Stage IVa

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Description
Moderately advanced local disease
(Lip) - Tumor has grown through the hard, outer layer of nearby bone, the nerve that gives feeling to lower teeth, the floor of the mouth, or the skin of the face.
(Oral cavity) - Tumor has spread to adjacent structures such as the bone of the upper or lower jaw, the deep muscle of the tongue, the maxillary sinus, and/or the skin of the face.
OR
Cancer has spread to:
- 1 lymph node on the same side of the neck, which is greater than 3 cm but no greater than 6 cm, or
- multiple lymph nodes on the same side of the neck, none of which are greater than 6 cm, or
- lymph nodes on opposite side or both sides of the neck, none of which are greater than 6 cm.