According to the 8th edition AJCC staging, a patient with a 4.5 cm squamous cell carcinoma of the oral tongue with a depth of invasion of 12 mm and a single ipsilateral lymph node of 2.5 cm without extranodal extension is classified as:
- A T2 N1 — Stage III
- B T3 N1 — Stage III ✓
- C T3 N2b — Stage IVA
- D T2 N2a — Stage IVA
Correct answer: B. T3 N1 — Stage III
Explanation
In the 8th AJCC edition, oral cavity T staging now incorporates depth of invasion (DOI): T1 ≤2 cm with DOI ≤5 mm; T2 if tumor ≤2 cm with DOI 5-10 mm or >2 cm but ≤4 cm with DOI ≤10 mm; T3 if >4 cm OR DOI >10 mm. This 4.5 cm tumor with 12 mm DOI meets T3 criteria independently on both counts. A single ipsilateral node ≤3 cm without ENE is N1. T3N1 = Stage III.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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