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Table 1 The tumor, node, metastasis (TNM) classification of the American Joint Committee on Cancer [24]

From: Nasopharyngeal carcinoma

Primary Tumor (T)
TX Primary tumor cannot be assessed
TO No evidence of primary tumor
Tis Carcinoma in situ
T1 Tumor confined to the nasopharynx
T2 Tumor extends to soft tissues of oropharynx and/or nasal fossa
   • T2a    • without parapharyngeal extension
   • T2b    • with parapharyngeal extension
T3 Tumor invades bony structures and/or paranasal sinuses
T4 Tumor with intracranial extension and/or involvement of cranial nerves, infratemporal fossa, hypopharynx, or orbit, or masticator space
Regional Lymph Nodes (N): Nasopharynx
The distribution of regional lymph node spread from nasopharyngeal cancer, particularly of the undifferentiated type, is different than that of other head and neck mucosal cancers and justifies use of a different N classification scheme. In children this does not have a prognostic impact.
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Unilateral metastasis in lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa.
N2 Bilateral metastasis in lymph node (s) 6 cm or less in greatest dimension, above the supraclavicular fossa
N3 Metastasis in a lymph node(s)
   • N3a    • greater than 6 cm in dimension
   • N3b    • extension to the supraclavicular fossa
Distant Metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis