Papillary thyroid cancer staging: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Papillary thyroid cancer}} | {{Papillary thyroid cancer}} | ||
{{CMG}}; {{AE}} {{Ammu}} | {{CMG}}; {{AE}} {{Ammu}} {{Sahar}} | ||
==Overview== | ==Overview== | ||
According to the American Joint Committee on Cancer (AJCC) | 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== | ==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]].<ref name="urlThyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#_441_toc |title=Thyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute |format= |work= |accessdate=}}</ref> | |||
* Each stage is assigned a letter and a number that designate the [[tumor]] size, number of involved [[lymph node]] regions, and [[metastasis]]. | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
Line 36: | Line 18: | ||
|- | |- | ||
| T0 | | T0 | ||
| ||No evidence of primary [[tumor]] | | || | ||
* No evidence of primary [[tumor]] | |||
| | | | ||
|- | |- | ||
| T1 | | T1 | ||
| ||[[Tumor]] ≤2 cm in greatest dimension limited to the [[thyroid]] | | || | ||
* [[Tumor]] ≤2 cm in greatest dimension limited to the [[thyroid]] | |||
| | | | ||
|- | |- | ||
| T1 | | T1 | ||
| a||[[Tumor]] ≤1 cm, limited to the [[thyroid]] | | a|| | ||
* [[Tumor]] ≤1 cm, limited to the [[thyroid]] | |||
| [[Image:Diagram showing stage T1a thyroid cancer CRUK 250.png|200px|thumb|none]] | | [[Image:Diagram showing stage T1a thyroid cancer CRUK 250.png|200px|thumb|none]] | ||
|- | |- | ||
| T1 | | T1 | ||
| b||[[Tumor]] >1 cm but ≤2 cm in greatest dimension, limited to the [[thyroid]] | | b|| | ||
* [[Tumor]] >1 cm but ≤2 cm in greatest dimension, limited to the [[thyroid]] | |||
| [[Image:Diagram showing stage T1b thyroid cancer CRUK 251.svg.png|200px|thumb|none]] | | [[Image:Diagram showing stage T1b thyroid cancer CRUK 251.svg.png|200px|thumb|none]] | ||
|- | |- | ||
| T2 | | T2 | ||
| ||[[Tumor]] >2 cm but ≤4 cm in greatest dimension, limited to the [[thyroid]] | | || | ||
* [[Tumor]] >2 cm but ≤4 cm in greatest dimension, limited to the [[thyroid]] | |||
| | | | ||
|- | |- | ||
| T3 | | T3 | ||
| ||[[Tumor]] >4 cm | | || | ||
* [[Tumor]] >4 cm limited to the [[thyroid]], or gross extrathyroidal extension invading only strap [[muscles]] | |||
| [[Image:Diagram showing stage T3 thyroid cancer CRUK 265.png|200px|thumb|none]] | | [[Image:Diagram showing stage T3 thyroid cancer CRUK 265.png|200px|thumb|none]] | ||
|- | |||
|T3 | |||
|a | |||
| | |||
* [[Tumor]] >4 cm limited to the [[thyroid]] | |||
| | |||
|- | |||
|T3 | |||
|b | |||
| | |||
* Gross extrathyroidal extension invading only strap [[muscles]] ([[sternohyoid]], [[sternothyroid]], [[thyrohyoid]], or [[Omohyoid muscle|omohyoid muscles]]) from a [[tumor]] of any size | |||
| | |||
|- | |- | ||
| T4 | | T4 | ||
| || | | || | ||
* [[Tumor]] includes gross extrathyroidal extension beyond the strap [[muscles]] | |||
| | | | ||
|- | |- | ||
| T4 | | T4 | ||
| a|| | | a|| | ||
* [[Tumor]] with gross extrathyroidal extension invading subcutaneous [[Soft tissue|soft tissues]], [[larynx]], [[trachea]], [[esophagus]], or [[recurrent laryngeal nerve]] from a [[tumor]] of any size | |||
[[Tumor]] | |||
|[[Image:Diagram showing stage T4a thyroid cancer CRUK 272.png|200px|thumb|none]] | |[[Image:Diagram showing stage T4a thyroid cancer CRUK 272.png|200px|thumb|none]] | ||
|- | |- | ||
| T4 | | T4 | ||
| b|| | | b|| | ||
* [[Tumor]] with gross extrathyroidal extension invading [[prevertebral fascia]] or encasing the [[carotid artery]] or [[mediastinal]] vessels from a [[tumor]] of any size. | |||
[[Tumor]] | |||
|[[Image:Diagram showing stage T4b thyroid cancer CRUK 273.png|200px|thumb|none]] | |[[Image:Diagram showing stage T4b thyroid cancer CRUK 273.png|200px|thumb|none]] | ||
|- | |- | ||
| TX | | TX | ||
| ||Primary [[tumor]] cannot be assessed | | || | ||
* Primary [[tumor]] cannot be assessed | |||
| | | | ||
|- | |- | ||
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|- | |- | ||
| N0 | | N0 | ||
| ||No [[lymph node]] involvement | | || | ||
* No [[lymph node]] involvement | |||
| | |||
|- | |||
|N0 | |||
|a | |||
| | |||
* One or more cytologically or [[histologically]] confirmed benign [[lymph nodes]] | |||
| | |||
|- | |||
|N0 | |||
|b | |||
| | |||
* No [[Radiological|radiologic]] or clinical evidence of locoregional [[lymph node]] [[metastasis]] | |||
| | | | ||
|- | |- | ||
| N1 | | N1 | ||
| || | | || | ||
* [[Metastasis]] to regional nodes | |||
| | | | ||
|- | |- | ||
| N1 | | N1 | ||
| a||[[ | | a|| | ||
* [[Metastasis]] to level VI or VII ([[Pretracheal lymph nodes|pretracheal]], [[Paratracheal lymph nodes|paratracheal]], or [[Prelaryngeal lymph nodes|prelaryngeal]]/Delphian, or upper mediastinal) [[lymph nodes]]. This can be unilateral or bilateral [[disease]] | |||
|[[Image:Diagram showing stage N1a thyroid cancer CRUK 242.png|200px|thumb|none]] | |[[Image:Diagram showing stage N1a thyroid cancer CRUK 242.png|200px|thumb|none]] | ||
|- | |- | ||
| N1 | | N1 | ||
| b||[[ | | b|| | ||
| [[Image:Diagram showing stage N1b thyroid cancer CRUK 243.png|200px|thumb|none]] | * [[Metastasis]] to unilateral, bilateral, or contralateral [[Cervical lymph nodes|cervical]] neck [[lymph nodes]] (levels I, II, III, IV, or V) or [[retropharyngeal lymph nodes]] | ||
