LIP & ORAL CAVITY STAGING DIAGRAM - Form TH-43 - Revised February 2010

Oct 13, 2026

Clinical and pathological staging diagram for lip and oral cavity tumors (AJCC 7th Edition, diagnosis date after 01 January 2010). Provides instructions and definitions to classify the TNM components: primary tumor (T), regional lymph nodes (N), and distant metastasis (M). Includes options for referral context, subsites laterality, prior treatment, ECOG performance status, smoking status, metastatic sites checklists, and administrative fields for completion, amendments, and data quality notification.

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LIP & ORAL CAVITY STAGING DIAGRAM

TNM 2009 Clinical and Pathological (AJCC 7th Edition)

Definitions for T, N, and M Descriptors

Administrative Fields and Revision Information

LIP & ORAL CAVITY STAGING DIAGRAM | New | Recurrent Disease | Referred for Follow up | | --- | --- | --- | | Referred as part of definitive treatment (initial treatment of disease) . | Definitive treatment already received.
Referred at recurrence. | Previously treated and followed elsewhere before referral. | TNM 2009 Clinical TNM 2009 Pathological T N M T N M X X X X 0 0 0 0 0 0 is 1 1 is 1 1 1 2a 1 2a 2 2b 2 2b 3 2c 3 2c 4a 3 4a 3 4b 4b | Disease Subsites | | Alveolus/Gingiva Hard Palate | Buccal
Lip | Floor of Mouth Oral Tongue | | --- | --- | --- | --- | --- | | Primary Laterality | | Right | Left | Bilateral | | Previous Treatment | Surgery
Chemotherapy Radiation
Nil | ECOG | 0 1 2 3 4 | | --- | --- | --- | --- | | Smoking Status | Never (<100 cig/life) Former
Quit<1year
Current | Metastatic Sites
(check all that apply) | Adrenal Bone Brain Distant Nodes Liver Lung Skin
Other: | |

Pack Years | | | | | | | | | Completed by: Date: (dd/mm/yy) Diagnosis/Stage Amended to: Reason: By: Date: (dd/mm/yy) NOTIFY DATA QUALITY & REGISTRY IF STAGE/DIAGNOSIS IS AMENDED FORM \#TH-43 Revised February 2010 LIP & ORAL CAVITY STAGING DIAGRAM AJCC 7th Edition for Diagnosis Date > 01 January 2010 Definitions for T, N, and M Descriptors PRIMARY TUMOR (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ T1 Tumor 2cm or less in greatest dimension T2 Tumor more than 2cm but not more than 4 cm in greatest dimension T3 Tumor more than 4cm in greatest dimension T4a Moderately advanced local disease. (lip) Tumor invades through cortical bone, inferior alveolar nerve, floor of mouth, or skin of face, i.e. , chin or nose (oral cavity) Tumor invades adjacent structures only (e.g. , through cortical bone,[mandible or maxilla] into deep [extrinsic] muscle of tongue [genioglossus, hyoglossus, palatoglossus, and styloglossus], maxillary sinus, skin of face) T4b Very advanced local disease. Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery Note: Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to classify a tumor as T4 . REGIONAL LYMPH NODES (N) NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3cm or less in greatest dimension N2 Metastasis in a single ipsilateral lymph node, more than 3cm but not more than 6cm 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 6cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3cm but not more than 6cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6cm in greatest dimension N3 Metastasis in a lymph node more than 6cm in greatest dimension DISTANT METASTASIS (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) M1 Distant metastasis FORM \#TH-43 Revised February 2010

FAQs

What are the T descriptor definitions for lip and oral cavity primary tumors?

T categories include TX (cannot be assessed), T0, Tis (carcinoma in situ), and T1–T4. T4 is divided into T4a (moderately advanced local disease with specific invasion) and T4b (very advanced local disease with masticator space/pterygoid plates/skull base involvement).

How are the N descriptor categories determined for regional lymph nodes?

NX indicates regional lymph nodes cannot be assessed, while N0 is no regional metastasis. N1 is a single ipsilateral node ≤3 cm; N2 covers multiple ipsilateral/bilateral/contralateral patterns with size limits, including N2a–N2c subdivisions. N3 is a lymph node >6 cm in greatest dimension.

What do the M descriptor options mean for distant metastasis and staging use?

M0 indicates no distant metastasis; clinical M is used to complete the stage group when pathologic M0 is not available. M1 indicates distant metastasis.

Oct 13, 2026

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