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  • Stage IVA includes: (T4a, N0, M0); (T4a, N1, M0); (T1, N2, M0); (T2, N2, M0); (T3, N2, M0); (T4a, N2, M0). T4a: Moderately advanced local disease. Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, or central compartment soft tissue. Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat. T1: Tumor limited to one subsite of hypopharynx and/or 2 cm or smaller in greatest dimension. T2: Tumor invading more than one subsite of hypopharynx or an adjacent site, or measuring more than 2 cm but not more than 4 cm in greatest dimension without fixation of hemilarynx. T3: Tumor larger than 4 cm in greatest dimension or with fixation of hemilarynx or extension to esophagus. 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(-). M0: No distant metastasis. (AJCC 8th ed.)
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