Head & Neck Cancer — TNM Staging
T (Tumour size, oral cavity)
- T1 ≤ 2 cm; T2 2-4 cm; T3 > 4 cm; T4 invades adjacent structures (cortical bone, deep muscle, etc.). (Depth of invasion now also modifies T.)
N (Regional nodes)
N0 = none; N1 = single ipsilateral ≤3 cm; higher N for larger/multiple/bilateral nodes or extranodal extension. Nodal status strongly affects prognosis.
Neck Dissection
- Radical neck dissection — removes levels I-V plus the sternocleidomastoid, internal jugular vein and accessory nerve.
- Modified radical — spares one or more of those non-lymphatic structures.
- Selective — preserves additional nodal levels.
Exam Tips ⭐
T1 ≤2 cm, T2 2-4 cm, T3 >4 cm; radical neck dissection removes levels I-V + 3 structures.