Stages of laryngeal cancer

Talk to your doctor if you have questions. Find out more about staging cancer.

The following is staging for supraglottic carcinoma, which starts in the top part of the larynx (the supraglottis), above the vocal cords.

The cancer is in the top layer of cells that line the supraglottis and has not grown deeper. It also hasnʼt spread to nearby lymph nodes or to distant parts of the body. This is also called carcinoma in situ.

The cancer has grown deeper, but it is only in one part of the supraglottis. The vocal cords can still move normally. It hasn’t spread to nearby lymph nodes or to distant parts of the body.

The cancer has grown into more than one part of the supraglottis or is in the glottis, but the vocal cords can move normally. It hasnʼt spread to nearby lymph nodes or to distant parts of the body.

Stage 3 is one of the following:

• The tumour is only in the larynx and the vocal cords can't move, or it has grown into areas near the larynx, such as the tissue in front of the epiglottis or the inner part of the thyroid cartilage and the vocal cords may not move. It hasnʼt spread to nearby lymph nodes or to distant parts of the body.
• The tumour may have grown into areas near the larynx and it may have affected a vocal cord. The cancer has spread to one nearby lymph node on the same side of the neck as the tumour. The cancer in the lymph node is no greater than 3 cm. It hasn’t spread to distant parts of the body.

Stage 4 is divided into 3 stages: 4a, 4b and 4c.

Stage 4a is one of the following:

• The tumour has grown into structures outside of the larynx such as the thyroid gland, trachea, esophagus, tongue or neck muscles. The cancer hasnʼt spread to nearby lymph nodes or it has spread to one lymph node on the same side of the neck as the tumour. The cancer in the lymph node is no larger than 3 cm.

• The tumour may have grown into structures outside of the larynx and it may have affected a vocal cord. The cancer has spread to one or more lymph nodes on the same side of the neck as the tumour. The cancer in the lymph node is at least 3 cm.

Stage 4a cancer of the larynx is also called moderately advanced local disease.

Stage 4b is one of the following:

• The tumour has grown into the space in front of the spine (called the prevertebral space), around a nearby blood vessel (called the carotid artery), or into structures in the space between the lungs (called the mediastinum). The cancer may have spread to nearby lymph nodes but hasn’t spread to distant parts of the body.

• The cancer may have grown into structures outside of the larynx and it may have affected a vocal cord. The cancer has spread to at least one lymph node and the cancer in that lymph node is larger than 6 cm, or it has grown outside of the lymph node. The cancer hasn’t spread to distant parts of the body.

Stage 4b cancer of the larynx is also called very advanced local disease.

The tumour may have grown into structures outside of the larynx and it may have affected a vocal cord. It may have spread to nearby lymph nodes. The cancer has spread to distant parts of the body, such as the lungs.

The following is staging for glottic carcinoma, which starts in the middle part of the larynx and includes the vocal cords.

The cancer is in the top layer of cells that line the glottis and hasnʼt grown deeper. It also hasn’t spread to nearby lymph nodes or to distant parts of the body. This is also called carcinoma in situ.

The cancer has grown deeper into the glottis but is still within the vocal cords. The vocal cords can still move normally. It hasnʼt spread to nearby lymph nodes or to distant parts of the body.

The cancer has grown into the the supraglottis or subglottis. The vocal cords may not move normally. It hasn’t spread to nearby lymph nodes or to distant parts of the body.

Stage 3 can be one of the following:

• The cancer is only within the larynx and the vocal cords can’t move. Or the tumour has grown into areas near the larynx such as the thyroid cartilage or the space on either side of the voice box (called the paraglottic space), and the vocal cords may no longer move.
• The cancer has spread to one nearby lymph node on the same side of the neck as the tumour. The cancer in the lymph node is no greater than 3 cm.

Stage 4 is divided into 3 stages: 4a, 4b and 4c.

