The stages of laryngeal and hypopharyngeal cancers are used to describe how far the cancer has spread in your body. The higher the stage number, the more widespread the cancer is. These stages are important when choosing the best treatments for you.
In the TNM system, three different codes are used to describe the size and location of the tumor, whether it has spread to the lymph nodes around the tumor, and whether it has spread (metastasized) to other parts of the body.
“T” plus a letter or number (0 to 4) is used to describe the size and location of the tumor. The tumor stages for laryngeal and hypopharyngeal cancers are based on where the tumor starts:
TX - The primary, or original, tumor cannot be evaluated because of incomplete information.
T0 - There is no evidence of a primary tumor.
Tis (carcinoma in situ) - The cancer is found only in the layer of cells that line the larynx or oropharynx.
T1 -
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Supraglottis - The tumor is located in only one of the five parts (subsites) of the glottis and the vocal cords move normally
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Glottis - The tumor is located only in the vocal cords, which move normally.
- T1a: The tumor is located on only one vocal cord.
- T1b: The tumor is located on both vocal cords.
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Subglottis - The tumor is located only in the subglottis.
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Hypopharynx - The tumor is located in only one of the three sections (subsites) of the hypopharynx. It is smaller than 2 centimeters (about ¾ inch).
T2 -
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Supraglottis - The tumor is located in more than one of the five subsites of the glottis and the vocal cords move normally.
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Glottis - The tumor has spread into the supraglottis or subglottis and the vocal cords move only a little.
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Subglottis - The tumor has spread to the vocal cords. The vocal cords move normally or they move less than normal.
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Hypopharynx - The tumor is located in more than one of the three subsites of the hypopharynx or a site next to the hypopharynx. Its diameter is between 2 centimeters and 4 centimeters and the vocal cords move normally.
T3 -
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Supraglottis - The tumor is located only in the larynx and the vocal cords do not move. The tumor might also have spread into tissues that surround the larynx.
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Glottis - The tumor is located only in the larynx and at least one vocal cord does not move.
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Subglottis - The tumor is located only in the larynx and the vocal cords do not move.
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Hypopharynx - The tumor is larger than 4 centimeters or it has spread to the vocal cords.
T4 -
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Supraglottis -
- T4a: The tumor has invaded the thyroid cartilage (firm tissue that separates the thyroid, a gland in the front of the neck, from the front of the larynx). It might also have spread outside the larynx.
- T4b: The tumor has invaded the chest and surrounded a carotid artery, which carries blood from the heart to the brain.
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Glottis -
- T4a: The tumor has invaded the thyroid cartilage, and it might have invaded tissues outside of the larynx.
- T4b: The tumor has invaded the chest and surrounded a carotid artery.
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Subglottis -
- T4a: The tumor has invaded the thyroid cartilage, tissues outside the larynx, or both.
- T4b: The tumor has invaded the chest and surrounded a carotid artery.
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Hypopharynx -
- T4a: The tumor has invaded structures next to the hypopharynx, such as the thyroid, carotid arteries, or esophagus (a tube that connects the throat to the stomach).
- T4b: The tumor has invaded nearby soft tissue, connective tissue, or blood vessels; the thyroid; or the esophagus.
The "N" in the TNM system stands for node. Lymph nodes are tiny organs shaped like beans that are located throughout the body. Lymph nodes help the body fight infections. Regional lymph nodes are near the mouth and throat, while distant lymph nodes are in other parts of the body. Lymph node stages are:
NX - The regional lymph nodes cannot be evaluated because of incomplete information.
N0 - The cancer has not spread into the lymph nodes.
N1 - The cancer has spread to one lymph node on the same side of the head or neck as the primary tumor. The lymph node is 3 centimeters (about 1¼ inch) or smaller.
N2a - The cancer has spread to one lymph node that is larger than 3 centimeters but smaller than 6 centimeters (about 2½ inches) and is on the same side of the neck as the primary tumor.
N2b - The cancer has spread to at least two lymph nodes that are smaller than 6 centimeters (about 2½ inches). These lymph nodes are on the same side of the neck as the primary tumor.
N2c - The cancer has spread to one or more lymph nodes that are smaller than 6 centimeters and are on the opposite side or both sides of the neck as the primary tumor.
N3 - The cancer has spread to at least one lymph node that is larger than 6 centimeters.
The "M" in the TNM system is used for cancer that has metastasized to other parts of the body. The stages for laryngeal and hypopharyngeal cancer metastasis are:
MX - Distant metastasis cannot be evaluated because of incomplete information.
M0 - The cancer has not metastasized to other parts of the body.
M1 - The cancer has metastasized to distant parts of the body outside the neck.
Cancer Stages 0 through IV
After the T, N, and M categories of your cancer have been identified, your doctor will combine this information to assign a stage (0 to IV) to your cancer. The higher the number, the more serious (advanced) the cancer is.
Stage 0 (carcinoma in situ) - This very early-stage cancer (sometimes referred to as a precancer) is found only in the epithelium (thin lining) of the larynx or hypopharynx (Tis, N0, M0).
Stage I - The tumor is small and has not spread to the lymph nodes or distant parts of the body (T1, N0, M0).
Stage II - The tumor has spread into surrounding structures but not to the lymph nodes or distant parts of the body (T2, N0, M0).
Stage III - The tumor is larger than 4 centimeters and has not spread to the regional lymph nodes, or it is smaller than 4 centimeters and has spread to at least one lymph node on the same side of the neck as the primary cancer (T3, N0, M0; or T1-T3, N1, M0).
Stage IVA - The tumor has spread into the neck, trachea, thyroid, or esophagus but not to any lymph nodes, or it has spread to one or more lymph nodes that are smaller than 6 centimeters and are on the same side of the head or neck as the primary tumor. Stage IVA tumors can also be any size and spread to one large lymph node (between 3 centimeters and 6 centimeters) or to several lymph nodes (smaller than 6 centimeters) on the same side of the neck as the primary tumor (T4a, N0-N2, M0; or T1-T3, N2, M0).
Stage IVB - The tumor is any size and has spread to at least one lymph node that is larger than 6 centimeters or has spread into the neck, trachea, thyroid, or esophagus and might or might not have spread to the lymph nodes (any T, N3, M0; or T4b, any N, M0).
Stage IVC - The tumor is any size and has spread to distant parts of the body. It might have spread to one or more lymph nodes (any T, any N, M1).
Recurrent - The cancer has come back (recurred) after it has been treated.
This content was last modified on
November 12, 2007
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