Table 2 TNM staging for thyroid cancer
From: Venous obstruction of thyroid malignancy origin: the Antoine Lacassagne Institute experience
T: Primary tumor All categories must be divided: (A) solitary, (b) multifocal tumor (the largest determines the classification). | TX: Primary tumor cannot be assessed T0: No evidence of primary tumor T1: Tumor ≤ 2 cm (greatest dimension) T2: 2 cm < Tumor ≤ 4 cm (greatest dimension, limited to thyroid) T3: Tumor > 4 cm or minimal extrathyroid invasion (eg. Extension to extrathyroid muscle and perithyroid soft tissue) T4a: Macroscopic invasion of adipose tissue, larynx, trachea, esophagus or recurrent laryngeal nerve T4b: Macroscopic invasion of prevertebral fascia, carotids, or mediastinal vessels All anaplastic carcinomas are considered T4 tumors T4a: Intrathyroid anaplastic carcinoma-surgically resectable T4b: Extrathyroidal anaplastic carcinoma-surgically unresectable | |
N: Regional Lymph Nodes Regional lymph nodes are the central compartment, lateral cervical, and upper mediastinal lymph nodes | Nx: Lymph node status is unknown N0: No lymph node invasion N1a: Metastasis to level VI (recurrent nerve, pretracheal, paratracheal, prelaryngeal lymph nodes) N1b: Other lymphatic invasion (lateral-cervical and/or mediastinal) | |
M: Distant Metastasis | Mx: Metastasic status is unknown M0: No metastasis M1: Distant Metastasis | |
Stage Grouping: | Separate stage groupings are recommended for papillary or follicular, medullary, and anaplastic (undifferentiated) carcinoma. | |
Papillary or Follicular Carcinomas | ||
< 45 years | ≥ 45 years | |
Stage I | Any T, any N, M0 | T1, N0, M0 |
Stage II | Any T, any N, M1 | T2, N0, M0 |
Stage III | Non Available | T3, N0, M0 |
T1-3, N1a, M0 | ||
Stage IVA | Non Available | T1-3, N1b, M0-1 |
T4a, N0-1a, M0 | ||
T1-4a, N1b, M0 | ||
Stage IVB | T4b, Any N, M0 | |
Stage IVC | Any T, Any N, M1 | |
Medullary Carcinomas | ||
Stage I | T1, N0, M0 | |
Stage II | T2, N0, M0 | |
Stage III | T3, N0, M0 | |
T1-3, N1a, M0 | ||
Stage IVA | Stage IVB | T4a, N0-1a, M0 |
Stage IVC | T1-4a, N1b, M0 T4b, Any N, M0 | |
Any T, Any N, M1 | ||
Anaplastic Carcinomas | ||
Stage IVA | T4a, Any N, M0 | |
Stage IVB | T4 b, Any N, M0 | |
Stage IVC | Any T, Any N, M1 |