Head and Neck

Question 1

Larynx (suppraglottis)

Answer 1

_pT1: limited to one subsite of supraglottis
_pT2: 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)
_ pT3: Tumor limited to larynx and / or invades any of the following: postcricoid area, preepiglottic space, paraglottic space, and / or inner cortex of thyroid cartilage
_pT4a: invades through the thyroid cartilage and / or invades tissues beyond the larynx
_pT4b: invades prevertebral space, encases carotid artery, or invades mediastinal structures

Question 2

Larynx (glottis)

Answer 2

_pT1a: Tumor limited to one vocal cord _pT1b: Tumor involves both vocal cords
_pT2: extends to supraglottis and / or subglottis
_pT3: limited to larynx with vocal cord fixation | invasion of paraglottic space | inner cortex of the thyroid cartilage
_pT4a: invades through outer cortex of the thyroid cartilage | invades tissues beyond the larynx
_pT4b: invades prevertebral space, encases carotid artery, or invades mediastinal structures

Question 3

Larynx (subglottis)

Answer 3

_pT1: Tumor limited to subglottis
_pT2: Tumor extends to vocal cord(s)
_pT3: Tumor limited to larynx|invasion of paraglottic space | inner cortex of the thyroid cartilage
_pT4a: Tumor invades cricoid or thyroid cartilage and / or invades tissues beyond the larynx
pT4b: Very advanced local disease. Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures

Question 4

Oral cavity

Answer 4

_pT1: <=2 cm with depth <= 5 mm
_pT2: <= 2 cm with DOl > 5 mm
Or > 2 cm - <= 4 cm with DOl <= 10 mm
_pT3: > 2 cm - <= 4 cm with DOl > 10 mm or > 4 cm with DOl < 10 mm
_pT4a: > 4 cm with DOl > 10 mm
or tumor invades adjacent structures only
_pT4b: Tumor invades masticator space, pterygoid plates, or skull base, and / or encases internal carotid artery

Question 5

Major salivary glands

Answer 5

_pT1: <= 2 cm
_pT2: > 2 cm - <= 4 cm
_pT3: > 4 cm and / or tumor having extraparenchymal extension
_pT4a: invades skin, mandible, ear canal, and / or facial nerve.
_pT4b: invades skull base and / or pterygoid plates and / or encases carotid artery

Question 6

Nasal cavity (maxillary sinus)

Answer 6

_pT1: limited maxillary sinus mucosa
_pT2: bone erosion | destruction| extension into hard palate | middle nasal meatus
_pT3: invades: bone posterior wall maxillary sinus | subcutaneous tissues | orbit |ethmoid
_pT4a: invades: anterior orbital | skin of cheek |pterygoid |infratemporal |cribriform | sinuses
_ pT4b: invades: dura, brain, middle cranial fossa,, nasopharynx, or clivus

Question 7

Nasal cavity and ethmoid sinus

Answer 7

_pT1: one subsite, with or without bony invasion
_pT2: two subsites or extending to adjacent region
_pT3: invade the medial/floor orbit, maxillary, palate
pT4a: anterior orbital, skin, anterior cranial fossa, pterygoid plates, sphenoid or frontal sinuses
pT4b: invades any of the following: orbital apex, dura, brain, middle cranial fossa, cranial nerves other than maxillary division of trigeminal nerve (V2), nasopharynx, or clivus

Question 8

OroPharynx (hpv)

Answer 8

_pT1: <= 2 cm
_pT2: > 2 cm - <= 4 cm
_pT3: > 4 cm or extension to lingual surface of epiglottis
_pT4: invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible or beyond

Question 9

Cutaneous SCC

Answer 9

_pT1: <= 2 cm in greatest dimension
_pT2: > 2 cm, but <= 4 cm
_pT3: > 4 cm or minor bone erosion or perineural invasion or deep invasion
_pT4a: Tumor with gross cortical bone / marrow invasion
_pT4b: Tumor with skull base invasion and / or skull base foramen involvement