Adrenocortical carcinoma staging: Difference between revisions

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| M1||Distant metastasis
| M1||Distant metastasis
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==Staging==
<br>
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Thyroid TNM staging'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
|-
! style="background: #DCDCDC;" |TX
! style="background: #F5F5F5;" |Primary [[tumor]] cannot be assessed
|-
! style="background: #DCDCDC;" |T0
! style="background: #F5F5F5;" |No evidence of primary [[tumor]]
|-
! style="background: #DCDCDC;" |T1
! style="background: #F5F5F5;" |[[Tumor]] ≤2 cm in greatest dimension limited to the [[thyroid]]
|-
! style="background: #DCDCDC;" |T1a
! style="background: #F5F5F5;" |[[Tumor]] ≤1 cm, limited to the [[thyroid]]
|-
! style="background: #DCDCDC;" |T1b
! style="background: #F5F5F5;" |[[Tumor]] >1 cm but ≤2 cm in greatest dimension, limited to the [[thyroid]]
|-
! style="background: #DCDCDC;" |T2
! style="background: #F5F5F5;" |[[Tumor]] >2 cm but ≤4 cm in greatest dimension, limited to the [[thyroid]]
|-
! style="background: #DCDCDC;" |T3
! 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)
|-
! style="background: #DCDCDC;" rowspan=2|T4a
! style="background: #F5F5F5;" |Moderately advanced [[disease]]
|-
! style="background: #F5F5F5;" |[[Tumor]] of any size extending beyond the thyroid capsule to invade subcutaneous [[soft tissue]]s, [[larynx]], [[trachea]], [[esophagus]], or [[recurrent laryngeal nerve]]
|-
! style="background: #DCDCDC;" rowspan=2|T4b
! style="background: #F5F5F5;" |Very advanced [[disease]]
|-
! style="background: #F5F5F5;" |[[Tumor]] invades prevertebral fascia or encases [[carotid artery]] or mediastinal vessel
|}
<br>
{| 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 node]] 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]]
|}
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Anatomic Stage/Prognostic Groups'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|T}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|N}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
|-
| 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 | '''YOUNGER THAN 45 YEARS'''
|-
! style="background: #DCDCDC;" |I
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |II
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M1
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" colspan=4 | '''45 YEARS AND OLDER'''
|-
! style="background: #DCDCDC;" |I
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M1
|-
! style="background: #DCDCDC;" |II
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |III
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |IVA
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |N1a
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T4a
! style="background: #F5F5F5;" |N1b
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |IVB
! style="background: #F5F5F5;" |T4b
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M0
|-
! style="background: #DCDCDC;" |Stage IVC
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |M1
|}
|}


Revision as of 13:46, 18 September 2017

Adrenocortical carcinoma Microchapters

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Risk calculators and risk factors for Adrenocortical carcinoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

According to the TNM staging system, there are four stages of adrenocortical cancer based on the tumor size, lymph nodes, and distant metastasis. Each stage is assigned a number and letter that designates the number of lymph nodes involved and presence/absence of distant metastasis.

Staging of adrenocortical carcinoma

The AJCC has designated staging by TNM to define adrenocortical carcinoma

Staging according to TNM staging system

Stage T N M
I T1 N0 M0
II T2 N0 M0
III T1 N1 M0
T2 N1 M0
T3 N0 M0
IV T3 N1 M0
T4 N0 M0
T4 N1 M0
Any T Any N M1

Tumor size (T)

TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤5 cm in greatest dimension, no extra-adrenal invasion
T2 Tumor >5 cm, no extra-adrenal invasion
T3 Tumor of any size with local invasion, but not invading adjacent organs
T4 Tumor of any size with invasion of adjacent organs

Lymph nodes (N)

NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastases in regional lymph node(s)

Metastasis (M)

M0 No distant metastasis
M1 Distant metastasis

Staging


Thyroid TNM staging
Stage Description
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤2 cm in greatest dimension limited to the thyroid
T1a Tumor ≤1 cm, limited to the thyroid
T1b 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 perithyroid soft tissues)
T4a Moderately advanced disease
Tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve
T4b Very advanced disease
Tumor invades prevertebral fascia or encases carotid artery or mediastinal vessel


Regional Lymph Nodes (N)
Stage Description
NX Regional lymph node cannot be assessed
N0 No regional lymph node metastasis]]
N1 Regional lymph node metastasis
N1a Metastases to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes)
N1b Metastases to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII)
Distant Metastasis (M)
Stage Description
M0 No distant metastasis
M1 Distant metastasis


Anatomic Stage/Prognostic Groups
Stage T N M
Papillary thyroid carcinoma
YOUNGER THAN 45 YEARS
I Any T Any N M0
II Any T Any N M1
45 YEARS AND OLDER
I T1 Any N M1
II T2 N0 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

References

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