Staging of laryngeal cancer

The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors decide on the best treatment for you.

TNM staging system

Doctors often use the TNM system to stage laryngeal cancer. TNM stands for tumour, node and metastases. This system gives the complete stage of the cancer:

  • T describes how much of the larynx and surrounding area is affected.
  • N describes whether the cancer has spread to any nearby lymph nodes.
  • M describes whether the cancer has spread to other parts of the body such as lungs (metastases or secondary cancer).

Doctors put numbers after the T, N and M. The numbers give more details about the size and spread of the cancer. Higher numbers mean the cancer is more advanced. Your doctor or nurse can give you more information about this staging system.

Number staging system

Another staging system uses numbers to describe the stage of the cancer.

This is a simplified number staging system for laryngeal cancer:

  • Stage 0 – This stage is sometimes called carcinoma in situ (CIS). The cancer cells are only in the lining of the larynx. There are usually no symptoms, so the cancer is not usually diagnosed at this stage. Your doctor may sometimes call this stage pre-cancerous.
  • Stage 1 – The cancer has grown further into the lining of the larynx. The vocal cords still move normally.
  • Stage 2 – The cancer is affecting another part of the larynx, and may affect the vocal cords moving. It has not spread outside the larynx.
  • Stage 3 – The movement of the vocal cords is affected. Or the cancer may have spread to one lymph node, which is no larger than 3cm. The cancer has spread within the larynx.
  • Stage 4 – The cancer has spread into the area surrounding the larynx. It may have spread to one or more lymph nodes, which may be larger than 3cm. It may have spread to other areas of the body.

Early-stage laryngeal cancer

In this information, we use the term early-stage cancer to describe cancers of the larynx that are stage 0, 1 or 2.

Locally advanced laryngeal cancer

Stage 3 and 4 tumours that have spread into the area surrounding the larynx are described as locally advanced cancer. But they have not spread to other areas of the body.

Advanced laryngeal cancer

Stage 4 tumours that have spread to other areas of the body are described as advanced cancer.

Staging for laryngeal cancer is complex. It depends on where in the larynx the cancer started. For example, cancer that starts in the vocal cords (glottis) rarely spreads to other areas of the body. Your doctor can tell you more about your individual situation.

Grading of laryngeal cancer

Grading is about how the cancer cells look under a microscope compared with normal cells. The grade helps your doctor plan your treatment.

  • Grade 1 (low-grade or well differentiated) – The cancer cells look similar to normal cells. They usually grow slowly and are less likely to spread.
  • Grade 2 (moderate- or intermediate-grade) – The cancer cells look more abnormal and are slightly faster growing.
  • Grade 3 (high-grade or poorly differentiated) – The cancer cells look very different from normal cells and may grow more quickly.