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喉癌TNM分期英文版 Primary tumor (T) TX: Primary tumor cannot be assessed T0: No evidence of primary tumor Tis: Carcinoma in situ Supraglottis T1: Tumor limited to one subsite* of supraglottis with normal vocal cord mobility T2: Tumor invades mucosa of more than one adjacent subsite* of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, or medial wall of pyriform sinus) without fixation of the larynx T3: Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre-epiglottic tissues, paraglottic space, and/or minor thyroid cartilage erosion (e.g., inner cortex) T4a: Tumor invades through the thyroid cartilage, and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of the neck including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Subsites include the following: Ventricular bands (false cords) Arytenoids Suprahyoid epiglottis Infrahyoid epiglottis Aryepiglottic folds (laryngeal aspect) Note: Supraglottis involves many individual subsites. Relapse-free survival may differ by subsite and by T and N groupings within stage.Glottis T1: Tumor limited to the vocal cord(s), which may involve anterior or posterior commissure, with normal mobility T1a: Tumor limited to one vocal cord T1b: Tumor involves both vocal cords T2: Tumor extends to supraglottis and/or subglottis and/or with impaired vocal cord mobility T3: Tumor limited to the larynx with vocal cord fixation and/or invades paraglottic space, and/or minor thyroid cartilage erosion (e.g., inner cortex) T4a: Tumor invades through the thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck, including deep extrinsic muscle of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Note: Glottic presentation may vary by volume of tumor, anatomic region involved, and the presence or absence of normal cord mobility. Relapse-free survival may differ by these and other factors in addition to T and N subgroupings within the stage.Subglottis T1: Tumor limited to the subglottis T2: Tumor extends to vocal cord(s) with normal or impaired mobility T3: Tumor limited to larynx with vocal cord fixation T4a: Tumor invades cricoid or thyroid cartilage and/or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck, including deep extrinsic muscles of the tongue, strap muscles, thyroid, or esophagus) T4b: Tumor invades prevertebral space, encases carotid artery, or invades mediastinal structures Regional lymph nodes (N) NX: Regional lymph nodes cannot be assessed N0: No regional lymph node metastasis N1: Metastasis in a single ipsilateral lymph node 3 cm or smaller in greatest dimension N2: Metastasis in a single ipsilateral lymph node larger than 3 cm but 6 cm or smaller in greatest dimension, or in multiple ipsilateral lymph nodes 6 cm or smaller in greatest dimension, or in bilateral or contralateral lymph nodes 6 cm or smaller in greatest dimension N2a: Metastasis in a single ipsilateral lymph node larger than 3 cm but 6 cm or smaller in greatest dimension N2b: Metastasis in multiple ipsilateral lymph nodes 6 cm or smaller in greatest dimension N2c: Metastasis in bilateral or contralateral lymph nodes 6 cm or smaller in greatest dimension N3: Metastasis in a lymph node larger than 6 cm in greatest dimension In clinical evaluation, the actual size of the nodal mass should be measured, and allowance should be made for intervening soft tissues. Most masses larger than 3 cm in diameter are not single nodes but confluent nodes or tumors in soft tissues of the neck. There are three stages of clinically positive nodes: N1, N2, and N3. The use of subgroups a, b, and c is not required but recommended. Midline nodes are considered homolateral nodes. Distant metastasis (M) MX: Distant metastasis cannot be assessed M0: No distant metastasis M1: Distant metastasis AJCC Stage Groupings Stage 0 Tis, N0, M0 Stage I T1, N0, M0 Stage II T2, N0, M0 Stage III T3, N0, M0 T1, N1, M0 T2, N1, M0 T3, N1, M0 Stage IVA T4a, N0, M0 T4a, N1, M0 T1, N2, M0 T2, N2, M0 T3, N2, M0 T4a, N2, M0 Stage IVB T4b, any N, M0 Any T, N3, M0 Stage IVC Any T, any N, M1
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