Follicular thyroid cancer staging: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(28 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Thyroid cancer }}
{{Follicular thyroid cancer}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Ammu}}  
==Overview==
==Overview==
According to the American Joint Committee on Cancer (AJCC) there are 4 stages of follicular 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==
<br>
* According to the American Joint Committee on Cancer (AJCC) there are 4 stages of follicular 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>
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
* Each stage is assigned a letter and a number that designate the [[tumor]] size, number of involved [[lymph node]] regions, and [[metastasis]].
|+'''''Thyroid TNM staging'''''
{| class="wikitable"
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
|+
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
 
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Primary tumor
|-
| align="center" style="background:#f0f0f0;" |'''Tumor size'''
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''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]]
| [[Image:Diagram showing stage T1a thyroid cancer CRUK 250.png|200px|thumb|none]]
|-
| T1
| 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]]
|-
| 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]]
| [[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
|  ||
* [[Tumor]] includes gross extrathyroidal extension beyond the strap [[muscles]]
|
|-
| T4
| 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
|[[Image:Diagram showing stage T4a thyroid cancer CRUK 272.png|200px|thumb|none]]
|-
| T4
| b||
* [[Tumor]] with gross extrathyroidal extension invading [[prevertebral fascia]] or encasing the [[carotid artery]] or [[mediastinal]] vessels from a [[tumor]] of any size.
|[[Image:Diagram showing stage T4b thyroid cancer CRUK 273.png|200px|thumb|none]]
|-
| TX
|  ||
* Primary [[tumor]] cannot be assessed
|
|-
|+
 
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Regional lymph node involvement
|-
|-
! style="background: #DCDCDC;" |TX
| align="center" style="background:#f0f0f0;" |'''Node involvement'''
! style="background: #F5F5F5;" |Primary tumor cannot be assessed.
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''Finding'''
|'''Image'''
|-
|-
! style="background: #DCDCDC;" |T0
| N0
! style="background: #F5F5F5;" |No evidence of primary tumor.
| ||
* No [[lymph node]] involvement
|
|-
|-
! style="background: #DCDCDC;" |T1
|N0
! style="background: #F5F5F5;" |Tumor ≤2 cm in greatest dimension limited to the thyroid.
|a
|
* One or more cytologically or [[histologically]] confirmed benign [[lymph nodes]]
|
|-
|-
! style="background: #DCDCDC;" |T1a
|N0
! style="background: #F5F5F5;" |Tumor ≤1 cm, limited to the thyroid.
|b
|
* No [[Radiological|radiologic]] or clinical evidence of locoregional [[lymph node]] [[metastasis]]
|
|-
|-
! style="background: #DCDCDC;" |T1b
| N1
! style="background: #F5F5F5;" |Tumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid.
| ||
* [[Metastasis]] to regional nodes
|
|-
|-
! style="background: #DCDCDC;" |T2
| N1
! style="background: #F5F5F5;" |Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid.
| 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]]
|-
|-
! style="background: #DCDCDC;" |T3
| N1
! style="background: #F5F5F5;" |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).
| b||
* [[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]]
|-
|-
! style="background: #DCDCDC;" rowspan=2|T4a
| NX
! style="background: #F5F5F5;" |Moderately advanced disease.
|  ||
* Regional [[lymph node]] cannot be assessed
|
|-
|-
! style="background: #F5F5F5;" |Tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve.
|+
 
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Distant metastasis
|-
|-
! style="background: #DCDCDC;" rowspan=2|T4b
| align="center" style="background:#f0f0f0;" |'''Presence of metastasis'''
! style="background: #F5F5F5;" |Very advanced disease.
| align="center" style="background:#f0f0f0;" |'''Sub-stage'''
| align="center" style="background:#f0f0f0;" |'''Finding'''
|'''Image'''
|-
|-
! style="background: #F5F5F5;" |Tumor invades prevertebral fascia or encases carotid artery or mediastinal vessel.
| M0
| ||
* No distant [[metastasis]]
|
|-
|-
! style="background: #DCDCDC;" |T4a
| M1
! style="background: #F5F5F5;" |Intrathyroidal anaplastic carcinoma.
| IV||
* Distant [[metastasis]]
|[[Image:Stage M1 Thyroid cancer.png|200px|thumb|none]]
|-
|-
! style="background: #DCDCDC;" |T4b
! style="background: #F5F5F5;" |Anaplastic carcinoma with gross extrathyroid extension.
|}
|}
<br>
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Regional Lymph Nodes (N)'''''
|+
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
 
