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Table 1 TNM staging for differentiated cancers (papillary and follicular)

From: Indolent thyroid cancer: knowns and unknowns

Primary Tumor (T)
 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
Regional Lymph Nodes (N) Regional lymph nodes are the central compartment, lateral cervical, and upper mediastinal lymph nodes.
 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)
Distant Metastasis (M)
 M0 No distant metastasis
 M1 Distant metastasis
Age less than 45 years
 Stage I Any T Any N M0
 Stage II Any T Any N M1
Age greater than 45 years
 Stage I T1 N0 M0
 Stage II T2 N0 M0
 Stage III T3 N0 M0
T1 N1a M0
T2 N1a M0
T3 N1a M0
 Stage IVA T4a N0 M0
T4a N1a M0
T1 N1b M0
T2 N1b M0
T3 N1b M0
T4a N1b M0
 Stage IVB T4b Any N M0
 Stage IVC Any T Any N M1
  1. Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer Science + Business Media