Nasal cavity and paranasal sinus cancer

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Stages of maxillary sinus cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for maxillary sinus cancer is the TNM system. For maxillary sinus cancer there are 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in a maxillary sinus and has not spread to other parts of the body. Regional usually means that cancer has spread to the lymph nodes of the neck (called cervical lymph nodes). Distant means in a part of the body farther from the maxillary sinuses.

Find out more about staging cancer.

Stage 0 (carcinoma in situ)

Cancer cells are only in the outer part of the lining of the maxillary sinus.

Stage 1

The tumour is only in the lining of the maxillary sinus.

Stage 2

The tumour has broken down or destroyed the bone of the sinus and is growing into the bony area on the roof of the mouth (hard palate) or the nasal cavity or both.

Stage 3

The tumour is in or has grown into any of the following:

  • the lining of the maxillary sinus
  • roof of the mouth
  • nasal cavity

The cancer has also spread to 1 lymph node in the neck on the same side as the tumour. The lymph node is no larger than 3 cm.

  • OR
  • The tumour has grown into any of the following:
  • the bone on the back wall of the maxillary sinus
  • the tissues under the skin
  • the floor or inner wall of the eye socket (orbit)
  • the lower part of the sphenoid bone (a bone in the middle part of the skull)
  • the ethmoid sinuses (small cavities in the ethmoid bone, above the nasal cavity and between the eyes)

The cancer may also have grown into 1 lymph node in the neck on the same side as the tumour. The lymph node is no larger than 3 cm.

Stage 4

Stage 4 maxillary sinus cancer can be divided into stages 4A, 4B and 4C depending on:

  • which nearby areas the tumour has grown into, such as the skin of the cheek, other bones of the skull, other paranasal sinuses or the brain
  • the number and size of the lymph nodes with cancer
  • if the cancer has grown outside of lymph nodes (extranodal extension)
  • whether the lymph nodes are on the same or opposite side of the neck as the tumour, or on both sides of the neck
  • if the cancer has spread to other parts of the body farther from the maxillary sinuses, such as to the lungs or liver (called distant metastasis)

Recurrent maxillary sinus cancer

Recurrent maxillary sinus 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 where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

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