## TNM Staging of Laryngeal Carcinoma **Key Point:** T1 laryngeal tumors are confined to one site of the larynx with normal vocal cord mobility. T1 is further subdivided into T1a (≤1 cm) and T1b (>1 cm but ≤2 cm). ### T Classification for Glottic Laryngeal Cancer | T Stage | Criteria | |---------|----------| | T1a | Tumor limited to one vocal cord, ≤1 cm | | T1b | Tumor limited to one vocal cord, >1 cm but ≤2 cm | | T2 | Tumor involves both vocal cords OR extends to supraglottis/subglottis | | T3 | Tumor with vocal cord fixation OR invades thyroid cartilage/anterior commissure | | T4a | Tumor invades through thyroid cartilage or soft tissues of neck | | T4b | Tumor invades prevertebral space, mediastinum, or encases carotid artery | ### Stage Grouping (N0 M0 tumors) | Stage | T Stage | |-------|----------| | Stage I | T1 | | Stage II | T2 | | Stage III | T3 | | Stage IVA | T4a | | Stage IVB | T4b | **High-Yield:** In this case, the lesion is confined to the left vocal cord with normal mobility and no cartilage invasion, making it T1. The question does not specify size, but the clinical presentation (3 months of hoarseness with a single vocal cord lesion) suggests a smaller tumor, consistent with T1a. However, if the lesion were >1 cm, it would be T1b. Given typical NEET PG convention and the absence of size specification favoring the smaller category, **T1a N0 M0 (Stage I)** is the most likely intended answer. **Clinical Pearl:** Early-stage glottic carcinomas (T1-T2, N0) have excellent prognosis with 5-year survival rates >90% with either radiation therapy or transoral laser microsurgery (TLM). **Mnemonic - Vocal Cord Involvement:** **FAINT** - **F**ixed cord = T3 (or higher) - **A**ffects both cords = T2 (or higher) - **I**nvasion of cartilage = T3 (or higher) - **N**ormal mobility, one cord = T1 - **T**hrough cartilage = T4 
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