Stage Information
Salivary Gland Cancer (PDQ®): Treatment
Health Professional Version
From National Cancer Institute: cancer.gov website: http://www.cancer.gov/cancer_information/doc_pdq.aspx?version=1&summaryid
=208_01455
Date Last Modified: 02/2002
Stage Information:
Tumors of the major salivary glands are staged according to size;
mobility; and, in parotid tumors, whether or not the facial nerve is involved.1-4
Diagnostic imaging studies may be used in staging. Magnetic resonance
imaging (MRI) offers an advantage over computed tomographic (CT) scanning
in the detection and localization of head and neck tumors and the distinction
of lymph nodes from blood vessels. Bone invasion is better visualized
by CT. MRI may give additional information on soft tissue extension, especially
of the deep lobe.5
The American Joint Committee on Cancer (AJCC) has designated staging by
TNM classification.6
TNM definitions:
Primary tumor (T)
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Tumor 2 cm or less in greatest dimension without extraparenchymal
extension
T2: Tumor more than 2 cm but not more than 4 cm in greatest dimension
without extraparenchymal extension
T3: Tumor having extraparenchymal extension without seventh nerve involvement
and/or more than 4 cm but not more than 6 cm in greatest dimension
T4: Tumor invades base of skull, seventh nerve, and/or exceeds 6 cm in
greatest dimension
Regional lymph nodes (N)
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
Distant metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis
AJCC stage groupings
Stage I
T1, N0, M0
T2, N0, M0
Stage II
T3, N0, M0
Stage III
T1, N1, M0
T2, N1, M0
Stage IV
T4, N0, M0
T3, N1, M0
T4, N1, M0
Any T, N2, M0
Any T, N3, M0
Any T, Any N, M1
References:
1. Spiro RH, Huvos AG, Strong EW: Cancer of the parotid gland: a clinicopathologic
study of 288 primary cases. American Journal of Surgery 130(4): 452-459,
1975.
2. Fu KK, Liebel SA, Levine ML, et al.: Carcinoma of the major and minor
salivary glands: analysis and treatment results and sites and causes of
failures. Cancer 40(6): 2882-2890, 1977.
3. Levitt SH, McHugh RB, Gomez-Marin O, et al.: Clinical staging system
for cancer of the salivary gland: a retrospective study. Cancer 47(11):
2712-2724, 1981.
4. Kuhel W, Goepfert H, Luna M, et al.: Adenoid cystic carcinoma of the
palate. Archives of Otolaryngology, Head and Neck Surgery 118(3): 243-247,
1992.
5. Consensus conference. Magnetic resonance imaging. JAMA: Journal of
the American Medical Association 259(14): 2132-2138, 1988.
6. Major salivary glands (parotid, submandibular, and sublingual). In:
American Joint Committee on Cancer: AJCC Cancer Staging Manual. Philadelphia,
Pa: Lippincott-Raven Publishers, 5th ed., 1997, pp 53-58.
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