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TNM and Stage Groupings > Thyroid
Thyroid
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| T1 |
Tumor 2 cm or less in greatest dimension limited to the thyroid |
| T1a |
Tumor 1 cm or less, limited to the thyroid |
| T1b |
Tumor more than 1 cm but not more than 2 cm in greatest dimension, limited to
the thyroid |
| T2 |
Tumor more than 2 cm but not more than 4 cm in greatest dimension, limited to
the thyroid |
| T3 |
Tumor more than 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
vessels |
All categories may be subdivided: (s) solitary tumor and (m) multifocal tumor
(the largest determines the classification).
Primary Tumor (T) - Anaplastic Carcinoma
| T Category |
Stage Category Definitions |
| T4a |
Intrathyroidal anaplastic carcinoma |
| T4b |
Anaplastic carcinoma with gross extrathyroid extension |
All anaplastic carcinomas are considered T4 tumors
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph nodes cannot be assessed. |
| N0 |
No regional lymph node metastasis |
| N1 |
Regional lymph node metastasis |
| N1a |
Metastasis to Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian
lymph nodes) |
| N1b |
Metastasis to unilateral, bilateral, or contralateral cervical (Levels I, II, III, IV or
V) or retropharyngeal or superior mediastinal lymph nodes (Level VII) |
Regional lymph nodes are the central compartment, lateral cervical, and upper
mediastinal lymph nodes.
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Distant metastasis |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups - Papillary or Follicular (Differentiated), under 45 years
| Stage |
T |
N |
M |
| I |
Any T |
Any N |
M0 |
| II |
Any T |
Any N |
M1 |
Anatomic Stage/Prognostic Groups - Papillary or Follicular (Differentiated), 45 years and older
| Stage |
T |
N |
M |
| I |
T1 |
N0 |
M0 |
| II |
T2 |
N0 |
M0 |
| III |
T3 |
N0 |
M0 |
| III |
T1 |
N1a |
M0 |
| III |
T2 |
N1a |
M0 |
| III |
T3 |
N1a |
M0 |
| IVA |
T4a |
N0 |
M0 |
| IVA |
T4a |
N1a |
M0 |
| IVA |
T1 |
N1b |
M0 |
| IVA |
T2 |
N1b |
M0 |
| IVA |
T3 |
N1b |
M0 |
| IVA |
T4a |
N1b |
M0 |
| IVB |
T4b |
Any N |
M0 |
| IVC |
Any T |
Any N |
M1 |
Anatomic Stage/Prognostic Groups - Medullary Carcinoma, all age groups
| Stage |
T |
N |
M |
| I |
T1 |
N0 |
M0 |
| II |
T2 |
N0 |
M0 |
| II |
T3 |
N0 |
M0 |
| III |
T1 |
N1a |
M0 |
| III |
T2 |
N1a |
M0 |
| III |
T3 |
N1a |
M0 |
| IVA |
T4a |
N0 |
M0 |
| IVA |
T4a |
N1a |
M0 |
| IVA |
T1 |
N1b |
M0 |
| IVA |
T2 |
N1b |
M0 |
| IVA |
T3 |
N1b |
M0 |
| IVA |
T4a |
N1b |
M0 |
| IVB |
T4b |
Any N |
M0 |
| IVC |
Any T |
Any N |
M1 |
Anatomic Stage/Prognostic Groups - Anaplastic Carcinoma
| Stage |
T |
N |
M |
| IVA |
T4a |
Any N |
M0 |
| IVB |
T4b |
Any N |
M0 |
| IVC |
Any T |
Any N |
M1 |
All anaplastic carcinomas are considered Stage IV
