Version May 2024
| Primary tumor (T) | |||
| Maxillary sinus | |||
| T category | T criteria | ||
| TX | Primary tumor cannot be assessed | ||
| Tis | Carcinoma in situ | ||
| T1 | Tumor limited to maxillary sinus mucosa with no erosion or destruction of bone | ||
| T2 | Tumor causing bone erosion or destruction including extension into the hard palate and/or middle nasal meatus, except extension to posterior wall of maxillary sinus and pterygoid plates | ||
| T3 | Tumor invades any of the following: bone of the posterior wall of maxillary sinus, subcutaneous tissues, floor or medial wall of orbit, pterygoid fossa, ethmoid sinuses | ||
| T4 | Moderately advanced or very advanced local disease | ||
| T4a | Moderately advanced local disease. Tumor invades anterior orbital contents, skin of cheek, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid or frontal sinuses. | ||
| T4b | Very advanced local disease. Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal verve (V2), nasopharynx, or clivus. | ||
| Nasal cavity and ethmoid sinus | |||
| T category | T criteria | ||
| TX | Primary tumor cannot be assessed | ||
| Tis | Carcinoma in situ | ||
| T1 | Tumor restricted to any one subsite, with or without bony invasion | ||
| T2 | Tumor invading two subsites in a single region or extending to involve an adjacent region within the nasoethmoidal complex, with or without bony invasion | ||
| T3 | Tumor extends to invade the medial wall or floor of the orbit, maxillary sinus, palate, or cribriform plate | ||
| T4 | Moderately advanced or very advanced local disease | ||
| T4a | Moderately advanced local disease. Tumor invades any of the following: anterior orbital contents, skin of nose or cheek, minimal extension to anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses. | ||
| T4b | Very advanced local disease. Tumor invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than (V2), nasopharynx, or clivus. | ||
| 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 | Metastasis in any node(s) with clinically overt ENE (ENEc) | ||
| 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(+). | |||
| Pathological N (pN) | |||
| 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 lymph node, 3 cm or smaller in greatest dimension and ENE(+); or 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 node(s), none larger than 6 cm in greatest dimension and ENE(–) | ||
| N2a | Metastasis in single ipsilateral node 3 cm or less 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(+) | ||
| 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 (no pathologic M0; use clinical M to complete stage group) | ||
| 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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