_________________________________________________________________________ Thyroid Dysfunction
PAPILLARY OR FOLLICULAR CARCINOMA STAGING AND ASSOCIATED PROGNOSIS a
Stage
TNM Classification
Five-Year Survival Rate
Papillary Carcinoma
Follicular Carcinoma
Stage I
T1, N0/NX, M0 T2, N0/NX, M0
Nearly 100%
Nearly 100%
Stage II
T1, N1, M0 T2, N1, M0 T3a/T3b, any N, M0
Nearly 100%
Nearly 100%
Stage III Stage IVA
T4a, any N, M0 T4b, any N, M0
93% 51%
71% 50%
Stage IVB Any T, any N, M1 aAll stages and prognoses are for patients 55 years of age or older. Source: [24; 40; 41]
Table 3
MEDULLARY CARCINOMA STAGING AND ASSOCIATED PROGNOSIS
Stage
TNM Classification
Five-Year Survival Rate
Stage I Stage II
T1, N0, M0 T2, N0, M0 T3, N0, M0
Nearly 100%
98%
Stage III Stage IVA
T1-3, N1a, M0 T4a, any N, M0 T1-3, N1b, M0 T4b, any N, M0 Any T, any N, M1
81% 28%
Stage IVB Stage IVC
Source: [24; 40; 41]
Table 4
ANAPLASTIC CARCINOMA STAGING AND ASSOCIATED PROGNOSIS a
Stage
TNM Classification T1-3a, N0/NX, M0
Five-Year Survival Rate
Stage IVA Stage IVB
7%
T1-3a, N1, M0 T3b, any N, M0 T4, any N, M0
Stage IVC Any T, any N, M1 aAll anaplastic carcinomas are considered stage IV. Source: [24; 40; 41] TREATMENT OPTIONS As all cancers have become more treatable over the past decades, so has thyroid cancer. There are several treatment options available for patients diagnosed with thyroid cancer, including surgery, radioactive iodine treatment, thyroid hor- mone therapy, radiation therapy, and chemotherapy. Most patients will undergo a combination of these modalities [31; 46] . Surgery is usually the initial treatment of choice for thyroid cancer. Total removal of the thyroid gland is often considered the best chance for survival with the lowest risk for a recurrence of the malignancy. Total thyroidectomy seldom requires more than one to two days of hospitalization and affords the patient
Table 5
some reassurance that the cancer is under control. Chemo- therapy is typically only used for anaplastic thyroid tumors or other types that have metastasized [31; 46; 47] . Radioactive iodine treatment destroys thyroid tissue that may be left after thyroid surgery or has metastasized beyond the thyroid gland. Thyroid hormone therapy is given to replace the hormones no longer being produced by the removed gland. It also helps to suppress the pituitary gland’s production of TSH, which could encourage the growth of any remaining cancer cells. Radioactive iodine therapy has been shown to improve the survival rate of patients with papillary or follicular thyroid cancer that has spread to the neck or other body parts [31; 46] .
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Book Code: ANCCTX2027
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