Nasal cavity, paranasal sinuses, nasopharynx
General
Staging-nasopharynx
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Last author update: 30 July 2021
Last staff update: 30 July 2021
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Staging[TI] nasopharynx[TIAB]
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Cite this page: Xu B. Staging-nasopharynx. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/nasalstagingnasopharynx.html. Accessed March 20th, 2023.
Definition / general
- All primary carcinomas of the nasopharynx are covered by this staging system
- These topics are not covered: metastasis, mucosal melanoma, lymphoma and sarcoma
Essential features
- AJCC 7th edition staging was sunset on December 31, 2017; as of January 1, 2018, use of the 8th edition is mandatory
ICD coding
- ICD-O: 8071/3 - keratinizing squamous cell carcinoma
- ICD-O: 8072/3 - nonkeratinizing squamous cell carcinoma
- ICD-O: 8083/3 - basaloid squamous cell carcinoma
- ICD-O: 8260/3 - nasopharyngeal papillary adenocarcinoma
- ICD-O: 8200/3 - salivary gland carcinoma
Primary tumor (pT)
- pTX: cannot be assessed
-
pT0: no evidence of primary tumor, with proven EBV positive lymph node metastasis
- pTis: carcinoma in situ
- pT1: confined to nasopharynx or involvement to oropharynx or nasal cavity without parapharyngeal extension
-
pT2: parapharyngeal extension or involvement of adjacent soft tissue including medial pterygoid / lateral pterygoid / prevertebral muscles
- pT3: bone invasion into skull base, cervical vertebra, pterygoid structures or paranasal sinuses
- pT4: involvement of intracranial structures, cranial nerve, hypopharynx, orbit or parotid gland or invasion beyond the lateral surface of the lateral pterygoid muscle
Regional lymph nodes (pN)
- pNX: cannot be assessed
-
pN0: no regional lymph node metastasis
- pN1: metastasis to unilateral cervical lymph node(s) or unilateral / bilateral retropharyngeal lymph node(s), above the inferior border of cricoid cartilage, ≤ 6 cm in size
-
pN2: metastasis to bilateral cervical lymph nodes, above the inferior border of cricoid cartilage, ≤ 6 cm in size
-
pN3: metastasis > 6 cm in size or below the inferior border of cricoid cartilage
Prefixes
- y: preoperative radiotherapy or chemotherapy
- r: recurrent tumor stage
AJCC prognostic stage groups
| Stage group 0: | Tis | N0 | M0
|
| Stage group I: | T1 | N0 | M0
|
| Stage group II: | T0 or T1 | N1 | M0
|
| | T2 | N0 or N1 | M0
|
| Stage group III: | T0, T1 or T2 | N2 | M0
|
| | T3 | N0, N1 or N2 | M0
|
| Stage group IV: | T4 | any N | any M
|
| | any T | N3 | any M
|
| | any T | any N | M1
|
| Stage group IVA: | T4 | any N | M0
|
| | any T | N3 | M0
|
| Stage group IVB: | any T | any N | M1
|
Registry data collection variables
Histologic grade (G)
- Not applicable for nasopharyngeal carcinoma
Histopathologic type
- Nasopharyngeal carcinoma
- Keratinizing squamous cell carcinoma
- Nonkeratinizing squamous cell carcinoma
- Basaloid squamous cell carcinoma
- Nasopharyngeal papillary adenocarcinoma
- Salivary gland carcinoma
Board review style question #1
Which of the following statements about the AJCC staging (8th edition) for nasopharyngeal carcinoma is true?
- pN is determined using a combination of laterality and location of involved lymph node and size of the metastasis
- The presence of extranodal extension increases the pN category
- pT is determined by tumor size and site of involvement
- A cervical lymph node with EBV positive squamous cell carcinoma and no primary tumor detected after extensive sampling is pTX
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