Classification Scheme of Ho for Nasopharyngeal Carcinoma

Description

Ho developed a classification and staging scheme for nasopharyngeal carcinoma. It is somewhat similar to the AJCC classification of tumors, with T, N and M stages for tumor spread.

Group	Finding	Code
T	tumor confined to the nasopharynx	T1
	extension to the nasal fossa, oropharynx, or adjacent muscles or nerves below the base of the skull	T2
	beyond T2 limits	T3
N	no cervical nodes palpable	N0
	node(s) wholly in the upper cervical level bounded below by the skin crease extending laterally and backward from or just below the thyroid notch (laryngeal eminence)	N1
	node(s) palpable between the crease and the supraclavicular fossa, the upper limit being the line joining the upper margin of the sternal end of the clavicle and the apex of an angle formed by the lateral surface of the neck and the superior margin of the trapezius	N2
	node(s) palpable in the supraclavicular fossa	N3
	skin involvement in the form of carcinoma en cuirasse	N3
	satellite nodules above the clavicles	N3
M	no hematogenous metastasis	M0
	hematogenous metastasis present,	M1
	lymph nodal metastasis below the clavicles	M1

from Table 1, page 80 Teo (1992)

where:

• Nasopharynx = space behind the choanal orifices and nasal septum and above the posterior margin of the soft palate in the resting position.

Subclassifications of T2	Code
nasal fossa extension only	T2n
oropharyngeal extension only	T2o
parapharyngeal extension only	T2p
combination of the above	T2(n,o,p)

Subclassifications of T3	Code
bone involvement below the base of the skull, including the floor of the sphenoid sinus	T3a
involvement of the base of the skull	T3b
involvement of the cranial nerves	T3c
involvement of the orbits, laryngopharynx or infratemporal fossa	T3d

The tumor can then be staged based on the TNM designation.

TNM Designation	Stage
T1 N0 M0	I
T1 N1 M0 T2 N0-1 M0	II
T1-T2 N2 M0 T3 N0-2 M0	III
T1-3 N3 M0	IV
T1-3 N0-3 M1	V

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Classification Scheme of Ho for Nasopharyngeal Carcinoma

Description

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