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  • Stage IVB includes: (T4b, Any N, M0); (Any T, N3, M0). T4b: Tumor with very advanced local disease. Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures. N3: Metastasis in a lymph node more than 6 cm in greatest dimension. M0: No distant metastasis. (AJCC 7th ed.)
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