ear, nose, and throat disorders
Laryngeal Cancer
Staging of Laryngeal Cancer
For purposes of clinical stage classification, the larynx is divided into 3 regions: supraglottis, glottis, and subglottis ( Staging reference ). Laryngeal cancer is staged according to size and site of the primary tumor (T). number and size of metastases to the cervical lymph nodes (N), and evidence of distant metastases (M). There are separate N categories for HPV-related and HPV-unrelated cancers. Staging usually requires imaging with CT, MRI, or both, and often PET. Clinical staging (cTNM) is based on the results of the physical examination and tests done before surgery. Pathologic staging (pTNM) is based on the pathologic characteristics of the primary tumor and the number of positive nodes found during surgery. Extranodal extension is incorporated into the "N" category for metastatic cancer to neck nodes. Clinical diagnosis of extranodal extension is based on finding evidence of gross extranodal extension during the physical examination together with imaging tests confirming the finding. Pathologic extranodal extension is defined as histologic evidence of tumor in a lymph node extending through the lymph node capsule into the surrounding connective tissue, with or without associated stromal reaction. 1. Amin MB, Edge S, Greene F, Byrd DR, et al: American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 8th edition. New York, Springer, 2017; AJCC Cancer Staging Form Supplement, 2018. 