This document discusses staging of oral malignancies. It begins with an introduction about oral cancer prevalence and challenges with late detection. It then covers the TNM staging system and STNMP classification system used to stage oral cancers. Different staging criteria are provided for various oral cancer sites. The conclusion emphasizes that early diagnosis is important for prognosis and outlines how staging helps clinicians determine operability and treatment plans.

1. Staging of Oral
Malignancies
Abhishek Roy
III MDS

2. Contents
 Introduction
 Common types of oral cancer
 TNM staging
 STNMP classification
 Conclusion

3. Introduction
 Oral Cancer is the 3rd most common type of cancer occurring in developing
countries with approximately 80000 new cases annually
 The rise of newer treatment modalities have not deterred the mortality rate;
treated cases having a 5 year survivability of around 50%
 One of the most common hindrances for this is the late detection of such lesions,
which dramatically affects the success ratio
 Furthermore, decreased knowledge amongst clinicians regarding the staging of
cancers also contributes to this phenomenon

7. STAGING
T
M
N

27. Tumour staging for
Oropharynx

29. Tumour staging for Nasal
Cavity and Ethmoid Sinus

30. T1 Tumor is confined to the ethmoid sinus
with or without bone
erosion
T2 Tumor invades two subsites in a single region
or extends to involve
an adjacent region within the nasoethmoidal
complex,
with or without bony invasion
T3 Tumor extends to invade the medial wall or
floor of the orbit,
maxillary sinus, palate, or cribriform plate
T4a Tumor invades any of the following: anterior
orbital contents,
skin of nose or cheek, minimal extension to
anterior cranial
fossa, pterygoid plates, sphenoid or frontal
sinuses
T4b Tumor invades any of the following: orbital
apex, dura, brain,
middle cranial fossa, cranial nerves other
than (V2), nasopharynx,
or clivus

31. Tumour staging for
Maxillary Sinus

33. Tumour staging for
Salivary Glands

34. T1 Tumor is 2 cm or less without
extraparenchymal extension
T2 Tumor is greater than 2 cm but not
more than 4 cm without
extraparenchymal
extension
T3 Tumor is more than 4 cm and/or
extraparenchymal extension
T4a Tumor invades the skin, mandible, ear
canal, and/or facial
nerve
T4b Tumor invades the skull base and/or
pterygoid plates and/or
encases the carotid artery

35. Tumour staging for
Nasopharynx

37. STAGING
T
M
N

42. N2c

43. N3

45. Node staging for
Nasopharynx

47. STAGING
T
M
N

58. Newer Classification

59. Alexander D. Rapidis, John D. Langdon,Mohan F. Patel, Peter W. Harvey. A New System For The Clinicopathological Classification And Identification Of
Intraoral Carcinomata. CANCER 1977:Jan,39-204-209.

60. Conclusion
 Early diagnosis of oral cancer is very important to ensure the future life of the
patient. It results in less morbidity and complications post surgery.
 The knowledge related to the staging of oral cancers is essential for the
clinician so as to analyse and estimate the prognosis and success rate of
various cases. It also helps to distinguish between operable and non-operable
cases.
 Detection and diagnosis are the vitals tools that will help in establishing the
surgical pathway and condition of post-surgical physical and psychological
profile of the patient.