There are several systems for determining the stage of cancer, based on which the forecast is. In these systems, we discuss various features such as cancer, and the patients themselves. Fortunately, thyroid cancer prognosis is usually very favorable. Unlike many other cancers, it is of great importance the patient's age and the time of diagnosis.
Patients who are 45 years or less rarely die from cancer of the thyroid gland, whether struck lymph nodes around the thyroid, of whether cancer has spread to adjacent tissue, and even from one he gave metastases. However, older patients, all these factors are important. However, for their proliferation of cancer cells in the lymph nodes are not normally means lower survival. Spread of malignant cells in the lymph nodes
Lymph nodes - what keeps our immune system
It increases the likelihood of recurrence of thyroid cancer, but it is also quite easy to treat by surgery and radioiodine.
Stages of thyroid cancer
The most common classification of the stages of development of cancer is TNM (T - tumor, or a tumor; N - nodule, the node; M - distant metastasis, distant metastasis).
T: Tumor size (in cm)
- T1: & lt; 1cm;
- T2: 1-4 cm;
- T3: & gt; 4 cm.
- T4: The tumor grows beyond the thyroid.
- T4a: sprouting in the adjacent structure;
- T4b: sprouting in the spine or the adjacent large blood vessels.
N: Lymph Nodes
- N0: lymph nodes are not affected;
- N1: the cancer has spread to regional lymph nodes;
- N1a: nodal involvement in the central part of the neck;
- N1b: nodal involvement in the side of the neck or chest.
M: The remote metastases
- (spread of cancer in other body, such as the lungs or bone).
- M0: No distant metastasis;
- M1: the presence of distant metastases.
On the basis of these three categories of cancer are assigned to the first, second, third or fourth stage. The first - the initial stage with the best prognosis, the fourth - the last and the least favorable prognosis. The following table shows the forecast of local recurrence (likelihood of recurrence of cancer of the thyroid gland in the neck), recurrence in distant organs and ten-year survival rates for various stages of thyroid cancer.
|
Stage
|
Age & lt; 45
|
Age & gt; 45
|
Local recurrence
|
Relapse in distant organs
|
Ten-year survival rate
|
|
I
|
Any T and N, M0
|
T1 N0 M0
|
5.5%
|
2.8%
|
98%
|
|
II
|
And T Any N, M1
|
T2 N0 M0
|
7%
|
7%
|
89%
|
|
III
|
-
|
T3 N0 M0
T1-3 N1a M0
|
27%
|
13.5%
|
Approximately 82%
|
|
IVa
|
-
|
T4a N0 M0
T1-4 N1b M0
|
|
|
|
|
IVb
|
-
|
T4b N0-1b M0
|
|
|
|
|
IVc
|
-
|
And T Any N M1
|
60.9%
|
100%
|
50%
|
Note that for patients with highly differentiated thyroid cancer (including papillary and follicular cancer) age is the most important prognostic factor. If the patient is less than 45 years, even in the presence of metastasis prognosis is very good.
In forecasting for patients with medullary thyroid cancer
Medullary thyroid cancer: identification of disease
Age does not play such a big role. On average, in patients with medullary thyroid cancer in the tumor growth only within the thyroid gland (T1-3) ten-year survival rate is 95%. Patients with metastatic medullary thyroid cancer survival from 20% to 40%.
Importantly, the classification is very subjective, especially for tumors with little special characteristics - for example, when follicular cancer. For this reason, to accurately determine the stage of follicular thyroid cancer
Follicular thyroid cancer: no one is safe
It may be more difficult than with other types of cancer - the output will largely depend on the subjective opinion of a physician. For example, some doctors estimate capsular and vascular invasion (minimal growth of cancer that can be seen only through a microscope), as the spread of cancer, while others - not. Accordingly, the assessment will be different stages of cancer and prognosis.
To predict the development of the disease in patients with papillary thyroid cancer has a special method - MAICS (abbreviation used prognostic factors: the presence of distant metastases (Metastasis), age (Age) patient, germination (Invasion) in the surrounding tissue, visible to the naked eye, the fullness (Completeness ) surgical removal of the tumor and the size (Size) of the tumor). All of these factors are used to calculate the total index MAICS follows:
|
Factors
|
The numerical value
|
|
Are there any remote metastases - that is, whether the cancer has spread beyond the neck?
|
Yes = 3
no = 0
|
|
The patient's age at the time of diagnosis of papillary thyroid cancer
|
Younger than 39 years = 3.1
Older than 40 years = 0.08 x age of the patient
|
|
Did the surgeon during the operation, the tumor has spread beyond the thyroid gland?
|
Yes = 1
no = 0
|
|
Were there any parts of the tumor that the surgeon was unable to remove (for example, part, attached to the trachea)
|
Yes = 1
no = 0
|
|
Tumor Size
|
0.3 x tumor size in inches
|
Once for each factor to determine the numerical value of all summed indicator turns MAICS, on the basis of which is determined by the likelihood that the patient will live not less than 20 years after he was diagnosed with papillary thyroid cancer
Thyroid cancer: it is curable
. Most patients with diagnosed MAICS less than 6.0.
|
Indicator MAICS
|
& lt; 6.0
|
6.0 - 6.99
|
7.0 - 7.99
|
& gt; 8.0
|
|
Twenty-year survival rate
|
99%
|
89%
|
56%
|
24%
|
A table shows the five-year survival for patients with different types of thyroid cancer:
|
Papillary thyroid cancer
|
|
|
Stage
|
5-year survival
|
|
I
|
Nearly 100%
|
|
II
|
Nearly 100%
|
|
III
|
93%
|
|
IV
|
51%
|
|
Follicular thyroid cancer
|
|
|
Stage
|
5-year survival
|
|
I
|
Nearly 100%
|
|
II
|
Nearly 100%
|
|
III
|
71%
|
|
IV
|
50%
|
|
Medullary thyroid cancer
|
|
|
Stage
|
5-year survival
|
|
I
|
Nearly 100%
|
|
II
|
98%
|
|
III
|
81%
|
|
IV
|
28%
|
