Salivary glands
Miscellaneous
TNM staging

Author: Adriana Handra-Luca, M.D. (see Authors page)

Revised: 21 March 2018, last major update September 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: TNM staging salivary glands[TI]

Cite this page: Handra-Luca, A. TNM staging. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/salivaryglandsTNM.html. Accessed July 17th, 2018.
Definition / general
  • Use for staging major salivary gland tumors only (parotid, submandibular, sublingual glands)
  • Tumors arising in minor salivary glands are staged according to anatomic site of origin
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 more than 4 cm in greatest dimension or tumor having extraparenchymal extension*
  • T4a: Moderately advanced disease; tumor invades skin, mandible, ear canal or facial nerve
  • T4b: Very advanced disease; tumor invades skull base or pterygoid plates or encases carotid artery

  • Note: extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues or nerve (except T4a and T4b)
  • *Microscopic evidence alone does not constitute extraparenchymal extension
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)
  • M0: No distant metastasis
  • M1: Distant metastasis
  • Mx: Cannot be assessed
Stage grouping
  • I: T1 N0 M0
  • II: T2 N0 M0
  • III: T3 N0 M0 or T1 - 3 N1 M0
  • IVA: T4a N0 - 1 M0 or T1 - T4a N2 M0
  • IVB: Any T N3 M0 or T4b any N M0
  • IVC: Any T any N M1