Thyroid cancer staging

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Thyroid cancer staging is done with the TNM staging system.

TNM staging system

Tumour stage not including anaplastic carcinoma

T stage Size/criteria Other requirements Comment
pT1a 1 cm or less limited to thyroid very common
pT1b >1 cm and <=2 cm limited to thyroid
pT2 >2 cm and <=4 cm limited to thyroid
pT3a >4 cm limited to thyroid changed from AJCC 7th Ed.
pT3b extension into strap muscles strap muscles include: sternothyroid m., sternothyroid, thyrohyoid, omohyoid changed from AJCC 7th Ed.
pT4a any size any of the following: subcutaneous tissue, trachea, esophagus, larynx, recurrent laryngeal nerve
pT4b any size any of the following: mediastinal vessels, encasing carotid artery, prevertebral fascia

Lymph nodes

N stage Criteria Comment
pN0 negative for lymph node metastasis
pN1a metastasis to level VI or VII level VI = pretracheal, paratracheal, prelaryngeal/Delphian, perithyroidal; VII = mediastinal lymph nodes
pN1b metastasis to level I, II, III, IV, V, or retropharyngeal (level VII changed to pN1a in AJCC 8th Ed.)


  • Central neck dissection = level VI and VII[1]

See also


  1. Giugliano G, Proh M, Gibelli B, Grosso E, Tagliabue M, De Fiori E, Maffini F, Chiesa F, Ansarin M (February 2014). "Central neck dissection in differentiated thyroid cancer: technical notes". Acta Otorhinolaryngol Ital 34 (1): 9–14. PMID 24711677.