CA Nasopharynx

Cancers of the nasopharynx click to access explanations in the original CAP template

** Please also refer to H&N biomarker protocol (HeadNeckBiomarkers 2.3.0.0, Apr-2026) for possible ancillary testings.

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Nasopharynx CA:
- Neuroendocrine carcinoma (WHO 5e):
- Other histologic type:
- Histologic grade:
- Tumor extension:
- Lymphatic and/or vascular invasion:
- Perineural invasion:
- HPV status by p16 IHC:
- HPV PCR-sequencing:
- EBV (EBER ISH):

Surgical margins:

- Surgical margins:

** Please also refer to additional specimens and frozen sections for margin status.

Lymph nodes examination:

- Number of regional lymph nodes examined:
- Number of lymph nodes involved:
- Extranodal extension (ENE) :
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Laterality:

** Please include also intraparotid and periparotid lymph nodes, in addition to the lymph nodes of the neck dissections.

Distant Metastasis: Not applicable Not identified Non-regional lymph node(s) (specify): Lung (specify): Liver (specify): Bone (specify): Brain (specify): Other (specify): Cannot be determined:

Pathologic Stage Classification (AJCC 9e):

+ Modified classification:	r (recurrent) y (post-neoadjuvant therapy)
- Primary tumor (pT):
+ T-suffix:	m (multiple primary tumors)
- Regional lymph nodes (pN):
- Distant metastasis (pM):

pT0: No evidence of primary tumor, but EBV-positive cervical node(s) involvement
pTis: Carcinoma in situ
pT1: Tumor confined to nasopharynx; OR Tumor with extension to any of the following without parapharyngeal involvement: oropharynx or nasal cavity
pT2: Tumor with extension to any of the following: Parapharyngeal space; or adjacent soft tissue involvement of medial pterygoid, lateral pterygoid, prevertebral muscles
pT3: Tumor with unequivocal infiltration into any of the following bony structures: Skull base (including pterygoid structures); or paranasal sinuses; or cervical vertebrae
pT4: Tumor with any of the following: Intracranial extension; or unequivocal radiological and / or clinical involvement of cranial nerves; or involvement of hypopharynx; or involvement of orbit (including inferior orbital fissure); or involvement of parotid gland; or extensive soft tissue infiltration beyond the anterolateral surface of the lateral pterygoid muscle

pN1: Tumor involvement of any of the following: Unilateral cervical lymph node(s) or unilateral or bilateral retropharyngeal lymph node(s); AND all of the following: Less than or equal to 6 cm in greatest dimension; and above the caudal border of cricoid cartilage; and without advanced extranodal extension
pN2: Tumor involvement of bilateral cervical lymph nodes AND all of the following: Less than or equal to 6 cm in greatest dimension; and above the caudal border of cricoid cartilage; and without advanced extranodal extension
pN3: Tumor involvement of unilateral or bilateral cervical lymph node(s); AND any of the following: Greater than 6 cm in greatest dimension; or extension below the caudal border of cricoid cartilage; or advanced radiologic extranodal extension with involvement of adjacent muscles, skin, and / or neurovascular bundle

pM1a: Microscopic confirmation of less than or equal to 3 metastatic lesions in one or more organs / sites
pM1b: Microscopic confirmation of greater than 3 metastatic lesions in one or more organs / sites

- Additional notes: