Papillary thyroid cancer staging
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Papillary thyroid cancer Microchapters |
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Differentiating Papillary thyroid cancer from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Papillary thyroid cancer staging On the Web |
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American Roentgen Ray Society Images of Papillary thyroid cancer staging |
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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]
Overview
According to the American Joint Committee on Cancer (AJCC)[1] 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
Stage
Based on overall cancer staging into stages I to IV, papillary thyroid cancer has a 5-year survival rate of 100 percent for stages I and II, 93 percent for stage III and 51 percent for stage IV.[2]
Papillary thyroid cancer in patients younger than 55 years
- Stage I: In stage I papillary thyroid cancer, the tumor is any size, may be in the thyroid, or may have spread to nearby tissues and lymph nodes. Cancer has not spread to other parts of the body.
- Stage II: In stage II papillary thyroid cancer, the tumor is any size and cancer has spread from the thyroid to other parts of the body, such as the lungs or bone, and may have spread to lymph nodes.
Papillary and follicular thyroid cancer in patients 55 years and older
- Stage I: In stage I papillary thyroid cancer, cancer is found only in the thyroid and the tumor is 2 centimeters or smaller.
- Stage II: In stage II papillary thyroid cancer, cancer is only in the thyroid and the tumor is larger than 2 centimeters but not larger than 4 centimeters.
- Stage III: In stage III papillary thyroid cancer, either of the following is found:
- The tumor is larger than 4 centimeters and only in the thyroid or the tumor is any size and cancer has spread to tissues just outside the thyroid, but not to lymph nodes; or
- The tumor is any size and cancer may have spread to tissues just outside the thyroid and has spread to lymph nodes near the trachea or the larynx (voice box)
- Stage IV: Stage IV papillary thyroid cancer is divided into stages IVA, IVB, and IVC.
- In stage IVA, either of the following is found:
- The tumor is any size and cancer has spread outside the thyroid to tissues under the skin, the trachea, the esophagus, the larynx (voice box), and/or the recurrent laryngeal nerve (a nerve with 2 branches that go to the larynx); cancer may have spread to lymph nodes near the trachea or the larynx.
- The tumor is any size and cancer may have spread to tissues just outside the thyroid. Cancer has spread to lymph nodes on one or both sides of the neck or between the lungs.
- In stage IVB, cancer has spread to tissue in front of the spinal column or has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.
- In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.
Staging
| 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 |
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| 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 |  |
| 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 |
| III | T3 | N0 | M0 |
| T1 | N1a | M0 | |
| T2 | N1a | M0 | |
| T3 | N1a | M0 | |
| IVA | T4a | N0 | M0 |
| T4a | N1a | M0 | |
| T1 | N1b | M0 | |
| T2 | N1b | M0 | |
| T3 | N1b | M0 | |
| T4a | N1b | M0 | |
| IVB | T4b | Any N | M0 |
| Stage IVC | Any T | Any N | M1 |
Reference
- ↑ Stage Information for Thyroid Cancer Cancer.gov (2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/stoc_h2_2- Accessed on October, 29 2015
- ↑ cancer.org > Thyroid Cancer By the American Cancer Society. In turn citing: AJCC Cancer Staging Manual (7th ed).