Papillary thyroid cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2] Sahar Memar Montazerin, M.D.[3]

Overview

According to the American Joint Committee on Cancer (AJCC) there are 4 stages of papillary thyroid cancer based on the clinical features and findings on imaging. Each stage is assigned a letter and a number that designate the tumor size, number of involved lymph node regions, and metastasis.

Staging

  • According to the American Joint Committee on Cancer (AJCC) there are 4 stages of papillary thyroid cancer based on the clinical features and findings on imaging.[1]
  • Each stage is assigned a letter and a number that designate the tumor size, number of involved lymph node regions, and metastasis.
Primary tumor
Tumor size Sub-stage Finding Image
T0
  • No evidence of primary tumor
T1
T1 a
Diagram showing stage T1a thyroid cancer CRUK 250.png
T1 b
  • Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid
Diagram showing stage T1b thyroid cancer CRUK 251.svg.png
T2
  • Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid
T3
  • Tumor >4 cm limited to the thyroid, or gross extrathyroidal extension invading only strap muscles
Diagram showing stage T3 thyroid cancer CRUK 265.png
T3 a
T3 b
T4
  • Tumor includes gross extrathyroidal extension beyond the strap muscles
T4 a
Diagram showing stage T4a thyroid cancer CRUK 272.png
T4 b
Diagram showing stage T4b thyroid cancer CRUK 273.png
TX
  • Primary tumor cannot be assessed
Regional lymph node involvement
Node involvement Sub-stage Finding Image
N0
N0 a
N0 b
N1
N1 a
Diagram showing stage N1a thyroid cancer CRUK 242.png
N1 b
Diagram showing stage N1b thyroid cancer CRUK 243.png
NX
Distant metastasis
Presence of metastasis Sub-stage Finding Image
M0
M1 IV
Stage M1 Thyroid cancer.png


Anatomic Stage/Prognostic Groups
Stage T N M
Papillary thyroid carcinoma
Younger than 55 years
I Any T Any N M0
II Any T Any N M1
55 years and older
I T1 Any N M0
II T1 N1 M0
T2 N1 M0
T3a Any N M0
T3b Any N M0
III T4a Any N M0
IVA T4b Any N M0
IVB Any T Any N M1
T1 N1 M0
T2 N1 M0
T3a N1 M0
T3b Any N M0
T4 Any N M0
IVC Any T Any N M1

Reference

  1. "Thyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute".

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