{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T01:52:55Z","timestamp":1782179575842,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,2,1]],"date-time":"2007-02-01T00:00:00Z","timestamp":1170288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The understanding of biology of well\u2010differentiated thyroid cancer has improved in the last two decades with the detailed understanding of prognostic factors and risk group stratification. The risk groups are crucial in the management of thyroid cancer and overall prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>TNM Staging System<\/jats:title><jats:p>The TNM staging system has been used in all human cancers, and it adheres to the biology of tumors. The data in thyroid cancer comes from retrospective studies, as there are no prospective randomized trials. The most recent TNM staging system was revised and published (6th edition) in 2002. The major attributes of the staging system include: age as the most important prognostic factor, and age is included in the staging system, below and above the age of 45; T1 tumors are considered to be those below 2\u00a0cm; T3 tumors include minor extrathyroidal extension invading the strap muscles; T4 tumors includes T4a and T4b, T4a being operable tumors; all anaplastic cancers are T4, although operable anaplastic thyroid cancers are considered to be T4a.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These changes in the TNM system are consistent with our current philosophy in the overall management of thyroid cancer and adjuvant therapy. The N staging system includes N1a and N1b\u2014N1a being level VI lymph nodes, while N1b includes level IV and superior mediastinal and contralateral neck nodes. The TNM staging system helps reporting our data and comparing results in different parts of the world. However, there is no level I evidence in thyroid cancer.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-006-0864-0","type":"journal-article","created":{"date-parts":[[2007,2,15]],"date-time":"2007-02-15T15:08:08Z","timestamp":1171552088000},"page":"879-887","source":"Crossref","is-referenced-by-count":87,"title":["TNM Classification of Thyroid Carcinoma"],"prefix":"10.1002","volume":"31","author":[{"given":"Ashok R.","family":"Shaha","sequence":"first","affiliation":[{"name":"Head and Neck Service Memorial Sloan\u2010Kettering Cancer Center 1275 York Avenue 10021 New York NY USA"},{"name":"Cornell University Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,2]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"69","article-title":"Tumor, Node and Metastasis (TNM)","volume":"1","author":"Denoix PF","year":"1944","journal-title":"Bull Inst Nat Hyg (Paris)"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ssu.10014"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11898"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/0-387-33126-3"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100347(199603\/04)18:2<127::AID\u2010HED3>3.0.CO;2\u20103"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(03)00384\u20102"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200002010\u201000001"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100142(19981215)83:12<2638::AID\u2010CNCR31>3.0.CO;2\u20101"},{"key":"e_1_2_1_10_2","first-page":"1088","article-title":"Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system","volume":"102","author":"Hay ID","year":"1987","journal-title":"Surgery"},{"key":"e_1_2_1_11_2","first-page":"947","article-title":"Predicting outcome in papillary thyroid carcinoma: development of reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989","volume":"114","author":"Hay ID","year":"1993","journal-title":"Surgery"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(05)80124\u20102"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2964(79)90291-3"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(97)00162\u20101"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(98)70034-0"},{"key":"e_1_2_1_16_2","first-page":"1154","article-title":"Addition of nuclear DNA content to the AMES risk\u2010group classification for papillary thyroid cancer","volume":"112","author":"Pasieka JL","year":"1992","journal-title":"Surgery"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19910715)68:2<324::AID\u2010CNCR2820680220>3.0.CO;2\u2010S"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(87)90758\u20103"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19850215)55:4<794::AID\u2010CNCR2820550418>3.0.CO;2\u2010Z"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02303583"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010198209000\u201000016"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(05)80732\u20109"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(05)80729\u20109"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(05)80539\u20102"},{"key":"e_1_2_1_25_2","first-page":"10","article-title":"Multivariate study of prognostic factors of differentiated thyroid carcinoma: the significance of histologic subtype","volume":"78","author":"Noguchi M","year":"1993","journal-title":"Int Surg"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(94)90321\u20102"},{"key":"e_1_2_1_27_2","first-page":"315","article-title":"Review. 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