Radiation Oncology Oral Boards – Flashcards
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Nasopharyngeal Cancer T1
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confined to NPX, or tumor extends to oropharynx (OPX) and/or nasal cavity without parapharyngeal extension
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Nasopharyngeal Cancer T2
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tumor with parapharyngeal extension (posterolat infiltration of tumor (i.e.. beyond pharyngobasilar fascia)
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Nasopharyngeal Cancer T3
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involves bony structures and/or paranasal sinuses
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Nasopharyngeal Cancer T4
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intracranial extension and/or involvement of CNs, infra temporal fossa, hypo pharynx, orbit, or masticator space.
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Nasopharyngeal Cancer N1
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unilat nodes greater or equal to 6cm above supraclavicular fossa and/or retropharyngeal LNs greater than or equal to 7cm (unilat or bilat)
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Nasopharyngeal Cancer N2
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bilat nodes greater than or equal to 6 cm abovesupraclavicular fossa
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Nasopharyngeal Cancer N3a
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LNs >6cm
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Nasopharyngeal Cancer 3b
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extension to supraclavicular fossa (includes some level IV-V nodes
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Nasopharyngeal Cancer Stage I
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T1N0
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Nasopharyngeal Cancer Stage II
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T1-2N1, T2N0
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Nasopharyngeal Cancer Stage III
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T3N0-2, any N2
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Nasopharyngeal Cancer Stage IVA
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T4N0-2
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Nasopharyngeal Cancer Stage IVB
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N3
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Nasopharyngeal Cancer Stage IVC
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M1
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Sinonasal Tract Tumors T1
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confined to sinus, no bone erosion
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Sinonasal Tract Tumors T2
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bone erosion without involvement of post wall of maxillary sinus or pterygoid plate
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Sinonasal Tract Tumors T3
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invasion of post wall of max sinus, pterygoid fossa, floor/wall of orbit, ethmoid sinus
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Sinonasal Tract Tumors T4a
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invasion of ant orbital structures, skin of cheek, pterygoid plate, infra temporal fossa, cribriform plate, sphenoid or frontal sinus
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Sinonasal Tract Tumors T4b
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invasion of orbital apex, nasopharynx, clivus, intracranial extension, CN involvement (except V2)
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Sinonasal Tract Tumors N1
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single, ipso, <3cm
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Sinonasal Tract Tumors N2a
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single, ipso, 3-6cm
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Sinonasal Tract Tumors N2b
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multiple, ipsi, < or = 6cm
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Sinonasal Tract Tumors N2c
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bilat or contralat, < or = 6cm
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Sinonasal Tract Tumors N3
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> 6 cm
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Sinonasal Tract Tumors Stage I
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T1N0
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Sinonasal Tract Tumors Stage II
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T2N0
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Sinonasal Tract Tumors Stage III
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T3N0 or T1-3N1
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Sinonasal Tract Tumors Stage IVA
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T4aN0-2 or T1-3N2
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Sinonasal Tract Tumors Stage IVB
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T4b or N3
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Sinonasal Tract Tumors Stage IVC
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M1
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Oral Cavity Cancer T1
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< 2 cm
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Oral Cavity Cancer T2
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2-4 cm
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Oral Cavity Cancer T3
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> 4 cm
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Oral Cavity Cancer T4a
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invasion of adjacent structures (bone, deep tongue muscles, maxillary sinus), resectable
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Oral Cavity Cancer T4b
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very advanced (invasion of masticator space, pterygoid plates, skull base, carotid artery) and typically unresectable
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Oral Cavity Cancer Stage I
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T1N0
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Oral Cavity Cancer Stage II
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T2N0
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Oral Cavity Cancer Stage III
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T3N0 or T1-3N1
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Oral Cavity Cancer Stage IVA
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T4a or N2 Dz
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Oral Cavity Cancer Stage IVB
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T4b or N3 Dz
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Oral Cavity Cancer Stage IVC
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M1 Dz
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Oropharyngeal Cancer T1
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< or = 2 cm
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Oropharyngeal Cancer T2
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2-4 cm
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Oropharyngeal Cancer T3
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>4 cm
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Oropharyngeal Cancer T4a
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invades larynx, deep/extrinsic tongue muscles, medial pterygoid, hard palate, mandible
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Oropharyngeal Cancer T4b
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invades lat pterygoid muscle, pterygoid plate, lat nasopharynx, skull invasion, carotid encasement
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Oropharyngeal Cancer Stage I
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T1N0
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Oropharyngeal Cancer Stage II
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T2N0
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Oropharyngeal Cancer Stage III
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T3N0 ot T1-3N1
