stage IVA lip and oral cavity cancer

Stage IV is divided into stages IVA, IVB, and IVC. In stage IVA, the tumor (1) is larger than 4 centimeters and the deepest point of tumor invasion is greater than 10 millimeters; or cancer has spread to the outer surface of the upper or lower jawbone, into the maxillary sinus, or to the skin of the face. The cancer may have spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the primary tumor; or (2) is any size or cancer has spread to the outer surface of the upper or lower jawbone, into the maxillary sinus, or to the skin of the face. Cancer has spread (a) to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue; or (b) to one lymph node that is larger than 3 centimeters but not larger than 6 centimeters, on the same side of the neck as the primary tumor; or (c) to multiple lymph nodes that are not larger than 6 centimeters, on the same side of the neck as the primary tumor; or (d) to multiple lymph nodes that are not larger than 6 centimeters, on the opposite side of the neck as the primary tumor or on both sides of the neck.