By Stephen Edge, David R. Byrd, Carolyn C. Compton, April G. Fritz, Frederick L. Greene, Andrew Trotti
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Extra info for AJCC Cancer Staging Manual Edition 7
2002;128(7):751–8, with permission of the American Medical Association. is designated En (no extranodal extension), Em (microscopic ECS), and Eg (gross ECS). These descriptors will not affect current nodal staging. The natural history and response to treatment of cervical nodal metastases from nasopharynx primary sites are different, in terms of their impact on prognosis, so they justify a different N classification scheme. Regional node metastases from well-differentiated thyroid cancer do not significantly affect the ultimate prognosis in most patients and therefore also justify a unique staging system for thyroid cancers.
Grandi C, Alloisio M, Moglia D, et al. Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications. Head Neck Surg. 1985;8:67–73. Harnsberger HR. Squamous cell carcinoma: nodal staging. In: Handbook of head and neck imaging. 2nd ed. St. Louis: Mosby; 1995. p. 283–298. Hillsamer PJ, Schuller DE, McGhee RB, et al. Improving diagnostic accuracy of cervical metastases with CT and MRI imaging. Arch Otolaryngol Head Neck Surg. 1990;116:2297–301. Jones AS, Roland NJ, Field JK, Phillips DE.
2002;128(7):751–8, with permission of the American Medical Association. 24 American Joint Committee on Cancer • 2010 FIGURE 1. Schematic indicating the location of the lymph node levels in the neck as described in Table 1. When enlarged lymph nodes are detected, the actual size of the nodal mass(es) should be measured. It is recognized that most masses over 3 cm in diameter are not single nodes but are confluent nodes or tumor in soft tissues of the neck. Pathologic examination is necessary for documentation of tumor extent in terms of the location or level of the lymph node(s) involved, the number of nodes that contain metastases, and the presence or absence of ECS of tumor, designated as En (not present), Em (microscopic), or Eg (gross).
AJCC Cancer Staging Manual Edition 7 by Stephen Edge, David R. Byrd, Carolyn C. Compton, April G. Fritz, Frederick L. Greene, Andrew Trotti