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
|-
 
|-
 
|-
|-
! style="background: #DCDCDC;" |NX
 
! style="background: #F5F5F5;" |Regional lymph nodes cannot be assessed.
|-
|-
! style="background: #DCDCDC;" |N0
 
! style="background: #F5F5F5;" |No regional lymph node metastasis.
|-
|-
! style="background: #DCDCDC;" |N1
 
! style="background: #F5F5F5;" |Regional lymph node metastasis.
|-
|-
! style="background: #DCDCDC;" |N1a
 
! style="background: #F5F5F5;" |Metastases to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes).
|-
 
|-
 
|-
|-
! style="background: #DCDCDC;" |N1b
! style="background: #F5F5F5;" |Metastases to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII).
|}


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Distant Metastasis (M)'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
|-
|-
! style="background: #DCDCDC;" |M0
 
! style="background: #F5F5F5;" |No distant metastasis.
|-
|-
! style="background: #DCDCDC;" |M1
 
! style="background: #F5F5F5;" |Distant metastasis.
|}
|}
 
<br />
<br>
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Anatomic Stage/Prognostic Groups'''''
|+'''''Anatomic Stage/Prognostic Groups'''''
Line 89: Line 180:
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
|-
|-
! style="padding: 0 5px; font-size: 95%; background: #DCDCDC" align=left | '''Papillary or follicular (differentiated)'''
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 align=center| '''Follicular thyroid carcinoma'''
|-
|-
! style="padding: 0 5px; font-size: 95%; background: #DCDCDC" align=left | '''YOUNGER THAN 45 YEARS'''
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | '''YOUNGER THAN 55 YEARS'''
|-
|-
! style="background: #DCDCDC;" |I
! style="background: #DCDCDC;" |I
Line 108: Line 199:


|-
|-
! style="padding: 0 5px; font-size: 95%; background: #DCDCDC" align=left | '''45 YEARS AND OLDER'''
| 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;" |M1
! style="background: #F5F5F5;" |M0
|-
|-
! style="background: #DCDCDC;" |II
! rowspan="4" style="background: #DCDCDC;" |II
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0
|-
|-
 
! style="background: #F5F5F5;" |T2
! style="background: #DCDCDC;" |III
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
 
! style="background: #F5F5F5;" |T3a
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
 
! style="background: #F5F5F5;" |T3b
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-


! style="background: #DCDCDC;" |
! style="background: #DCDCDC;" |III
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


Line 150: Line 235:


! style="background: #DCDCDC;" |IVA
! style="background: #DCDCDC;" |IVA
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |T4b
! style="background: #F5F5F5;" |N0
! 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;" |T4a
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M1


|-
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
 
! style="background: #F5F5F5;" |T3a
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
 
! style="background: #F5F5F5;" |T3b
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0


|-
|-
 
! style="background: #F5F5F5;" |T4
! style="background: #DCDCDC;" |IVB
! style="background: #F5F5F5;" |T4b
! style="background: #F5F5F5;" |Any N  
! style="background: #F5F5F5;" |Any N  
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0
Line 198: Line 273:
|-
|-


! style="background: #DCDCDC;" |Stage IVC
! style="background: #DCDCDC;" |IVC
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any N  
! style="background: #F5F5F5;" |Any N  
! style="background: #F5F5F5;" |M1
! style="background: #F5F5F5;" |M1
|-
|}
 
==Reference==
{{Reflist|2}}
 
[[Category:Endocrine system]]
[[Category:Endocrinology]]
[[Category:Otolaryngology]]
[[Category:Disease]]
[[Category:Genetic disorders]]
[[Category:Types of cancer]]
[[Category:Hereditary cancers]]
[[Category:Thyroid disease]]

Latest revision as of 21:46, 29 July 2020

Follicular thyroid cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Follicular thyroid cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Follicular 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 Follicular 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 Follicular thyroid cancer staging

CDC on Follicular thyroid cancer staging

Follicular thyroid cancer staging in the news

Blogs on Follicular thyroid cancer staging

Directions to Hospitals Treating Follicular thyroid cancer

Risk calculators and risk factors for Follicular 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) there are 4 stages of follicular 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 follicular 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
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 limited to the thyroid, or gross extrathyroidal extension invading only strap muscles
T3 a
T3 b
T4
  • Tumor includes gross extrathyroidal extension beyond the strap muscles
T4 a
T4 b
TX
  • Primary tumor cannot be assessed
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


Anatomic Stage/Prognostic Groups
Stage T N M
Follicular 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".
Retrieved from "https://www.wikidoc.org/index.php?title=Follicular_thyroid_cancer_staging&oldid=1638300"