Papillary thyroid cancer staging

Papillary thyroid cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Papillary thyroid cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Papillary thyroid cancer staging On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Papillary thyroid cancer staging All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Papillary thyroid cancer staging
CDC on Papillary thyroid cancer staging
Papillary thyroid cancer staging in the news
Blogs on Papillary thyroid cancer staging
Directions to Hospitals Treating Papillary thyroid cancer
Risk calculators and risk factors for Papillary thyroid cancer staging

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.
• 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		Tumor ≤2 cm in greatest dimension limited to the thyroid
T1	a	Tumor ≤1 cm, limited to the thyroid
T1	b	Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid
T2		Tumor >2 cm but ≤4 cm in greatest dimension, 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 peri-thyroid soft tissues)
T4		Advanced disease
T4	a	Moderately advanced disease Tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve
T4	b	Very advanced disease Tumor invades prevertebral fascia or encases carotid artery or mediastinal vessel
TX		Primary tumor cannot be assessed
Regional lymph node involvement
Node involvement	Sub-stage	Finding	Image
N0		No lymph node involvement
N1		No regional lymph node metastasis
N1	a	Metastases to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes)
N1	b	Metastases to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII)
NX		Regional lymph node cannot be assessed
Distant metastasis
Presence of metastasis	Sub-stage	Finding	Image
M0		No distant metastasis
M1	IV	Distant metastasis

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