What are the Stages of NPC?

Staging of NPC is established based on clinical and radiologic examination findings. Unfortunately, most NPC patients (over 70%) are already in the advanced Stage III or IV of the disease when first examined by the physician. This is due to the fact that NPC is hidden deep behind the nose in the skull base such that early signs or symptoms of the cancer are exceedingly difficult to detect, until very late.

  • Stage 0: In situ cancer before the tumor growth
  • Stage I: Small tumor confined to nasopharynx
  • Stage II: Tumor extending in the local area or any evidence of limited neck (nodal) disease
  • Stage III: A large tumor with or without neck disease, or a tumor with bilateral neck disease
  • Stage IV: Intracranial or infratemporal involvement of tumor, extensive neck disease, or any distant metastasis


A staging system is a standard way for the cancer care team to sum up the extent of a cancer’s spread. The most common system used to describe the spread of NPC is the TNM system created by the American Joint Committee on Cancer (AJCC). This system contains 3 key pieces of information:

T describes whether the main (primary) tumor has invaded other organs or tissues near the nasopharynx.
N describes whether the cancer has spread to nearby (regional) lymph nodes (bean-sized collections of immune system cells throughout the body).
M indicates whether the cancer has metastasized (spread) to other parts of the body. (The most common sites of distant NPC spread are the lungs, liver, and bones.)

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