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Oropharyngeal Cancer Stage IVA
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T4aN0-1 or T1-4aN2
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Oropharyngeal Cancer Stage IVB
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T4b or N3
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Oropharyngeal Cancer Stage IVC
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M1
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Salivary Gland Cancer T1
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< or = 2 cm
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Salivary Gland Cancer T2
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2-4 cm
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Salivary Gland Cancer T3
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> 4 cm
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Salivary Gland Cancer T4a
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local invasion of adjacent structures usually still resectable; skin, mandible, ear, facial nerve invasion
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Salivary Gland Cancer T4b
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local invasion of adjacent structures usually unresectable; skull vase, pterygoid plate, carotid artery invasion
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Salivary Gland Cancer Stage I
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T1N0
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Salivary Gland Cancer Stage II
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T2N0
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Salivary Gland Cancer Stage III
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T3N0 or T1-3N1
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Salivary Gland Cancer Stage IVA
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T4aN0-1 or T1-4aN2
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Salivary Gland Cancer Stage IVB
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T4b any N or any TN3
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Salivary Gland Cancer Stage IVC
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any T any NM1
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Supraglottic Larynx Cancer T1
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1 subsite
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Supraglottic Larynx Cancer T2
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1 adjacent subsite or outside supra glottis (base of tongue (BOT), vallecula, pyriform sinus) without fixation of larynx
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Supraglottic Larynx Cancer T3
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cord fixation and/or invasion of postcricoid area or pre-epiglottic tissue
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Supraglottic Larynx Cancer T4a
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Resectable, through thyroid cartilage, trachea, soft tissue of neck, deep/intrinsic muscles of tongue, thyroid, esophagus
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Supraglottic Larynx Cancer T4b
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invasion of pre vertebral space, mediastinum, carotid
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Glottic Larynx Cancer T1
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limited to TVCs +/- ant/post commissure involvement with normal mobility (1a, 1 TVC; 1b, both cords)
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Glottic Larynx Cancer T2
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extends to supr- or sub glottis with impaired vocal cord mobility
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Glottic Larynx Cancer T3
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fixed vocal cords
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Glottic Larynx Cancer T4a
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Resectable, through thyroid cartilage, trachea, soft tissue of neck, deep/intrinsic musles of tongue, thyroid, esophagus
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Glottic Larynx Cancer T4b
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invasion of pre vertebral space, mediastinum, carotid
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Subglottic Larynx Cancer T1
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tumor limited to subglottis
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Subglottic Larynx Cancer T2
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extension to vocal cords, with normal or impaired mobility
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Subglottic Larynx Cancer T
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limited to larynx with vocal cord fixation
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Subglottic Larynx Cancer T1
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Resectable, through thyroid cartilage, trachea, soft tissue of neck, deep/intrinsic musles of tongue, thyroid, esophagus
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Subglottic Larynx Cancer T1
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invasion of pre vertebral space, mediastinum, carotid
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Hypopharynx Cancer T1
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<2 cm or 1 subsite
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Hypopharynx Cancer T1=2
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2-4 cm or >1 subsite
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Hypopharynx Cancer T3
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>4cm or fixation of hemilarynx
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Hypopharynx Cancer T4a
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invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, esophagus or central soft tissue
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Hypopharynx Cancer T4b
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invades prevertebral fascia, carotid artery or mediastinal structures
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Laryngeal and Hypopharyngeal Cancer Stage I-II
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T1-2N0
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Laryngeal and Hypopharyngeal Cancer Stage III
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T3N0 or N1
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Laryngeal and Hypopharyngeal Cancer Stage IVA
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T4a or N2
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Laryngeal and Hypopharyngeal Cancer Stage IVB
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T4b or N3
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Laryngeal and Hypopharyngeal Cancer Stage IVC
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M1
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Thyroid Cancer T1a
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< 1 cm
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Thyroid Cancer T1b
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> 1cm and < 2 cm
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Thyroid Cancer T2
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2-4 cm (limited to thyroid)
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Thyroid Cancer T3
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> 4 cm with only min extra thyroidal extension
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Thyroid Cancer T4a
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local extension but still technically resectable
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Thyroid Cancer T4b
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unresectable Dz
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Thyroid Cancer N1a
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mets to pre/paratracheal nodes, prelaryngeal nodes (level VI)
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Thyroid Cancer N1b
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mets to cervical neck (levels I-V), upper mediastinal nodes
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Thyroid Cancer Stage I
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M0 and age or = 45 yrs
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Thyroid Cancer Stage II
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M1 and age or = 45 yrs
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Thyroid Cancer Stage III
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T3N0 or T1-3N1a and age > or = 45 yrs
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Thyroid Cancer Stage IVA
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T4a or N1b and age > or = 45 yrs
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Thyroid Cancer IVB
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T4b and age age > or = 45 yrs
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Thyroid Cancer IVC
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M1 and age > or = 45 yrs
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Mesothelioma Cancer TIS
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CIS
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Mesothelioma Cancer T1a
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limited to ipso parietal pleura, no visceral pleural involvement
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Mesothelioma Cancer T1b
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+ipsi parietal pleural and focal involvement of visceral pleura
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Mesothelioma Cancer T2
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involves ipso pleural surfaces with at least 1 of the following a) confluent visceral pleural tumor, b) invasion of diaphragmatic muscle, or c) solitary focus of tumor invading soft tissues of CW, and d) nontransmural involvement of pericardium
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Mesothelioma Cancer T3
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involves any ipso pleural surfaces with at least 1 of the following a) invasion of endothoracic fascia, b) invasion into mediastinal fat, c) solitary focus of tumor invading soft tissues of CW, and d) nontransmural involvement of pericardium
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Mesothelioma Cancer T4
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involves any ipso pleural surfaces with at least 1 of the following: a) diffuse or multifocal invasion of soft tissues of CW, b) any rib involvement, c) invasion through diaphragm to peritoneum, d) invasion of any mediastinal organs, e) direct extension to contralto pleura, f) invasion into spine, g) extension to internal surface of pericardium, h) pericardial effusion and j) invasion of brachial plexus
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Mesothelioma Cancer N1
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mets involving brochopulmonary or hilar nodes
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Mesothelioma Cancer N2
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mets to ipsi mediastinum (MN) or to subcarinal or internal mammary nodes
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Mesothelioma Cancer N3
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mets to contralat MN, internal mammary nodes, or hilar LNs, or to ipsi or contralat supraclavicular nodes
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Mesothelioma Cancer Stage IA
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T1aN0
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Mesothelioma Cancer Stage IB
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T1bN0
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Mesothelioma Cancer Stage II
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T2N0
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Mesothelioma Cancer Stage III
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T1-2N1-2 or T3N0-2
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Mesothelioma Cancer Stage IV
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T4 or N3 or M1
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Breast Cancer T0
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no primary tumor found
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Breast Cancer Tis
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in situ (DCIS or LCIS or Paget's)
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Breast Cancer T1
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≤ 2 cm
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Breast Cancer T1mi
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≤ 0.1 cm (microinvasive)
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Breast Cancer T1a
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> 0.1 to 0.5 cm
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Breast Cancer T1b
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> 0.5 to 1 cm
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Breast Cancer T1c
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> 1 to 2 cm
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Breast Cancer T2
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> 2 to 5 cm
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Breast Cancer T3
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> 5 cm
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Breast Cancer T4
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Chest wall /skin
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Breast Cancer T4a
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Chest wall (not including pectoralis muscle)
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Breast Cancer T4b
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Skin edema (peau d'orange), ulceration, or satellite skin nodules
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Breast Cancer T4c
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4a and 4b Chest wall (not including pectoralis muscle) and Skin edema (peau d'orange), ulceration, or satellite skin nodules
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Breast Cancer T4d
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Inflammatory carcinoma
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Breast Cancer cN0
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No lymph node metastases
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Breast Cancer cN1
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Movable ipsilateral axillary lymph nodes
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Breast Cancer cN2a
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Ipsilateral axillary lymph nodes fixed or matted
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Breast Cancer cN2b
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Clinically detected internal mammary nodes in the absence of axillary lymph node metastases
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Breast Cancer cN3a
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Infraclavicular lymph nodes (level III)
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Breast Cancer cN3b
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Clinically apparent internal mammary nodes with axillary lymph node involvement
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Breast Cancer cN3c
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Supraclavicular lymph nodes
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Breast Cancer pN0
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No lymph node metastases
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Breast Cancer pN1mi
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Micrometastases (> 0.2mm but <= 2.0 mm)
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Breast Cancer pN1a
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1-3 axillary lymph nodes (at least 1 > 2.0mm)
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Breast Cancer pN1b
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Metastases in IM nodes (micrometastases, or macrometastases detected by SLN biopsy but not clinically detected)
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Breast Cancer pN1c
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1-3 axillary lymph nodes and metastases in IM nodes (micrometastases, or macromets detected by SLN but not clinically detected)
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Breast Cancer pN2a
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4-9 axillary lymph nodes (at least 1 > 2.0 mm)
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Breast Cancer pN2b
