Staging
The staging of head and neck cancer includes a classification for nodal disease. It is important to note the critical difference in size of nodes with break points at 3 and 6 cm. The staging system for head and neck malignancies considers all malignancies with palpable cervical adenopathy as Stage 3 or Stage 4, reflecting the grim prognostic implications of palpable nodal disease. 2 The most important prognostic indicator in patients with squamous carcinoma of the head and neck remains the status of the cervical lymph nodes. 3
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
N2a: Metastasis in a single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension
N2b: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
N2c: Metastasis in bilateral or contralateral nodes, no more than 6 cm in greatest dimension
N3: Metastasis in a lymph node more than 6 cm in greatest dimension 2
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