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7. Oral Cavity
AJCC Cancer Staging Manual, Eighth Edition. ©2016 American College of Surgeons. All rights reserved. Last updated 5 June 2018.
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1 Terms of Use
The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination,
and staging evaluation, or for documenting treatment plans or follow-up. The staging forms available in conjunction with the AJCC Cancer
Staging Manual, Eighth Edition may be used by individuals without permission from the ACS or the publisher. They cannot be sold, distributed,
published, or incorporated into any software (including any electronic record systems), product, or publication without a written license
agreement with ACS. The forms cannot be modified, changed, or updated without the express written permission of ACS.
2 Instructions
See Principles of Cancer Staging (Chapter 1) of the AJCC Cancer Staging Manual, Eighth Edition for complete staging rules. Always refer to the
respective chapter in the Manual for disease-specific rules for classification, as this form is not representative of all rules, exceptions and
instructions for this disease.
This form may be used by physicians to record data on T, N, and M categories; prognostic stage groups; additional prognostic factors; cancer
grade; and other important information. This form may be useful for recording information in the medical record and for communicating
information from physicians to the cancer registrar.
The staging form may be used to document cancer stage at different points in the patient’s care
and during the course of therapy, including
before therapy begins, after surgery and completion of all staging evaluations, or at the time of recurrence. It is best to use a separate form for
each time point staged along the continuum for an individual cancer patient. However, if all time points are recorded on a single form, the
staging basis for each element should be identified clearly.
This form may provide more data elements than required for collection by standard setters such as NCI SEER, CDC NPCR, and CoC NCDB.
3 Time of Classification (select one):
Clinical Classification: Used for all patients with cancer identified before treatment. It is composed of diagnostic
workup information, until first treatment, including clinical history and symptoms, physical examination, imaging,
endoscopy, biopsy of the primary site, biopsy or excision of a single regional node or sentinel nodes, or sampling of
regional nodes, with clinical T, biopsy of distant metastatic site, surgical exploration without resection, and other
Pathological Classification: Used for patients if surgery is the first definitive therapy. Composed of information from
diagnostic workup from clinical staging combined with operative findings, and pathology review of resected surgical
Posttherapy Clinical Classification: after primary systemic and/or radiation therapy, or after neoadjuvant therapy and
before planned surgery. Criteria: First therapy is systemic and/or radiation therapy
Posttherapy Pathological Classification: Used for staging after neoadjuvant therapy and planned post neoadjuvant
therapy surgery. Criteria: First therapy is systemic and/or radiation therapy and is followed by surgery.
Recurrence or Retreatment Classification: Used for assigning stage at time of recurrence or progression until
treatment is initiated.
Autopsy Classification: Used for cancers not previously recognized that are found as an incidental finding at autopsy,
and not suspected before death (i.e., this classification does not apply if an autopsy is performed in a patient with a
previously diagnosed cancer).
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