How are true malignant mixed tumors (carcinosarcomas) staged?

Updated: Dec 01, 2015
  • Author: M Sherif Said, MD, PhD; Chief Editor: M Sherif Said, MD, PhD  more...
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Answer

Answer

Tumor spread may occur by direct extension, hematogenous, lymphatic, or perineural invasion.

Tumor staging in the salivary glands depends on whether the tumor is located in the head or neck area. Tables 1 and 2 define the American Joint Committee on Cancer (AJCC) staging of malignant tumors of the major salivary glands (ie, parotid, submandibular, sublingual). [28]

Table 1. TNM Classification (Open Table in a new window)

T-

Primary Tumor

Tx

Primary tumor cannot be assessed

T0

No evidence of primary tumor

T1

Tumor 2cm or less in greatest dimension, without extraparenchymal extension

T2

Tumor more than 2cm, but not more than 4cm, in greatest dimension, without extraparenchymal extension

T3

Tumor more than 4cm and/or tumor having extraparenchymal extension

T4a

Tumor invades skin, mandible, ear canal, and/or facial nerve

T4b

Tumor invades skull base and/or pterygoid plates and/or carotid artery

N-

Regional Lymph Nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Metastasis into a single ipsilateral lymph node, 3cm or less in greatest dimension

N2

Metastasis into a single ipsilateral lymph node, greater than 3cm in greatest dimension but not greater than 6cm in greatest dimension, or in multiple ipsilateral lymph nodes, none greater than 6cm in greatest dimension, or in bilateral or contralateral lymph nodes, none greater than 6cm in greatest dimension

N3

Metastasis in a lymph node greater than 6cm in greatest dimension

M-

Distant metastasis

MX

Distant metastasis cannot be assessed

M0

No distant metastasis

M1

Distant metastasis

Table 2. Stage Grouping (Open Table in a new window)

Stage

Grouping

Stage I

T1 N0 M0

Stage II

T2 N0 M0

Stage III

T3 N0 M0

 

T1 N1 M0

 

T2 N1 M0

 

T3 N1 M0

Stage IVA

T4a N0 M0

 

T4a N1 M0

 

T1 N2 M0

 

T2 N2 M0

 

T3 N2 M0

 

T4a N2 M0

Stage IVB

T4b Any N M0

 

Any T N3 M0

Stage IVC

Any T Any N M1


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