Cite this page: Tranesh GA, Qu H. Staging-nonmelanocytic carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticstagingskincarcinoma.html. Accessed November 30th, 2024.
Definition / general
- Staging of melanomas is described in Skin-Melanocytic tumors chapter
- Staging of related eye tumors is described in the Eye chapter for Conjunctiva, Eyelid, Lacrimal gland
- Includes spindle cell variant of squamous cell carcinoma and adnexal carcinomas
- Applies to clinical and pathologic staging
TNM descriptors
- Required only if applicable
- m (multiple)
- r (recurrent)
- y (posttreatment)
Primary tumor (T)
- TX: Primary tumor cannot be assessed
- T0: No evidence of primary tumor
- Tis: Carcinoma in situ
- T1: Tumor 2 cm or less in greatest dimension with less than 2 high risk features
- T2: Tumor more than 2 cm in greatest dimension with or without one additional high risk features, or any size with two or more high risk features.
- T3: Tumor with invasion of maxilla, mandible, orbit, or temporal bone.
- T4: Tumor invades skeleton (axial or appendicular) or perineural invasion of skull base
Regional lymph nodes (N)
- NX: Regional lymph nodes cannot be assessed
- N0: No regional lymph node metastases
- N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
- N2: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
- N2a: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension
- N2b: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
- N2c: Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
- N3: Metastasis in a lymph node, more than 6 cm in greatest dimension
Distant metastasis (M)
- Not applicable
- M0: No distant metastasis
- M1: Distant metastasis, specifiy sites if known
Stage grouping
- Stage 0: Tis N0 M0
- Stage I: T1 N0 M0
- Stage II: T2 N0 M0
- Stage III: T3 N0 M0 or T1-3 N1 M0
- Stage IV: T1-3 N2 M0 or any T N3 M0 or T4 any N M0 or any T any N M1
Notes
- Patients with primary clinical squamous cell carcinoma or other cutaneous carcinomas with no evidence (clinical, radiologic or pathologic) of regional or distant metastases are divided into two stages:
- Stage I for tumors measuring 2 cm or less in size
- Stage II for those that are greater than 2 cm in size
- If there is clinical concern for extension of tumor into bone and radiologic evaluation is negative, these data may be included to support the Stage I vs. II designation
- Tumors that are 2 cm or less in size can be upstaged to Stage II if they contain two or more high-risk features
- Stage III patients are those with:
- Clinical, histologic or radiologic evidence of one solitary node measuring 3 cm or less in size or
- Tumor extension into bone: maxilla, mandible, orbit or temporal bone
- Stage IV patients are those with:
- Tumor with direct or perineural invasion of skull base or axial skeleton
- 2 or more involved lymph nodes or
- Single or multiple involved lymph nodes measuring > 3 cm in size or
- Distant metastasis
Additional references