Differentiated thyroid cancer (staging)
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Staging of thyroid malignancies is by the TNM staging system. This applies to papillary, follicular and medullary thyroid cancer. For anaplastic cancer, there is no generally accepted stating system. All patients with anaplastic thyroid cancer are considered to have stage IV disease.
T: Tumour
- TX - Primary tumor cannot be assessed
- T0 - No evidence of primary tumor
- T1 - Tumor ≤2 cm in greatest dimensionlimited to the thyroid
- T1a - Tumor ≤1 cm, limited to the thyroid
- T1b - Tumor >1 cm but ≤2 cm in greatestdimension, limited to the thyroid
- T2 - Tumor >2 cm but ≤4 cm in greatestdimension, limited to the thyroid
- T3 - Tumor >4 cm in greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension (e.g.,extension to sternothyroid muscle or perithyroid soft tissues)
- T4 - Advanced disease
- T4a - Moderately advanced disease - tumor of any size extending beyond thethyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus,or recurrent laryngeal nerve
- T4b - Very advanced disease - tumor invades prevertebral fascia orencases carotid artery or mediastinal vessels
-
cT4a -
Intrathyroidalintrathyroidal anaplastic carcinoma - cT4b -
Anaplasticanaplastic carcinoma with grossextrathyroid extension
-
cT4a -
N: Nodes
- NX - Regional lymph nodes cannot beassessed
- N0 - No regional lymph node metastasis
- N1 - Regional lymph node metastasis
- N1a - Metastases to Level VI (pretracheal,paratracheal, and prelaryngeal/Delphian lymph nodes)
- N1b - Metastases to unilateral, bilateral,or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal orsuperior mediastinal lymph nodes (Level VII)
M: Metastases
- MX – Distant metastases cannot be assessed
- M0 - No distant metastasis
- M1 - Distant metastasis
-<p>Staging of <a href="/articles/thyroid-malignancies" title="thyroid malignancies">thyroid malignancies</a> is by the <a href="/articles/tnm-staging-system" title="TNM staging">TNM staging system</a>. This applies to <a href="/articles/papillary_thyroid_cancer" title="Papillary thyroid cancer">papillary</a>, <a href="/articles/follicular-thyroid-cancer" title="Follicular thyroid carcinoma">follicular</a> and <a href="/articles/medullary-thyroid-cancer" title="Medullary thyroid carcinoma">medullary</a> thyroid cancer. For <a href="/articles/anaplastic-thyroid-carcinoma" title="Anaplastic thyroid carcinoma">anaplastic</a> cancer, there is no generally accepted stating system. All patients with <a href="/articles/anaplastic-thyroid-cancer" title="anaplastic thyroid cancer">anaplastic thyroid cancer</a> are considered to have stage IV disease.</p><h5>T: Tumour</h5><ul>-<li>TX - Primary tumor cannot be assessed </li>-<li>T0 - No evidence of primary tumor</li>-<li>T1 - Tumor ≤2 cm in greatest dimension-limited to the thyroid<ul>-<li>T1a - Tumor ≤1 cm, limited to the thyroid</li>-<li>T1b - Tumor >1 cm but ≤2 cm in greatest-dimension, limited to the thyroid</li>-</ul>-</li>-<li>T2 - Tumor >2 cm but ≤4 cm in greatest-dimension, limited to the thyroid</li>-<li>T3 - Tumor >4 cm in greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension (e.g.,-extension to sternothyroid muscle or perithyroid soft tissues)</li>-</ul><ul>-<li>T4 - Advanced disease<ul>-<li>T4a - Moderately advanced disease - tumor of any size extending beyond the-thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus,-or recurrent laryngeal nerve</li>-<li>T4b - Very advanced disease - tumor invades prevertebral fascia or-encases carotid artery or mediastinal vessels</li>- +<p>Staging of <a href="/articles/thyroid-malignancies">thyroid malignancies</a> is by the <a href="/articles/tnm-staging-system">TNM staging system</a>. This applies to <a href="/articles/papillary-thyroid-cancer">papillary</a>, <a href="/articles/follicular-thyroid-cancer">follicular</a> and <a href="/articles/medullary-thyroid-cancer">medullary</a> thyroid cancer. For <a href="/articles/anaplastic-thyroid-carcinoma">anaplastic</a> cancer, there is no generally accepted stating system. All patients with <a href="/articles/anaplastic-thyroid-cancer">anaplastic thyroid cancer</a> are considered to have stage IV disease.</p><h5>T: Tumour</h5><ul>
- +<li>TX - Primary tumor cannot be assessed </li>
- +<li>T0 - No evidence of primary tumor</li>
- +<li>T1 - Tumor ≤2 cm in greatest dimension limited to the thyroid<ul>
- +<li>T1a - Tumor ≤1 cm, limited to the thyroid</li>
- +<li>T1b - Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid</li>
-<li><ul>-<li><em>cT4a - Intrathyroidal anaplastic carcinoma</em></li>-<li><em>cT4b - Anaplastic carcinoma with gross-extrathyroid extension</em></li>-</ul></li>-</ul><h5>N: Nodes</h5><ul>-<li>NX - Regional lymph nodes cannot be-assessed</li>-<li>N0 - No regional lymph node metastasis</li>- +<li>T2 - Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid</li>
- +<li>T3 - Tumor >4 cm in greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension (e.g., extension to sternothyroid muscle or perithyroid soft tissues)</li>
- +</ul><ul><li>T4 - Advanced disease<ul>
- +<li>T4a - Moderately advanced disease - tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve</li>
- +<li>T4b - Very advanced disease - tumor invades prevertebral fascia or encases carotid artery or mediastinal vessels</li>
- +<li><em>cT4a - intrathyroidal anaplastic carcinoma</em>
- +</li>
- +<li><em>cT4b - anaplastic carcinoma with gross extrathyroid extension</em></li>
- +</ul>
- +</li></ul><h5>N: Nodes</h5><ul>
- +<li>NX - Regional lymph nodes cannot be assessed</li>
- +<li>N0 - No regional lymph node metastasis</li>
-<li>N1a - Metastases to Level VI (pretracheal,-paratracheal, and prelaryngeal/Delphian lymph nodes)</li>-<li>N1b - Metastases to unilateral, bilateral,-or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or-superior mediastinal lymph nodes (Level VII)</li>- +<li>N1a - Metastases to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes)</li>
- +<li>N1b - Metastases to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII)</li>
-</li>- +</li>
-<li>MX – Distant metastases cannot be assessed</li>-<li>M0 - No distant metastasis</li>-<li>M1 - Distant metastasis</li>- +<li>MX – Distant metastases cannot be assessed</li>
- +<li>M0 - No distant metastasis</li>
- +<li>M1 - Distant metastasis</li>
References changed:
- 1. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. (2018) <a href="https://books.google.co.uk/books?vid=ISBN9783319406176">ISBN: 9783319406176</a><span class="ref_v4"></span>
- JCC: Thyroid. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 87-96
Tags changed:
- refs
- cases
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