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Newest Staging System for Differentiated Thyroid Cancer Begins This Month
In the 2018 staging guidelines from the American Joint Commission on Cancer (AJCC), patients under age 55 at the time of diagnosis with papillary, follicular, or Hurthle cell thyroid cancer, or their variants, are considered lower risk than patients age 55 or older.
AJCC changed the age from 45 to 55 as of January 2018. However, there is no single "cutoff" point for age. One article noted that after age 35, thyroid cancer mortality increases with increasing age.
Stage I
- In patients younger than 55: Cancer (any size) is located in the thyroid gland. It may also be present in nearby neck (cervical) lymph nodes and/or nearby neck tissue. However, it has not spread to distant sites.
- In patients 55 years of age or older: Cancer is only located in the thyroid gland and is less than 4 centimeters (about 1.5 inches) in size. It is not in nearby neck tissue or lymph nodes and has not spread to any distant sites.
Stage II
- In patients younger than 55: Cancer has spread beyond the thyroid and neck area (i.e., there are distant metastases).
- In patients 55 years of age or older: Cancer is either over 4 centimeters in size or else is any size and has spread to lymph nodes or into strap muscles in the nearby neck tissue, but has not spread to distant sites. Or else cancer is in the thyroid only and is over 4 centimeters (about 1.5 inches) in size. It has not spread to lymph nodes, nearby neck tissue, or distant sites.
Stage III
- Patients 55 years of age or younger are Stages I or II only.
- In patients 55 years of age or older: The tumor is any size and cancer has spread to nearby cervical lymph nodes and nearby neck tissue, subcutaneous tissue, larynx, trachea, esophagus, and/or recurrent laryngeal nerve but not to distant sites, or else the tumor is larger than 4 centimeters but has not spread outside the thyroid gland other than minimally to nearby neck tissue but not to distant sites.
Stage IV
- In patients 55 years of age or older: Cancer has spread to other parts of the body outside the neck area, such as lungs and bones, or has extensively invaded nearby tissues in the neck (other than nearby neck lymph nodes), including large blood vessels.
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