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Metastases in clinically detected IM nodes in the absence of axillary lymph nodes
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Breast Cancer pN3a
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10 or more axillary lymph nodes (at least 1 > 2.0 mm); or infraclavicular (level III) lymph nodes
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Breast Cancer pN3b
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Metastases in clinically detected IM nodes in the presence of positive axillary nodes; or microscopic IM nodes and more than 3 axillary lymph nodes
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Breast Cancer pN3c
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Supraclavicular lymph nodes
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Breast Cancer Stage 0
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Tis
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Breast Cancer Stage IA
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T1 N0
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Breast Cancer Stage IB
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T0-T1 N1mi
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Breast Cancer Stage IIA
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T0-1 N1 or T2 N0
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Breast Cancer Stage IIB
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T2 N1 or T3 N0
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Breast Cancer Stage IIIA
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T3 N1 or T0-3 N2
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Breast Cancer Stage IIIB
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T4 N0-2
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Breast Cancer Stage IIIC
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N3
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Breast Cancer Stage IV
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M1
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Esophagus Cancer T1
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invades lamina propria, muscular mucosae, or submucosa
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Esophagus Cancer T1a
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invades lamina propria or muscular mucosae
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Esophagus Cancer T1b
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invades submucosa
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Esophagus Cancer T2
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invades mucularis propria
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Esophagus Cancer T3
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invades adventitia
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Esophagus Cancer T4
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invades adjacent structures
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Esophagus Cancer T4a
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resectable tumor invading pleura, pericardium, or diaphragm
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Esophagus Cancer T4b
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unresectable tumor invading other adjacent structures, such as aorta, vertebral body, trachea, etc.
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Esophagus Cancer N0
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no lymph node metastases
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Esophagus Cancer N1
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metastasis in 1-2 regional nodes
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Esophagus Cancer N2
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metastasis in 3-6 regional nodes
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Esophagus Cancer N3
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metastasis in 7 or more nodes
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Stomach Cancer Tis
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in situ; no invasion of lamina propria
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Stomach Cancer T1
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(mucosal invasion) invades lamina propria, muscularis mucosae, or submucosa
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Stomach Cancer T1a
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invades lamina propria or muscular mucosae
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Stomach Cancer T1b
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invades submucosa
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Stomach Cancer T2
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(wall invasion) invades muscularis propria
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Stomach Cancer T3
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penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures
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Stomach Cancer T4
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invades serosa (visceral peritoneum) or adjacent structures
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Stomach Cancer 4a
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invades serosa (visceral peritoneum)
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Stomach Cancer 4b
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invades adjacent structures
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Stomach Cancer N0
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no nodes
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Stomach Cancer N1
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1-2 nodes
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Stomach Cancer N2
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3-6 nodes
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Stomach Cancer N3
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7 or more nodes
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Stomach Cancer N3a
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7-15 nodes
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Stomach Cancer N3b
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16 or more nodes
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Stomach Cancer Stage IA
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(add to 1) T1N0
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Stomach Cancer Stage IB
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(add to 2) T1N1 or T2N0
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Stomach Cancer Stage IIA
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(add to 3) T1N2, T2N1, T3N0
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Stomach Cancer Stage IIB
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(add to 4) T1N3, T2N2, T3N1, T4aN0
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Stomach Cancer Stage IIIA
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(add to 5) T2N3, T3N2, T4aN1
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Stomach Cancer Stage IIIB
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(add to 6 or T4b) T3N3, T4a N2, T4b N1, T4b N0
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Stomach Cancer Stage IIIC
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T4aN3, T4b N2-3
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Stomach Cancer Stage IV
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Any M1
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Anus Cancer Tis
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carcinoma in situ
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Anus Cancer T1
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2 cm or less
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Anus Cancer T2
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2 - 5 cm
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Anus Cancer T3
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>5 cm
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Anus Cancer T4
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invades adjacent organ, e.g. vagina, urethra, bladder. (invasion of the rectal wall, perirectal skin, subcutaneous tissue, or sphincter muscle is not included as T4.)
