Familial Nasopharyngeal Carcinoma 6

Early Stage Nasopharyngeal Cancer: A Highly Curative Disease with Radiation Therapy 139Table 10.1. Staging systemsCurrent and 1997 AJCC 1992 AJCC Ho 1992 ChineseT1:confined to nasopharynx T1:one subsite T1:confined to nasopharynx T1:confined to nasopharynxT2:soft tissue invasion (nasalcavity or oropharynx)a: Without parapharyngealextensionb: With parapharyngealextensionT3:bony or paranasal sinusextensionT4:intercranial extension orcranial nerve or infratemporalfossa, hypopharynx or orbitalinvolvementT2:more than one subsiteT3:nasal cavity and/or oropharynxinvolvementT4:invades adjacent structureT2:nasal fossa, oropharynx,muscle or nerves below base ofskullT3a:bone involvement belowbase of skullT3b:involves base of skullT3c:cranial nervesT3d:orbits, laryngopharynx orinfratemporal fossaN1:unilateral, ≤6 cm N1:single ipsilateral ≤3 cm node N1:upper neck above thyroidnotchN2:bilateral, ≤6 cm N2a:single ipsilateral >3, ≤6 cm N2:below thyroid notch aboveline joining end of clavicle andsuperior margin of trapeziusN3a:>6 cm nodeN3b:supraclavicular involvementStage I: T1N0M0N2b:or multiple ipsilateral nodesall ≤6 cmN2c:bilateral or contralateralnodes all ≤6 cmN3:>6 cm nodeN3:supraclavicular or skininvolvementStage IIA: T2aN0M0 M1:metastases M1:metastases M1:metastasesStage IIBT1N1M0T2N1M0T2aN1M0T2bN0M0T2bN1M0Stage IIIT1N2M0T2aN2M0T2bN2M0T3N0M0T3N1M0T3N2M0Stage IVAT4N0M0T4N1M0T4N2M0Stage IVB: any T N3M0IVC: any T any N M1aThe SO (stylo-occipital) line extends from the styloid process to posterior edge of the occipital foramenT2:nasal cavity, oropharynx, softpalate, cervical prevertebral softtissue, parapharyngeal anterior tothe SO a lineT3:posterior to SO a line, eitheranterior or posterior cranialnerves, skull base, pterygoidplates, pterygopalatine fossa.T4:both anterior and posteriorcranial nerves, paranasal sinuses,cavernous sinus, orbit, infratemporalfossa, C1 or C2N1:mobile nodes 7 cmStage I: T1 N0M0 Stage I: T1N0 Stage I: T1N0M0Stage II: T2 N0M0 Stage II: T2 and/or N1 Stage II: T2N0–1M0 orT1–2N1M0Stage IIIT3 N0M0T1N1M0T1N1M0T2N1M0T3N1M0Stage IVT4N0M0T4N1M0Any T N2M0Any T N3M0Any T any N M1Stage III: T3 and/or N2Stage IV: N3 (any T)Stage V: M1Stage III: T3N0–2M0 orT1–3N2M0Stage IVA: T4N0–3M0or T1–4N3M0Stage IVB: M1