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Thyroid Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Thyroid Cancer

Definitions of TNM

The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define thyroid cancer.[1]

Table 1. Primary Tumor (T)a,b

a Reprinted with permission from AJCC: Thyroid. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 87-96.
b All categories may be subdivided: (s) solitary tumor and (m) multifocal tumor (the largest determines the classification).
c All anaplastic carcinomas are considered T4 tumors.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
T1Tumor ≤2 cm in greatest dimension limited to the thyroid.
T1aTumor ≤1 cm, limited to the thyroid.
T1bTumor >1 cm but ≤2 cm in greatest dimension, limited to the thyroid.
T2Tumor >2 cm but ≤4 cm in greatest dimension, limited to the thyroid.
T3Tumor >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).
T4aModerately advanced disease.
Tumor of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve.
T4bVery advanced disease.
Tumor invades prevertebral fascia or encases carotid artery or mediastinal vessels.
c T4aIntrathyroidal anaplastic carcinoma.
c T4bAnaplastic carcinoma with gross extrathyroid extension.

Table 2. Regional Lymph Nodes (N)a,b

a Reprinted with permission from AJCC: Thyroid. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 87-96.
b Regional lymph nodes are the central compartment, lateral cervical, and upper mediastinal lymph nodes.
NXRegional lymph nodes cannot be assessed.
N0No regional lymph node metastasis.
N1Regional lymph node metastasis.
N1aMetastases to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes).
N1bMetastases to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV, or V) or retropharyngeal or superior mediastinal lymph nodes (Level VII).

Table 3. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Thyroid. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 87-96.
M0No distant metastasis.
M1Distant metastasis.
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