Salivary Gland Cancer Staging
Staging is the process of finding out if and how far a cancer has spread. The stage of a cancer is one of the most important factors in choosing treatment options and predicting your chance for cure and long-term survival.

Staging is based on the results of the physical exam, biopsy, the physician’s impression during or after surgery to remove the tumor (presence or absence of invasion of the tumor to other organs) and imaging tests (ultrasound, computed tomography scan, magnetic resonance imaging, positron emission tomography scan or endoscopy).

Stage I
In stage I, the tumor is in the salivary gland only and is 2 centimeters or smaller.

Stage II
In stage II, the tumor is in the salivary gland only and is larger than 2 centimeters but not larger than 4 centimeters.

Stage III
In stage III, one of the following is true:

The tumor is not larger than 4 centimeters and has spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.

The tumor is larger than 4 centimeters and/or has spread to soft tissue around the affected gland. Cancer may have spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.

Stage IV
Stage IV is divided into stages IVA, IVB and IVC as follows:

Stage IVA:
The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to one or more lymph nodes on either or both sides of the body and the lymph nodes are not larger than 6 centimeters; or

Cancer has spread to the skin, jawbone, ear canal and/or facial nerve, and may have spread to one or more lymph nodes on either or both sides of the body. The lymph nodes are not larger than 6 centimeters.

Stage IVB:
The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a lymph node larger than 6 centimeters; or

Cancer has spread to the base of the skull and/or the carotid artery, and may have spread to one or more lymph nodes of any size on either or both sides of the body.

Stage IVC:
The tumor may be any size and may have spread to soft tissue around the affected gland, to the skin, jawbone, ear canal, facial nerve, base of the skull or carotid artery, or to one or more lymph nodes on either or both sides of the body. Cancer has spread to distant parts of the body.

Salivary gland cancers are also grouped by grade. The grade of a tumor describes how fast the cancer cells are growing based on how the cells look under a microscope. Low-grade cancers grow more slowly than high-grade cancers.

Minor salivary gland cancers are staged according to where they were first found in the body.