ede LL ots cand Anatomic site a Le ‘OP: tonsil, base of tongue ae cd Larynx, OC, hypopharynx ‘Younger Older 3 Tobacco/Etoh Marijuana Diethygiene Clinical presentation | Unknown or cystic primary Classical Incidence Increasing Decreasing Comorbidities Greater Tene ce Cae aO Head and Neck Changes Worse + For all sites there are separate classifications for clinical and pathological neck nodes There is a new classification for p16 positive oropharyngeal cancers. Tumours that have p16 immunohistochemistry overexpression. The classification for nasopharyngeal cancers and thyroid cancers has been modified The there is a new classification for squamous cell carcinoma of the skin in the head and neck region There is a new classification for cervical nodal involvement with unknown primaryClinical Ni, N2a, N2b and N2c unchanged || Ni, N2a, N2b and N2c unchanged other than specify without other than specify without extranodal extension extranodal extension pN3a Metastasis in a lymph node N3a Metastasis in a lymph node_ more than 6 cmin greatest ‘dimension without extranodal ‘extension N3b Metastasis in a single or Clinical and Pathological T categories + Ti Tumour 2.cm or less in greatest dimension + 72. Tumour more than 2 cm but not more than 4 om. + 73. Tumour more than 4 cmin or extension to lingual surface of epigitiis +74 a, Tum invades ay ofthe flowing: Ina, deep/ tink mace of ‘tongue (genioglossus, hyoglossus, palatoglossus, and styloglossus), medial pterygoid, hard palate, mandible*; lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, stall base; or encases carotid arteryClinical N categories ‘NO _No regional lymph node metastasis Ni Unilateral metastasis, in lymph node(S) all 6 cm or less N2 Clinical Pathological Stage 11,72 NOt Mo ||StageI T1,72 NO1 Mo Stage I 12,72 N2 Mo ||StageNT3,72 N2 Mo 73 _NONi,N2_— MO 13 NONI Stage II T1-T4 N3 MO ||StageIT3,T4 NZ Mo 14 AnyN MO Stage IV AnyT AnyN Mo ||StageV AnyT AnyN Mo[FHP postive stage as per nasopharyngeal carcinomas |Fp16 postive stage as per p16 postive oropharyra: carcinomas {FHP and pi6 negative clinical and pathological node definiéons are as ‘above ‘StogeM™ TO Ni ‘Stage WA TO NZ ‘Stage WB TO N3 ‘Stage WC TO N3,N2, N3