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Abstract
A proposal is made for the TNM classification system of malignant tumours of the head and neck regions, where a definite classification has not yet been determined by UICC. The regions include the maxillary sinus, ethmoid cells, frontal sinus, sphenoid sinus, nasal cavity, external nose, middle ear, external ear, parotid gland, submandibular gland, trachea and orbit. The extent of the primary tumour is divided into four grades. Although the criteria for application of this grading are different from one region to another, the common principle of the classifioation is as follows:
T1: Tumour of 2 cm or less in its greatest dimension and tumour without deep infiltration.
T2: Tumour of more than 2 cm but not more than 4 cm in its greatest dimension, or tumour with deep infiltration but confined to the primary region with the external periosteum or the capsule of the gland remaining intact.
T3: Tumour of more than 4 cm but not more than 6 cm in its greatest dimension, or tumour extending beyond the primary region through the external periosteum or the capsule of the gland.
T4: Tumour of more than 6 cm in its greatest dimension, or tumour extending to main neighbouring structures such as the base of skull, cranial cavity, cervical vertebrae, deep cervical muscles, carotid artery and thoracic cavity.
For N and M, the same criteria are used as in the UICC classification.
On the premise of recording by computer, the classification numbers of all malignant tumours according to the TNM system are recorded as the code numbers. Wide utilization of the classification is proposed by chronological and serial recording of the findings by codes during the course of treatment and follow-up.