Stage IV salivary gland cancer is divided into stages IVA, IVB, and IVC. In stage IVA, (1) cancer has spread to one or more lymph nodes on either or both sides of the body and the lymph nodes are not larger than 6 centimeters; the tumor may be any size and may have spread to soft tissue around the affected gland; or (2) cancer has spread to the skin, jawbone, ear canal, and/or facial nerve, and may have spread to one or more lymph nodes on either or both sides of the body; the lymph nodes are not larger than 6 centimeters. In stage IVB, (1) cancer has spread to a lymph node larger than 6 centimeters; the tumor may be any size and may have spread to soft tissue around the affected gland; or (2) cancer has spread to the base of the skull and/or the carotid artery, and may have spread to one or more lymph nodes of any size on either or both sides of the body. In stage IVC, cancer has spread to distant parts of the body.