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TNM and Stage Groupings > Larynx
Larynx
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| Tis |
Carcinoma in situ |
Primary Tumor (T) - Supraglottis
| T Category |
Stage Category Definitions |
| T1 |
Tumor limited to one subsite of supraglottis with normal vocal cord mobility |
| T2 |
Tumor invades mucosa of more than one adjacent subsite of supraglottis or
glottis or region outside the supraglottis (e.g., mucosa of base of tongue,
vallecula, medial wall of pyriform sinus) without fixation of the larynx |
| T3 |
Tumor limited to larynx with vocal cord fixation and/or invades any of the
following: postcricoid area, pre-epiglottic space, paraglottic space, and/or
inner cortex of thyroid cartilage. |
| T4a |
Moderately advanced local disease.
Tumor invades through the thyroid cartilage and/or invades tissues beyond
the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle
of the tongue, strap muscles, thyroid, or esophagus) |
| T4b |
Very advanced local disease.
Tumor invades prevertebral space, encases carotid artery, or invades
mediastinal structures |
Primary Tumor (T) - Glottis
| T Category |
Stage Category Definitions |
| T1 |
Tumor limited to the vocal cord(s) (may involve anterior or posterior
commissure) with normal mobility |
| T1a |
Tumor limited to one vocal cord |
| T1b |
Tumor involves both vocal cords |
| T2 |
Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord
mobility |
| T3 |
Tumor limited to the larynx with vocal cord fixation and/or invasion of paraglottic
space, and/or inner cortex of the thyroid cartilage |
| T4a |
Moderately advanced local disease.
Tumor invades through the outer cortex of the thyroid cartilage and/or
invades tissues beyond the larynx (e.g., trachea, soft tissues of neck
including deep extrinsic muscle of the tongue, strap muscles, thyroid, or
esophagus) |
| T4b |
Very advanced local disease.
Tumor invades prevertebral space, encases carotid artery, or invades
mediastinal structures |
Primary Tumor (T) - Subglottis
| T Category |
Stage Category Definitions |
| T1 |
Tumor limited to the subglottis |
| T2 |
Tumor extends to vocal cord(s) with normal or impaired mobility |
| T3 |
Tumor limited to larynx with vocal cord fixation |
| T4a |
Moderately advanced local disease.
Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond the
larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscles of
the tongue, strap muscles, thyroid, or esophagus) |
| T4b |
Very advanced local disease.
Tumor invades prevertebral space, encases carotid artery, or invades
mediastinal structures |
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph nodes cannot be assessed |
| N0 |
No regional lymph node metastasis |
| N1 |
Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension |
| N2 |
Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than
6 cm in greatest dimension, or in multiple ipsilateral lymph nodes, none more
than 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes,
none more than 6 cm in greatest dimension |
| N2a |
Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than
6 cm in greatest dimension |
| N2b |
Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest
dimension |
| N2c |
Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in
greatest dimension |
| N3 |
Metastasis in a lymph node, more than 6 cm in greatest dimension |
*Note: Metastases at level VII are considered regional lymph node metastases.
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Distant metastasis |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
| 0 |
Tis |
N0 |
M0 |
| I |
T1 |
N0 |
M0 |
| II |
T2 |
N0 |
M0 |
| III |
T3 |
N0 |
M0 |
| III |
T1 |
N1 |
M0 |
| III |
T2 |
N1 |
M0 |
| III |
T3 |
N1 |
M0 |
| IVA |
T4a |
N0 |
M0 |
| IVA |
T4a |
N1 |
M0 |
| IVA |
T1 |
N2 |
M0 |
| IVA |
T2 |
N2 |
M0 |
| IVA |
T3 |
N2 |
M0 |
| IVA |
T4a |
N2 |
M0 |
| IVB |
T4b |
Any N |
M0 |
| IVB |
Any T |
N3 |
M0 |
| IVC |
Any T |
Any N |
M1 |
