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Stage IVA includes: (T4, N0, M0); (T4, N1, M0); (T4, N2, M0). T4: Nasopharyngeal cancer with intracranial extension and/or involvement of cranial nerves, hypopharynx, orbit, or with extension to the infratemporal fossa/masticator space. N0: No regional lymph node metastasis. N1: Nasopharyngeal cancer with unilateral metastasis in cervical lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa, and/or unilateral or bilateral, retropharyngeal lymph nodes, 6 cm or less in greatest dimension. Midline nodes are considered ipsilateral nodes. N2: Nasopharyngeal cancer with bilateral metastasis in cervical lymph node(s), 6 cm or less in greatest dimension, above the supraclavicular fossa. Midline nodes are considered ipsilateral nodes. M0: No distant metastasis. (AJCC 7th ed.)
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