Thyroid cancer is a common malignant tumor of head and neck. The clinical staging criteria of thyroid cancer is an independent prognostic indicator of thyroid cancer, which can be used as a prognostic evaluation indicator of thyroid cancer and the degree of tumor invasion and infiltration, and has a great guiding effect on the late guiding treatment of thyroid cancer.
TNM staging criteria of thyroid cancer
Primary tumor (T)
Note: All classifications can be subdivided into: a, isolated tumor; b, multifocal tumor (the largest of which determines the staging)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor largest diameter ≤50px, confined to the thyroid gland
T2 Tumor >50px, but ≤100px, confined to the thyroid gland
T3 Tumor >100px in size, confined to the thyroid gland or any tumor with minimal extrathyroidal invasion (e.g., thyroid muscle of the sternum or soft tissue around the thyroid gland)
T4a tumor, regardless of size, is beyond the thyroid envelope and invades subcutaneous soft tissue, larynx, trachea, esophagus or laryngeal nerve
T4b Tumor invades the prevertebral fascia or encircles the carotid artery or mediastinal vessels
All undifferentiated carcinomas are T4 tumors
T4a Undifferentiated carcinoma confined to the thyroid gland – surgically resectable
T4b Undifferentiated carcinoma with extra-thyroidal invasion – surgically unresectable
Regional lymph nodes (N)
Regional lymph nodes are median, lateral cervical and superior mediastinal lymph nodes in the neck
NX Regional lymph nodes cannot be evaluated
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
N1a Group VI metastases (pre-tracheal, paratracheal, and anterior laryngeal/Delphian lymph nodes)
N1b Metastasis to unilateral, bilateral, or contralateral cervical or upper mediastinal lymph nodes
Distant metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 With distant metastasis
Clinical staging of different thyroid cancers
Papillary or follicular carcinoma of the thyroid
Under 45 years old
Stage I Any T Any N M0
Stage II Any T Any N M1
45 years old or above
Stage I T1 N0 M0
Phase II T2 N0 M0
Phase III T3 N0 M0
T1 N1a M0
T2 N1a M0
T3 N1a M0
Phase IVA T4a N0 M0
T4a N1a M0
T1 N1b M0
T2 N1b M0
T3 N1b M0
T4a N1b M0
Phase IVB T4b Any N M0
Stage IVC Any T Any N M1
Medullary thyroid carcinoma
Stage I T1 N0 M0
Stage II T2 N0 M0
Stage III T3 N0 M0
T1 N1a M0
T2 N1a M0
T3 N1a M0
Phase IVA T4a N0 M0
T4a N1a M0
T1 N1b M0
T2 N1b M0
T3 N1b M0
T4a N1b M0
Phase IVB T4b Any N M0
Stage IVC Any T Any N M1
Undifferentiated (interstitial) carcinoma
All interstitial carcinomas are stage IV
Stage IVA T4a Any N M0
Stage IVB T4b Any N M0
Stage IVC Any T Any N M1