Topics in Oral Medicine

TNM Staging

From the DentTest dentistry textbook. Last updated 6 August 2026.

T - Tumour Stage

  • Tis: carcinoma in situ

  • T1: tumour 2cm or less and 5mm or less depth of invasion

  • T2: tumour 2cm or less and with 5-10mm depth of invasion OR 2-4cm in width with <10mm depth of invasion

  • T3: tumour more than 4cm width OR more than 10mm depth of invasion

  • T4a: tumour invades through the cortical bone of the mandible or maxillary sinus, or invades skin of the face

  • T4b: tumour invades masticator space, pterygoid plates, or skull base, or encases internal carotid artery

N – Lymph Node status

  • N0: no regional lymph node involvement

  • N1: metastasis in a single ipsilateral node; 3cm maximum diameter with no extranodal extension

  • N2a: as per N1 but with extranodal extension, or 3-6cm maximum diameter without nodal extension

  • pN2b: metastasis in multiple ipsilateral nodes, none more than 6cm, without extranodal extension

  • pN2c: metastasis in bilateral or contralateral nodes, none more than 6cm without extranodal extension

  • N3a: metastasis in a lymph node more than 6cm without extranodal extension

  • N3b: metastasis in a lymph node mode than 3cm diameter with extranodal extension or multiple ipsilateral, contralateral or bilateral nodes with extranodal extension

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