | N0, N1 | M0 | IVA |
| T0, T1, T2, T3, T4a | N2 | M0 | IVA |
| Any T | N3 | M0 | IVB |
| T4b | Any N | M0 | IVB |
| Any T | Any N | M1 | IVC |
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