Part of Cancer staging guidance sheets
Skin carcinoma of the head and neck (ICD10 C00.0-2, C00.6, C44.0, C44.2-4)
Introduction
This is the data sheet for TNM 9th edition staging of the skin carcinoma of the head and neck (ICD10 C00.0-2, C00.6, C44.0, C44.2-4)
For more detailed information regarding TNM staging, please see pages 138-140 of the UICC TNM 9 book.
Stage groupings
|
Stage Group |
T stage |
N stage |
M stage |
|---|---|---|---|
|
Stage 0 |
Tis |
N0 |
M0 |
|
Stage I |
T1 |
N0 |
M0 |
|
Stage II |
T2 |
N0 |
M0 |
|
Stage III |
T3 |
N0 |
M0 |
|
|
T1, T2, T3 |
N1 |
M0 |
|
Stage IVA |
T1, T2, T3 |
N2, N3 |
M0 |
|
|
T4 |
Any N |
M0 |
|
Stage IVB |
Any T |
Any N |
M1 |
TNM clinical classification
T - primary tumour
| T value | Description |
|---|---|
|
cTX |
Primary tumour cannot be identified |
|
cT0 |
No evidence of primary tumour |
|
cTis |
Carcinoma in situ |
|
cT1 |
Tumour 2 cm or less in greatest dimension |
|
cT2 |
Tumour >2 cm and ≤4 cm in greatest dimension |
|
cT3 |
Tumour >4 cm in greatest dimension or minor bone erosion or perineural invasion or deep invasion1 |
|
cT4a |
Tumour with gross cortical bone/marrow invasion |
|
cT4b |
Tumour with foraminal involvement of the axial skeleton2 , invasion with foraminal involvement or invasion into the epidural space |
Note:
1Deep invasion is defined as invasion beyond the subcutaneous fat or >6 mm (as measured from the granular layer of adjacent normal epidermis to the base of the tumour). Perineural invasion is defined as tumour cells within the nerve sheath of a nerve lying deeper than the dermis or measuring 0.1 mm or larger in calibre or involvement of five or more nerves per section, without foramen or skull base invasion or transgression.
2Axial skeleton includes the skull, vertebrae and sacrum
N - regional lymph nodes
|
N value |
Description |
|---|---|
|
cNX |
Regional lymph nodes cannot be assessed |
|
cN0 |
No regional lymph node metastasis |
|
cN1 |
Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension without extranodal extension |
|
cN2 |
Metastasis described as: cN2a - Metastasis in a single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension without extranodal extension cN2b - Metastasis in multiple ipsilateral lymph nodes, not more than 6 cm in greatest dimension, without extranodal extension cN2c - Metastasis in bilateral or contralateral lymph nodes, not more than 6 cm in greatest dimension, without extranodal extension |
|
cN3a |
Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension |
|
cN3b |
Metastasis in a single or multiple lymph nodes with clinical extranodal extension* |
Note:
* Clinical extranodal extension is defined as the presence of skin involvement or soft tissue invasion with deep fixation to underlying muscle or adjacent anatomical structures or clinical signs of nerve involvement. Image detected unequivocal extranodal extension is becoming standard.
M - distant metastasis
|
M value |
Description |
|---|---|
|
cM0 |
No distant metastasis |
|
cM1 |
Distant Metastasis |
TNM pathological classification
pT - primary tumour
The pT categories correspond to the cT categories.
pN - regional lymph nodes
pN – Regional Lymph Nodes - Histological examination of a selective neck dissection specimen should ordinarily include 10 or more lymph nodes. Histological examination of a radical or modified radical neck dissection specimen should ordinarily include 15 or more lymph nodes.
|
pN value |
Description |
|---|---|
|
pNX |
Regional lymph nodes cannot be assessed |
|
pN0 |
No regional lymph node metastasis |
|
pN1 |
Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension without extranodal extension |
|
pN2 |
Metastasis described as: pN2a - Metastasis in a single ipsilateral lymph node, less than 3 cm in greatest dimension with extranodal extension or, more than 3 cm but not more than 6 cm in greatest dimension without extranodal extension pN2b - Metastasis in multiple ipsilateral lymph nodes, not more than 6 cm in greatest dimension, without extranodal extension pN2c - Metastasis in bilateral or contralateral lymph nodes, not more than 6 cm in greatest dimension, without extranodal extension |
|
pN3a |
Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension |
|
pN3b |
Metastasis in a lymph node more than 3 cm in greatest dimension with extranodal extension or multiple ipsilateral, or any contralateral or bilateral node(s) with extranodal extension |
Note:
Note Pathological extranodal extension (pENE) should only be diagnosed when tumour that is present within the confines of a lymph node definitively transgresses through the entire thick ness of the lymph node capsule into the surrounding connective tissue, with or without stromal reaction. A soft tissue deposit should be considered as at least one lymph node with extranodal extension if it occurs at a site where a regional lymph node would be expected
Last edited: 2 February 2026 4:25 pm
