Version May 2024
| Primary tumor (T) | |||
| T category | T criteria | ||
| TX | Primary tumor cannot be assessed | ||
| Tis | Carcinoma in situ | ||
| T1 | Tumor limited to one subsite of hypopharynx and/or 2 cm or smaller in greatest dimension | ||
| T2 | Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures larger than 2 cm but not larger than 4 cm in greatest dimension without fixation of hemilarynx | ||
| T3 | Tumor larger than 4 cm in greatest dimension or with fixation of hemilarynx or extension to esophageal mucosa | ||
| T4 | Moderately advanced and very advanced local disease | ||
| T4a | Moderately advanced local disease. Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, esophageal muscle, or central compartment soft tissue.* | ||
| T4b | Very advanced local disease. Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures. | ||
| * Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat. | |||
| 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) and clinically overt ENE(+) | ||
| N3a | Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–) | ||
| N3b | Metastasis in any node(s) and 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 |
| T1, T2, T3 | N1 | M0 | III |
| T4a | N0, N1 | M0 | IVA |
| 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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