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Cite this page: Malik F, Clay MR. Staging-head and neck. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuestagingheadneck.html. Accessed October 16th, 2021.
Pathologic TNM staging of sarcomas of the head and neck, AJCC 8th edition
Primary tumor (pT)
- pTX: Primary tumor cannot be assessed
- pT1: Tumor ≤ 2 cm in greatest dimension
- pT2: Tumor > 2 cm and ≤ 4 cm
- pT3: Tumor > 4 cm
- pT4: Tumor with invasion of adjoining structures
- pT4a: Orbital, skull base / dural, central compartment viscera, fascial skeleton or pterygoid muscle invasion
- pT4b: Brain parenchymal invasion, carotid artery encasement, prevertebral muscle invasion or central nervous system involvement via perineural spread
Notes:
- Note the lower cutoffs for tumor size (aggressive tumors are identified at smaller size in this region of the body)
- Largest tumor diameter (in any plane) should be measured
- Special consideration should be given to tumors that may have tail-like projections, such as undifferentiated pleomorphic sarcoma and myxofibrosarcoma
- Surrounding edema, if present, should be excluded from size measurement
Regional lymph nodes (pN)
- pN0: No regional lymph node metastasis
- pN1: Regional lymph node metastasis
Notes:
- pNX is not used for soft tissue tumors and no pN should be reported if no lymph nodes are present
Histologic grade (G)
- GX: Grade cannot be assessed
- G1: Total differentiation, mitotic count and necrosis score of 2 or 3
- G2: Total differentiation, mitotic count and necrosis score of 4 or 5
- G3: Total differentiation, mitotic count and necrosis score of 6, 7 or 8
Notes:
AJCC prognostic stage groups
- Since this is a new classification and still needs data collection, prognostic stage grouping is not yet defined
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