Stage IV Oropharyngeal (p16-Negative) Carcinoma AJCC v8

**Semantic type:** Neoplastic Process

**Definition:** Stage IV includes: IVA: (T4a, N0, M0); (T4a, N1, M0); (T1, N2, M0); (T2, N2, M0); (T3, N2, M0); (T4a, N2, M0); IVB: (Any T, N3, M0); (T4b, Any N, M0); IVC: (Any T, Any N, M1). T4a: Moderately advanced local disease. Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible. Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of the larynx. T1: Tumor 2 cm or smaller in greatest dimension. T2: Tumor larger than 2 cm but not larger than 4 cm in greatest dimension. T3: Tumor larger than 4 cm in greatest dimension or extension to lingual surface of epiglottis. T4b: Very advanced local disease. Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery. N0: No regional lymph node metastasis. N1: Tumor with metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE (-). N2: Tumor with metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(-); or metastases in multiple ipsilateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(-); or metastases in bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(-). N3: Tumor with metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(-); or metastasis in a single ipsilateral lymph node larger than 3 cm in greatest dimension and ENE(+); or metastases in multiple ipsilateral, contralateral, or bilateral lymph nodes any with ENE(+). M0: No distant metastasis. M1: Distant metastasis. (AJCC 8th ed.)

**Synonyms:** - Stage IV Oropharyngeal (p16-Negative) Squamous Cell Carcinoma AJCC v8 - Stage IV Oropharyngeal (p16-Negative) Throat Cancer