|[[Image:Diagram showing stage N1b thyroid cancer CRUK 243.png|200px|thumb|none]] | |||
|- | |- | ||
| NX | | NX | ||
| ||Regional [[lymph node]] cannot be assessed | | || | ||
* Regional [[lymph node]] cannot be assessed | |||
| | | | ||
|- | |- | ||
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|- | |- | ||
| M0 | | M0 | ||
| ||No distant [[metastasis]] | | || | ||
* No distant [[metastasis]] | |||
| | | | ||
|- | |- | ||
| M1 | | M1 | ||
| IV||Distant [[metastasis]] | | IV|| | ||
* Distant [[metastasis]] | |||
|[[Image:Stage M1 Thyroid cancer.png|200px|thumb|none]] | |[[Image:Stage M1 Thyroid cancer.png|200px|thumb|none]] | ||
|- | |- | ||
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 align=center| '''Papillary thyroid carcinoma''' | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 align=center| '''Papillary thyroid carcinoma''' | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | ''' | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | '''Younger than 55 years''' | ||
|- | |- | ||
! style="background: #DCDCDC;" |I | ! style="background: #DCDCDC;" |I | ||
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|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | ''' | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | '''55 years and older''' | ||
|- | |- | ||
! style="background: #DCDCDC;" |I | ! style="background: #DCDCDC;" |I | ||
! style="background: #F5F5F5;" |T1 | ! style="background: #F5F5F5;" |T1 | ||
! style="background: #F5F5F5;" |Any N | ! style="background: #F5F5F5;" |Any N | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #DCDCDC;" |II | ! rowspan="4" style="background: #DCDCDC;" |II | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |T1 | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |N1 | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T2 | |||
! style="background: #F5F5F5;" |N1 | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T3a | |||
! style="background: #F5F5F5;" |Any N | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T3b | |||
! style="background: #F5F5F5;" |Any N | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #DCDCDC;" | | ! style="background: #DCDCDC;" |III | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |T4a | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |Any N | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
Line 222: | Line 235: | ||
! style="background: #DCDCDC;" |IVA | ! style="background: #DCDCDC;" |IVA | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |T4b | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |Any N | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #DCDCDC;" | | ! rowspan="6" style="background: #DCDCDC;" |IVB | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |Any T | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |Any N | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |M1 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T1 | ! style="background: #F5F5F5;" |T1 | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |N1 | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T2 | ! style="background: #F5F5F5;" |T2 | ||
! style="background: #F5F5F5;" | | ! style="background: #F5F5F5;" |N1 | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T3a | |||
! style="background: #F5F5F5;" |N1 | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T3b | |||
! style="background: #F5F5F5;" |Any N | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
|- | |- | ||
! style="background: #F5F5F5;" |T4 | |||
! style="background: #F5F5F5;" | | |||
! style="background: #F5F5F5;" |Any N | ! style="background: #F5F5F5;" |Any N | ||
! style="background: #F5F5F5;" |M0 | ! style="background: #F5F5F5;" |M0 | ||
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|- | |- | ||
! style="background: #DCDCDC;" | | ! style="background: #DCDCDC;" |IVC | ||
! style="background: #F5F5F5;" |Any T | ! style="background: #F5F5F5;" |Any T | ||
! style="background: #F5F5F5;" |Any N | ! style="background: #F5F5F5;" |Any N | ||
Line 287: | Line 290: | ||
[[Category:Hereditary cancers]] | [[Category:Hereditary cancers]] | ||
[[Category:Thyroid disease]] | [[Category:Thyroid disease]] | ||
Latest revision as of 23:34, 29 July 2020
Papillary thyroid cancer Microchapters |
Differentiating Papillary thyroid cancer from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Papillary thyroid cancer staging On the Web |
American Roentgen Ray Society Images of Papillary thyroid cancer staging |
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.[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 |
|
||
T1 | |||
T1 | a | ||
T1 | b | ||
T2 | |||
T3 | |||
T3 | a | ||
T3 | b |
|
|
T4 | |||
T4 | a |
|
|
T4 | b |
|
|
TX |
|
||
Regional lymph node involvement | |||
Node involvement | Sub-stage | Finding | Image |
N0 |
|
||
N0 | a |
|
|
N0 | b |
|
|
N1 |
|
||
N1 | a |
|
|
N1 | b |
|
|
NX |
|
||
Distant metastasis | |||
Presence of metastasis | Sub-stage | Finding | Image |
M0 |
|
||
M1 | IV |
|
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 |