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Anus Cancer N0
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no lymph nodes
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Anus Cancer N1
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perirectal lymph nodes
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Anus Cancer N2
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unilateral internal iliac or (unilateral) inguinal lymph nodes or both
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Anus Cancer N3
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perirectal AND inguinal lymph nodes; and/or bilateral internal iliac; and/or (bilateral) inguinal lymph nodes
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Anus Cancer Stage 0
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Tis
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Anus Cancer Stage I
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T1 N0
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Anus Cancer Stage II
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T2-3 N0
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Anus Cancer Stage IIIA
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T1-3 N1, T4 N0
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Anus Cancer Stage IIIB
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T4 N1, Any N2, Any N3
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Anus Cancer Stage IV
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M1
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Sarcoma T1
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less than or equal to 5cm
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Sarcoma T1a
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superficial, less than or equal to 5cm
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Sarcoma T1b
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deep, less than or equal to 5cm
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Sarcoma T2
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greater than 5cm
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Sarcoma T2a
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superficial, greater than 5cm
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Sarcoma T2b
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deep, greater than 5cm
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Sarcoma N0
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no regional lymph nodes
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Sarcoma N1
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there are regional lymph nodes
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Sarcoma M0
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No Distant Metastases
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Sarcoma M1
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there are Distant Metastases
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Sarcoma Stage IA
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T1a/b N0 G1 - low grade (grade 1), small
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Sarcoma Stage IB
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T2a/b N0 G1 - low grade (grade 1), large
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Sarcoma Stage IIA
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T1a/b N0 G2-3 - mod/high grade (grade 2-3), small
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Sarcoma Stage IIB
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T2a/b N0 G2 - mod grade (grade 2), large
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Sarcoma Stage III
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T2a/b G3, or N1 - high grade (grade 3), large; or node positive
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Sarcoma Stage IV
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M1 - metastatic
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Cervical Cancer Tis
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Carcinoma in situ
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Cervical Cancer FIGO IA1
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Confined to uterus (extension to corpus should be disregarded). Invasive carcinoma visible only by microscopy. Stromal invasion 3.0 mm or less in depth and 7.0 mm or less in horizontal spread
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Cervical Cancer FIGO IA2
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Confined to uterus (extension to corpus should be disregarded). Invasive carcinoma visible only by microscopy. Stromal invasion >3.0-5.0 mm in depth and 7.0 mm or less in horizontal spread
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Cervical Cancer FIGO IB1
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Clinically visible lesion 4.0 cm or less, or microscopic lesion > IA2.
