Scenario: 2026 diagnosis
- Presented with biopsy +Base of Tongue SCC p16+
- PET: Ill-defined hypermetabolic fullness left base of tongue in concordance w/underlying SCC. No evidence of metastatic disease.
- Transoral robotic left base of tongue resection, left neck dissection: 1.0 cm HPV Associated SCC, LVI-, PNI-, Margins-, 5 lymph nodes (Left Level 2A,3,4, 2B) negative
Question: How will you assign the pathologic pN category?
- cN0
- pN0
- pNX
Answer & Rationale: pNX
Refer to AJCC Cancer Staging Manual. 9th ed. Springer; 2026. Oropharynx (HPV-associated) chapter. There are minimum requirements for the number of nodes to be removed to assign a pN0. This case did not meet that criteria, for this scenario, only 5 nodes were removed, therefore the registrar will assign a pNX.
