HOW ARE THYROID CANCERS STAGED?
Understanding the details of each stage of thyroid cancer is critical for both treatment planning and prognosis. Dr Sandeep Uppal and his team at The ENT Clinic adhere to the most current staging guidelines to offer tailored, evidence-based care for each patient. Below is a breakdown of what each stage generally entails:
PAPILLARY AND FOLLICULAR THYROID CANCER STAGING
STAGE I
Tumour is 2 cm or smaller in size.
No lymph node involvement.
No distant metastasis.
STAGE II
Tumour is between 2 cm and 4 cm.
No lymph node involvement.
No distant metastasis.
STAGE III
Tumour is larger than 4 cm or any tumour with minimal extrathyroidal extension.
May have spread to nearby lymph nodes.
No distant metastasis.
STAGE IV
Divided into IVA, IVB, and IVC based on the extent of spread to tissues, lymph nodes, and distant metastasis.
Stage IVA
Tumour of any size that may extend beyond the thyroid capsule to invade subcutaneous soft tissue, larynx, trachea, oesophagus, or recurrent laryngeal nerve.
Lymph node involvement may be present.
No distant metastasis.
Stage IVB
Tumour invades prevertebral fascia or encases the carotid artery or mediastinal vessels.
May or may not have lymph node involvement.
No distant metastasis.
Stage IVC
Tumour of any size.
May or may not have lymph node involvement.
Distant metastasis is present.
Reference: AJCC Cancer Staging Manual, 8th Edition.
MEDULLARY THYROID CANCER STAGING:
STAGE I
Tumour is 2 cm or smaller.
No lymph node involvement.
No distant metastasis.
STAGE II
Tumour is between 2 cm and 4 cm.
No lymph node involvement.
No distant metastasis.
STAGE III
Tumour size varies.
Spread to nearby lymph nodes.
No distant metastasis.
STAGE IV
Stage 4 medullary thyroid cancer (MTC) represents a critical and challenging phase of the disease. The stage is generally broken down into sub-stages: IVA, IVB, and IVC, each with distinct characteristics.
It is divided into IVA, IVB, and IVC, indicating more extensive local spread, lymph node involvement, or distant metastasis.
Stage IVA
Tumour of any size that extends beyond the thyroid.
May involve adjacent structures such as the larynx, trachea, oesophagus, or recurrent laryngeal nerve.
Lymph node involvement is common but limited to the central neck area.
No distant metastasis.
Stage IVB
Tumour invades more distant structures such as the prevertebral fascia or encases the carotid artery or mediastinal vessels.
Lymph node involvement can extend to lateral neck or mediastinal nodes.
No distant metastasis.
Stage IVC
Tumour of any size and extent.
May or may not involve lymph nodes.
Distant metastasis is present, often involving the liver, lungs, or bones.
Reference: AJCC Cancer Staging Manual, 8th Edition; Wells SA Jr, Asa SL, Dralle H, et al., Thyroid, 2015.
ANAPLASTIC THYROID CANCER STAGING
Unlike other forms, anaplastic thyroid cancer is always considered to be at an advanced stage when it is diagnosed. Due to its aggressive nature, rapid growth, and early spread to surrounding tissues and distant organs, it is not categorized into the earlier stages (1-3) that are typical for other forms of thyroid cancer.
Stage IVA
Tumour of any size, confined to the thyroid.
May have lymph node involvement.
No distant metastasis.
Stage IVB
Tumour of any size, extending beyond the thyroid.
May have lymph node involvement.
No distant metastasis.
Stage IVC
Tumour of any size.
May have lymph node involvement.
Distant metastasis present.
Reference: AJCC Cancer Staging Manual, 8th Edition.
By understanding these stages in detail, Dr Sandeep Uppal and his team at The ENT Clinic are better equipped to offer comprehensive and individualized treatment plans. They collaborate closely with other specialists to provide the most effective care for each stage of thyroid cancer, enhancing the potential for successful outcomes.