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{
"id" : "thyroid_t_6166",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Path T Thyroid",
"title" : "Pathologic T",
"notes" : "**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for thyroid tumors.\n\n**Note 2:** Per TNM, anaplastic carcinomas are assigned T4.\n\n**Note 3:** Tumor size must be known to assign a value of T1, T2 or T3. You may use a physician’s statement of the T category if this is the only information in the medical record. \n* If the tumor appears to be in the T1, T2 or T3 categories, but no size or category is specified, assign TX\n\n**Note 4:** Assign the appropriate T category (T1, T2 or T3) based on the tumor size for the following descriptions\n\n Single invasive tumor confined to thyroid\n Extension into thyroid capsule, but not beyond\n Multiple foci confined to thyroid\n\n Confined to thyroid, NOS \n Localized, NOS\n\n**Note 5:** Multifocal tumors of all histological types should be designated (m) (the largest determines the classification), e.g, T2. \n* Record the information regarding solitary vs. multifocal tumors in **Site-Specific Factor 1, Solitary vs Multifocal Tumor**",
"footnotes" : "\\* T4 [NOS] is not defined by UICC in the 7th edition. Approval has been provided by UICC to use \"Tumor invades bone, nerve or extrinsic deep muscles\" as T4 [NOS].\n\\# T4 [NOS] is not defined in AJCC 7th edition.",
"last_modified" : "2018-02-02T14:54:24.376Z",
"definition" : [ {
"key" : "path_t",
"name" : "Pathologic T",
"type" : "INPUT"
}, {
"key" : "path_t_display",
"name" : "Pathologic T Display",
"type" : "DESCRIPTION"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "notes",
"name" : "Registrar Notes",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "pX", "pTX", "Primary tumor cannot be assessed", "Note: Anaplastic tumors: Do not assign TX. See T4\n\nPathologic classification criteria met, evaluation done: \n Physician unable to assess T\n Surgical resection of primary tumor, extension not stated \n Tumor size (TS) unknown for T categories where TS needed to determine T\nPhysician assigns pTX, no other information available to determine T\n\nConfined to thyroid, histology not anaplastic, and size not known" ], [ "p0", "pT0", "No evidence of primary tumor", "" ], [ "p1", "pT1", "Tumor 2 cm or less in greatest dimension, \nLIMITED to the thyroid", "Note 1: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories\n\nNote 2: T1 is not applicable for anaplastic tumors.\n\nStated as T1[NOS]" ], [ "p1A", "pT1a", "Tumor 1 cm or less in greatest dimension, \nLIMITED to the thyroid", "Stated as T1a\n\nNote: T1a is not applicable for anaplastic tumors." ], [ "p1B", "pT1b", "Tumor more than 1 cm but not more than 2 cm in greatest dimension, \nLIMITED to the thyroid", "Stated as T1b\n\nNote: T1b is not applicable for anaplastic tumors." ], [ "p2", "pT2", "Tumor more than 2 cm but not more than 4 cm in greatest dimension, \nLIMITED to the thyroid", "Stated as T2\n\nNote: T2 is not applicable for anaplastic tumors." ], [ "p3", "pT3", "Tumor more than 4 cm in greatest dimension \nLimited to the thyroid \n\nAny tumor with minimal extrathyroid extension \n (e.g., extension to sternothyroid muscle or perithyroid soft tissues)", "Stated as T3\n\nNote: T3 is not applicable for anaplastic tumors.\n\nMinimal extrathyroid extension including:\n Strap muscle(s):\n Omohyoid\n Sternohyoid\n Sternothyroid\n Thyrohyoid\n\nPericapsular soft tissue/connective tissue" ], [ "p4", "pT4", "Not defined by UICC*#", "Note 1: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories\n\nNote 2: Anaplastic tumors: Assign T4, or one of its subcategories. Assign T4 [NOS] if no information available to assign T4a or T4b.\n\nTumor invades, bone, nerve or extrinsic deep muscles\n\nStated as T4[NOS]" ], [ "p4A", "pT4a", "Tumor extends beyond the thyroid capsule and invades any of the following: \n Subcutaneous soft tissues\n Larynx\n Trachea\n Esophagus\n Recurrent laryngeal nerve \n\n(anaplastic carcinoma only) Tumor (any size) limited to the thyroid", "Cricoid cartilage\nEsophagus\nLarynx\nNerves:\n Recurrent laryngeal \n Vagus\nParathyroid\nSternocleidomastoid muscle\nTrachea\n\nStated as T4a" ], [ "p4B", "pT4b", "Tumor invades: \n Prevertebral fascia\n Mediastinal vessels \n\nOr encases carotid artery\n\n(anaplastic carcinoma only) Tumor (any size) extends beyond the thyroid capsules", "Bone\nBlood vessel(s) (major):\n Carotid artery (encased)\n Jugular vein\n Thyroid artery or vein\nSkeletal muscle, other than strap or sternocleidomastoid muscle\nThyroid cartilage\nTumor described as \"\"FIXED to adjacent tissues\"\"\n\nFurther contiguous extension including:\n Mediastinal tissues\n Prevertebral fascia\n\nStated as T4b" ], [ "88", "88", "Not applicable", "Primary site/histology not TNM defined \nIn situ case but no pTis is defined by TNM\nDeath certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Pathologic classification criteria not met \nPathologic classification criteria met, evaluation done: \n Results not documented in patient record \n No surgical resection of known primary tumor (not T0) \n Resection insufficient for site-specific pathologic assessment\nNo surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category\nEvidence of metastatic disease (pM1), no other workup\nOnly Pathologic Stage Group documented (no T, N, or M information available)" ] ]
}