Stage 4a means one of the following:

• The cancer has grown into structures outside of the larynx such as the thyroid gland, trachea, esophagus, tongue or neck muscles. The cancer hasnʼt spread to nearby lymph nodes or it has spread to one lymph node on the same side of the neck as the tumour. The cancer in the lymph node is no larger than 3 cm.
• The cancer may have grown into structures outside of the larynx and affected a vocal cord. It has spread to one or more lymph nodes on the same side of the neck as the tumour. The cancer in the lymph node is at least 3 cm.

Stage 4a cancer of the larynx is also called moderately advanced local disease.

Stage 4b is one of the following:

• The cancer has grown further into the neck, into the area in front of the spine (called the prevertebral space), around a nearby blood vessel (called the carotid artery), or into structures in the space between the lungs (called the mediastinum). The cancer may have spread to nearby lymph nodes and has not spread to distant parts of the body.

• The cancer may have grown into structures outside of the larynx and affected a vocal cord. It has spread to at least one lymph node and is at least 6 cm, or it has spread outside of the lymph node. It hasn’t spread to distant parts of the body.

Stage 4b cancer of the larynx is also called very advanced local disease.

The cancer may have grown into structures outside of the larynx and affected a vocal cord. It may have spread to nearby lymph nodes. The cancer has spread to distant parts of the body, such as the lungs.

The following is staging for subglottic carcinoma, which starts in the bottom part of the larynx (the subglottis), below the vocal cords.

The cancer is in the top layer of cells that line the subglottis and has not grown deeper. It hasnʼt spread to nearby lymph nodes or to distant parts of the body. This is also called carcinoma in situ.

The cancer has grown deeper but is in the subglottis only. It hasn’t spread to nearby lymph nodes or to distant parts of the body.

The cancer has grown into the vocal cords, which may no longer move normally. It hasnʼt spread to nearby lymph nodes or to distant parts of the body.

Stage 3 is one of the following:

• The cancer is only in the larynx and one vocal cord can’t move. Or the cancer is growing into the space on either side of the larynx (called the paraglottic space) or into the thyroid cartilage. The cancer hasn’t spread to nearby lymph nodes or distant parts of the body.
• The cancer may have grown into structures outside the larynx and affected a vocal cord. It has spread to one nearby lymph node on the same side of the neck as the tumour. The cancer in this lymph node is not larger than 3 cm. The cancer hasnʼt spread to distant parts of the body.

Stage 4 is divided into three stages: 4a, 4b and 4c.

Stage 4a is one of the following:

• The cancer has grown into and through the cricoid or thyroid cartilage. It may be growing into structures outside of the larynx such as the thyroid gland, trachea, esophagus, tongue or neck muscles. The cancer hasn’t spread to nearby lymph nodes or it has spread to one lymph node on the same side of the neck as the tumour. The cancer in the lymph node is no larger than 3 cm. The cancer hasnʼt spread to distant parts of the body.
• The cancer may have grown into structures outside of the larynx and affected a vocal cord. It has spread to one or more lymph nodes on the same side of the neck as the tumour. The cancer in the lymph node is at least 3 cm. The cancer hasn’t spread to distant parts of the body.

Stage 4a cancer of the larynx is also called moderately advanced local disease.

Stage 4b is one of the following:

• The cancer has grown further into the neck, into the area in front of the spine (called the prevertebral space), around a nearby blood vessel (called the carotid artery), or into structures in the space between the lungs (called the mediastinum). The cancer may have spread to nearby lymph nodes but hasnʼt spread to distant parts of the body.

• The cancer may have grown into structures outside of the larynx and affected a vocal cord. It has spread to at least one lymph node and the cancer in that lymph node is larger than 6 cm, or it has spread outside of the lymph node. It hasn’t spread to distant parts of the body.

Stage 4b cancer of the larynx is also called very advanced local disease.

The cancer has grown into structures outside of the larynx and affected a vocal cord. It may have spread to nearby lymph nodes. The cancer has spread to distant parts of the body, such as the lungs.

Recurrent laryngeal 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.