Pathologic Staging of HPV-Associated Oropharyngeal Cancer*
Stage | Tumor (Maximum Penetration)† | Regional Lymph Node Metastasis‡ | Distant Metastasis§ |
|---|---|---|---|
I | T0-2 | pN0-1 | M0 |
II | T0-2 | pN2 | M0 |
T3-4 | pN0-1 | M0 | |
III | T0-4 | pN2 | M0 |
IV | Any T | Any pN | M1 |
* HPV association as indicated by p16 positivity | |||
Head and neck cancers are staged according to size and site of the primary tumor (T), number and size of metastases to the cervical lymph nodes (N), and evidence of distant metastases (M). † T0 = no primary tumor identified; T1 = tumor ≤ 2 cm in greatest dimension; T2 = tumor > 2 cm but ≤ 4 cm; T3 = tumor > 4 cm or invading the lingual surface of the epiglottis; T4 = tumor invading the larynx, extrinsic tongue muscles, medial pterygoid, the hard palate, mandible, or beyond | |||
‡ pN = Pathologic N; pN0 = none; pN1 = metastasis in ≤ 4 lymph nodes; pN2 = metastasis to > 4 lymph nodes. | |||
§ M0 = none; M1 = present | |||
Data from Amin MB, Edge S, Greene F, Byrd DR, et al: American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 8th edition. New York, Springer, 2017; AJCC Cancer Staging Form Supplement, 2018. | |||