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Cervical Cancer FIGO IB2
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Clinically visible lesion more than 4.0 cm or microscopic lesion > IA2
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Cervical Cancer FIGO IIA1
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Invades beyond uterus but not to pelvic wall or lower 1/3 of vagina. Without parametrial invasion (i.e. involves upper 2/3 of vagina). Clinically visible lesion 4.0 cm or less
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Cervical Cancer FIGO IIA2
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Invades beyond uterus but not to pelvic wall or lower 1/3 of vagina. Without parametrial invasion (i.e. involves upper 2/3 of vagina). Clinically visible lesion more than 4.0 cm
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Cervical Cancer FIGO IIB
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Invades beyond uterus but not to pelvic wall or lower 1/3 of vagina. With parametrial invasion
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Cervical Cancer FIGO IIIA
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Extends to pelvic wall, lower 1/3 of vagina, or causes hydronephrosis. Involves lower 1/3 of vagina, no extension to pelvic wall
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Cervical Cancer FIGO IIIB
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Extends to pelvic wall, lower 1/3 of vagina, or causes hydronephrosis. Extends to pelvic wall or causes hydronephrosis or non-functioning kidney
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Cervical Cancer FIGO IVA
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Invades mucosa of bladder or rectum or extends beyond true pelvis (bullous edema not sufficient)
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Cervical Cancer FIGO IVB
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Distant metastasis
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Cervical Cancer N0
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No regional LN metastasis
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Cervical Cancer N1
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Regional LN metastasis
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Vulva Cancer Tis
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in situ
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Vulva Cancer Staging/FIGO IA (N0)
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≤ 2 cm in size and <= 1mm depth of stromal invasion
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Vulva Cancer Staging/FIGO IB (N0)
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> 2 cm in size, or any size with >1mm depth of stromal invasion
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Vulva Cancer Staging/FIGO II (N0)
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extension to adjacent perineal structures (lower/distal 1/3 urethra, lower/distal 1/3 vagina, or anal involvement)
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Vulva Cancer Staging/FIGO IIIA (N1)
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N1a - 1-2 LN mets, each < 5 mm N1b - 1 LN met ≥ 5 mm
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Vulva Cancer Staging/ FIGO IIIB (N2a & N2b)
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(N2a) 3 or more LN, each < 5 mm each (N2b) 2 or more LN ≥ 5 mm
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Vulva Cancer Staging/ FIGO IIIC (N2c)
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LN with extracapsular spread
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Vulva Cancer Staging/ FIGO IVA (N3)
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extension to any of the following: upper/proximal 2/3 of urethra, upper/proximal 2/3 of vagina, bladder mucosa, rectal mucosa, or fixed to pelvic bone. (N3) fixed or ulcerated LN
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Vulva Cancer Staging/ FIGO IVB (M1)
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Distant Metastases (includes pelvic LN met)
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Uterine Sarcoma FIGO IA (T1a)
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limited to the uterus. 5 cm or less
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Uterine Sarcoma FIGO IB (T1b)
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limited to the uterus. more than 5 cm
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Uterine Sarcoma FIGO IIA (T2a)
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extends beyond uterus but within the pelvis. involves adnexa
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Uterine Sarcoma FIGO IIB (T2b)
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extends beyond uterus but within the pelvis. involves other pelvic tissues
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Uterine Sarcoma FIGO IIIA (T3a)
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tumor infiltrates abdominal tissues (must infilitrate the tissues and not just protrude into the abdominal cavity). One site.
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Uterine Sarcoma FIGO IIIB (T3b)
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tumor infiltrates abdominal tissues (must infilitrate the tissues and not just protrude into the abdominal cavity). More than one site.
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Uterine Sarcoma FIGO IIIC (N1)
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invades regional lymph nodes
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Uterine Sarcoma FIGO IVA (T4)
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invades bladder or rectum
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Uterine Sarcoma FIGO IVB (M1)
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Distant Metastases
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Uterine Sarcoma N0
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no regional lymph nodes
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Uterine Cancer Tis
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in situ
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Uterine Cancer FIGO IA (T1a)
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confined to corpus. limited to endometrium or invades less than 1/2 of myometrium
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Uterine Cancer FIGO IB (T1b)
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confined to corpus. invades ≥ 1/2 of myometrium
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Uterine Cancer FIGO II (T2)
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invades stromal tissue of the cervix but does not extend beyond uterus Note: endocervical glandular involvement only should be considered as Stage I not Stage II
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Uterine Cancer FIGO IIIA (T3a)
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involves serosa and/or adnexa (direct extension or metastasis)
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Uterine Cancer FIGO IIIB (T3b)
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vaginal involvement (direct extension or metastasis) or parametrial involvement
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Uterine Cancer FIGO IIIC1 (N1)
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metastasis to pelvic lymph nodes Regional nodes include obturator, internal iliac, external iliac, common iliac, para-aortic, presacral, and parametrial Note: For pathologic staging, FIGO classifies cases with <6 resected LNs as pNX
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Uterine Cancer FIGO IIIC2 (N2)
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metastasis to para-aortic lymph nodes. Regional nodes include obturator, internal iliac, external iliac, common iliac, para-aortic, presacral, and parametrial Note: For pathologic staging, FIGO classifies cases with <6 resected LNs as pNX
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Uterine Cancer FIGO IVA (T4)
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invades bladder mucosa and/or bowel mucosa
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Uterine Cancer FIGO IVB (M1)
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distant metastasis - includes inguinal LN, intraperitoneal disease (including omentum), lung, liver, or bone.
