Table 1 Classification criteria and stage groups by different systems for nasopharyngeal carcinoma

From: Comparison of TNM staging systems for nasopharyngeal carcinoma, and proposal of a new staging system

The 6th edition of UICC/AJCC

The 7th edition of UICC/AJCC

The Chinese 2008 staging system

The proposed staging system

T-classification

T1: nasopharynx

T1: nasopharynx, oropharynx or nasal cavity

T1: nasopharynx

T1: nasopharynx

T2a: oropharynx and/or nasal cavity

T2b: parapharyneal extension

T2: parapharyneal extension

T2: oropharynx, nasal cavity, parapharyneal extension

T2: oropharynx, nasal cavity, parapharyneal extension, medial and lateral pterygoid muscles

T3: bony structures and/or paranasal sinuses

T3: bony structures and/or paranasal sinuses

T3: skull base, medial pterygoid muscle extension

T3: bony structures and/or paranasal sinuses

T4: intracranial extension and/or cranial nerves, infratemporal fossa hypopharynx, orbit or masticatory spacea

T4: intracranial extension and/or cranial nerves, hypopharynx, orbit or infratemporal fossa/masticatory spaceb

T4: cranial nerves, paranasal sinuses, masticatory space excluding medial pterygoid muscle, intracranial (cavernous sinus, dural meninges) extension

T4: intracranial extension and/or cranial nerves, infratemporal fossa hypopharynx, orbit or masticatory space excluding medial and lateral pterygoid muscles

N-classification

N0: none

N0: none

N0: none

N0: none

N1: unilateral node(s), ⩽6 cm in greatest dimension, above the supraclavicular fossa

N1: unilateral cervical and/or unilateral or bilateral retropharyngeal node(s), ⩽6 cm in greatest dimension, above the supraclavicular fossa

N1a: retropharyngeal node(s)

N1b: unilateral level Ib, II, III and Va involvement, and the maximum diameter ⩽3 cm

N1: unilateral or bilateral retropharyngeal node(s), unilateral level Ib, II, III, and Va involvement, and the maximum diameter ⩽3 cm

N2: bilateral node(s), ⩽6 cm in greatest dimension, above the supraclavicular fossa

N2: bilateral cervical node(s), ⩽6 cm in greatest dimension, above the supraclavicular fossa

N2: bilateral level Ib, II, III and Va involvement, or the maximum diameter >3 cm, or with extranodal neoplastic spread

N2: bilateral level Ib, II, III and Va involvement, or the maximum diameter >3 cm, or with extranodal neoplastic spread

N3a: >6 cm

N3b: in supraclavicular fossa

N3a: >6 cm

N3b: in supraclavicular fossa

N3: level IV and Vb involvement

N3: level IV and Vb involvement

Stage group

I: T1 N0 M0

I: T1 N0 M0

I: T1 N0 M0

I: T1 N0 M0

IIa: T2a N0 M0

IIb: T1-2a N1 M0, T2b N0-1 M0

II: T1 N1 M0, T2 N0-1 M0

II: T1 N1a-1b M0, T2 N0-1b M0

II: T1 N1 M0, T2 N0-1 M0

III: T1-2b N2 M0, T3 N0-2 M0

III: T1-2 N2 M0, T3 N0-2 M0

III: T1-2 N2 M0, T3 N0-2 M0

III: T1-2 N2 M0, T3 N0-2 M0

IVa: T4 N0-2 M0

IVb: any T N3 M0

IVc: any T, any N M1

IVa: T4 N0-2 M0

IVb: any T N3 M0

IVc: any T, any N M1

IVa: T1-3N3M0, T4 N0-3 M0

IVb: any T, any N M1

IVa: T1-3N3M0, T4 N0-3 M0

IVb: any T, any N M1

  1. Abbreviations: AJCC=American Joint Committee for Cancer; UICC=International Union against Cancer.
  2. aMasticator space involvement denotes extension of tumour beyond the anterior surface of the lateral pterygoid muscle or lateral extension beyond the posterolateral wall of the maxillary antrum and the pterygomaxillary fissure.
  3. bMasticator space primarily consists of the muscles of mastication. Anatomically, the superficial layer of the deep cervical fascia splits to enclose the muscles of mastication to enclose this space. These muscles are the medial and lateral pterygoid, masseter and temporalis.
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