Stages of cancer of the lip and oral cavity

Stages of mouth cancer and lip cancer are indicated using Roman numerals from I to IV, with I being the smallest and IV the largest or most advanced.

* Stage I - the tumor is under 1 inch in diameter (2 cm) and has not reached nearby lymph nodes.

* Stage II - the tumor is over 1 inch in diameter (2 cm) but less than 2 inches (4 cm) and has not reached nearby lymph nodes.

* Stage III - any of the three possibilities below:
o The tumor is over 2 inches (4 cm) in diameter.
o The tumor has spread to just one nearby lymph node on the same side of the neck as the tumor.
o The cancer in the lymph node is no more than 3cm.

* Stage IV - any of the possibilities below:
o The cancer has reached tissues around the oral cavity and lip. Nearby lymph nodes may or may not contain cancer.
o The cancer has spread to 2 or more lymph nodes on the same side of the neck as the tumor.
o The cancer has spread to lymph nodes on the other side of the neck.
o Lymph nodes on either side have a tumor that measures over 6 cm.
o The cancer has spread further, to other parts of the body.

The TNM staging method

This is another method of staging mouth cancers. T describes the tumor, N describes the lymph node(s), and M describes metastasis (distant spread). X means there is no data to make an assessment.

* TX - not possible to assess primary tumor.
* T0 - there is no evidence of a primary tumor.
* Tis - carcinoma in situ (cancer only in the place where it began; it has not spread).
* T1 - tumor 2 cm maximum measurement in greatest dimension.
* T2 - tumor over 2 cm and 4 cm maximum in greatest dimension.
* T3 - tumor over 4 cm in greatest dimension. In the case of lip cancer, tumor invades adjacent structures, such as cortical bone, deep muscle of tongue, maxillary sinus, and skin.
* T4 - In the cases of oral cavity cancer, tumor invades adjacent structures, such as cortical bone, deep muscle of tongue, maxillary sinus, and skin.

* NX - nearby lymph nodes cannot be assessed.
* N0 - nearby lymph nodes have no cancer.
* N1 - cancer in one nearby lymph node on same side of neck. Maximum 3 cm in greatest dimension.
* N2
o N2a - cancer has spread to one lymph node on same side of neck, no more than 6 cm in greatest dimension.
o N2b - Cancer has spread to 2 or more lymph nodes; none are greater than 6 cm in greatest dimension.
o N2c - Cancer has spread to lymph nodes on either side of the neck, or both sides of the neck, no bigger than 6 cm in greatest dimension.
* N3 - cancer has spread to a lymph node and is over 6 cm in greatest dimension.

* MX - distant metastasis (spread) cannot be assessed.
* M0 - no distant metastasis.
* M1 - distant metastasis.

Therefore if a patient is described as T2N1M0, it means:

There is a primary tumor between 2 cm and 4 cm, it has spread (metastasized) to one single lymph node on one side, that node is less than 3 cm in size, there is no distant metastasis.