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Salivary gland
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Staging salivary gland cancer

Staging is a way of describing or classifying a cancer based on the extent of cancer in the body. Extent includes the size of the tumour and where the cancer is in the body. Your healthcare team uses the stage to plan treatment and estimate your prognosis.

The most common staging system for salivary gland cancer is the TNM system. Each stage is given a number from 1 to 4. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. Generally, the higher the number, the more the cancer has spread.

When describing the stage, doctors may use the terms local, regional and distant. Local means that the cancer is only in the salivary gland and has not spread to other parts of the body. Regional means close to or around the salivary gland. Distant means in a part of the body farther from the salivary gland.

TNM descriptions

T describes the size of the primary tumour and if it has grown into tissues around the salivary gland. T is usually given as a number from 1 to 4. A higher number means that the tumour is larger or has grown deeper into nearby tissues or both.

 

N describes the lymph nodes around the salivary gland. N0 means the cancer hasn’t spread to the lymph nodes. N1, N2 or N3 means cancer has spread to lymph nodes. N1 to N3 can also describe the side of the neck where the cancer has spread, as well as the size of the lymph nodes that contain cancer.

 

M describes whether or not the cancer has spread, or metastasized, to other parts of the body. M0 means that cancer has not spread to other parts of the body. M1 means that it has spread to other parts of the body.

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Stage I

TNMDescription

T1

N0

M0

The tumour is 2 cm or less, and it has not grown into tissues around the salivary gland.

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Stage II

TNMDescription

T2

N0

M0

The tumour is larger than 2 cm but not larger than 4 cm. It has not grown into tissues around the salivary gland.

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Stage III

TNMDescription

T3

Any N

M0

One of the following applies:

  • The tumour is larger than 4 cm.
  • The cancer has grown into soft tissues in the neck around the salivary gland.

T1, T2 or T3

N1

M0

One of the following applies:

  • The tumour is 2 cm or less. It has not grown into tissues around the salivary gland.
  • The tumour is larger than 2 cm but not larger than 4 cm. It has not grown into tissues around the salivary gland.
  • The tumour is larger than 4 cm.
  • The tumour has grown into soft tissues in the neck around the salivary gland.

Cancer has spread to 1 lymph node on the same side as the salivary gland tumour and it is no larger than 3 cm.

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Stage IVA

TNMDescription

T4a

N0 or N1

M0

The tumour has grown into one or more of the following:

  • skin
  • lower jaw bone
  • ear canal
  • facial nerve

Cancer may have spread to 1 lymph node on the same side as the salivary gland tumour and it is no larger than 3 cm.

T1, T2 or T3

N2

M0

One of the following applies:

  • The tumour is 2 cm or less. It has not grown into tissues around the salivary gland.
  • The tumour is larger than 2 cm but not larger than 4 cm. It has not grown into tissues around the salivary gland.
  • The tumour is larger than 4 cm. It has not grown into tissues around the salivary gland.
  • The tumour has grown into soft tissues in the neck around the salivary gland.

Cancer has spread to the lymph nodes near the salivary gland. One of the following applies:

  • N2a – Cancer has spread to 1 lymph node in the neck on the same side as the salivary gland tumour. The lymph node is larger than 3 cm but not larger than 6 cm.
  • N2b – Cancer has spread to lymph nodes on the same side of the neck as the salivary gland tumour. None of the lymph nodes is larger than 6 cm.
  • N2c – Cancer has spread to lymph nodes in the neck on the opposite side as the salivary gland tumour. None of the lymph nodes is larger than 6 cm.

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Stage IVB

TNMDescription

T4b

Any N

M0

The tumour can be any size and may or may not have grown into any surrounding tissues.

The cancer may or may not have spread to lymph nodes.

Any T

N3

M0

The tumour can be any size and may or may not have grown into any surrounding tissues.

Cancer has spread to 1 lymph node, and the lymph node is larger than 6 cm.

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Stage IVC

TNMDescription

Any T

Any N

M0

The tumour can be any size and may or may not have grown into any surrounding tissues.

The cancer may or may not have spread to lymph nodes.

There is a distant metastasis (cancer has spread to other parts of the body, such as the lungs, bone, or brain).

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Recurrent salivary gland cancer

Recurrent salivary gland cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to the primary tumour, it’s called regional recurrence. It can also recur in another part of the body, which is called a distant metastasis.

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