Stages of hypopharyngeal cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for hypopharyngeal cancer is the TNM system. For hypopharyngeal cancer there are 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

Location of the Pharynx
Location of the Pharynx

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the lower part of the pharynx (throat) and has not spread to other parts of the body. Regional means close to the pharynx or around it. Distant means in a part of the body farther from the pharynx.

Find out more about staging cancer.

Stage 0 (carcinoma in situ)

The tumour is only in the lining of the hypopharynx.

Stage 1

The tumour is in only one area of the hypopharynx or it is not larger than 2 cm.

Stage 2

The tumour is in more than 1 area of the hypopharynx or an area next to the hypopharynx, or it is larger than 2 cm but not larger than 4 cm. The larynx (voice box) can move normally.

Stage 3

The tumour is any of the following:

  • It is larger than 4 cm.
  • It doesn’t allow the larynx to move normally.
  • It has reached the esophagus.


The cancer has spread to 1 lymph node in the neck that is no larger than 3 cm and is on the same side of the neck as the tumour.

Stage 4

Stage 4 hypopharyngeal cancer can be divided into stages 4A, 4B or 4C depending on:

  • which nearby areas the tumour has grown into
  • the number and size of the lymph nodes with cancer
  • if the cancer has grown outside of lymph nodes (extranodal extension)
  • whether the lymph nodes are on the same or opposite side of the neck as the tumour, or on both sides of the neck
  • if the cancer has spread to other parts of the body farther from the pharynx, such as to the lungs or liver (called distant metastasis)

Recurrent hypopharyngeal cancer

Recurrent hypopharyngeal cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.
  • Hamoir M, Machiels JP, Schmitz S, Gregoire V . Multidisciplinary management of hypopharyngeal carcinoma. Bernier J (ed.). Head and Neck Cancer: Multimodality Management. Springer; 2016: 28: 511-537.
  • Kruser TJ, Pagedar NA, Hoffman HT, Harari PM . Cancers of the hypopharynx and cervical esophagus: general principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 19: 482 - 509.
  • National Cancer Institute . Hypopharyngeal Cancer Treatment (PDQ®) Health Professional Version . 2016 :

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