Stage IVA includes: (T4a, N0, M0); (T3-T4a, N1, M0). T4a: Moderately advanced disease. Tumor involves deep soft tissue, cartilage, bone, or overlying skin. T3: Mucosal disease. N0: No regional lymph node metastases. N1: Tumor with regional lymph node metastases. M0: No distant metastasis. (AJCC 7th ed.) [from
NCI]