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{
  "id" : "clin_t_thyroid_93682",
  "algorithm" : "tnm",
  "version" : "1.7",
  "name" : "Clin T Thyroid",
  "title" : "Clinical 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. If a clinical workup confirms a non-anaplastic histology that is followed by a pathologic confirmation of anaplastic (pT4), a clinical T other than cT4 may be assigned. If the only information is clinical, then a cT4 must be assigned if the histology is anaplastic.\n* Anaplastic is defined by: histology (8020/3, 8021/3, 8030/3, 8031/3, 8032/3) or Grade 4 (undifferentiated, anaplastic)\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" : "2018-04-11T19:53:04.599Z",
  "definition" : [ {
    "key" : "clin_t",
    "name" : "Clinical T",
    "type" : "INPUT"
  }, {
    "key" : "clin_t_display",
    "name" : "Clinical T Display",
    "type" : "DESCRIPTION"
  }, {
    "key" : "description",
    "name" : "Description",
    "type" : "DESCRIPTION"
  }, {
    "key" : "notes",
    "name" : "Registrar Notes",
    "type" : "DESCRIPTION"
  } ],
  "rows" : [ [ "cX", "cTX", "Primary tumor cannot be assessed", "Clinical classification criteria met, evaluation done: \n    Physician unable to assess T\n    Extension cannot be determined \n    Tumor size (TS) unknown for T categories where TS  needed to determine T\nPhysician assigns cTX, no other information available to determine T\n\nConfined to thyroid, histology not anaplastic, and size not known" ], [ "c0", "cT0", "No evidence of primary tumor", "" ], [ "c1", "cT1", "Tumor 2 cm or less in greatest dimension, \nLIMITED to the thyroid", "Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories\n\nStated as T1[NOS]" ], [ "c1A", "cT1a", "Tumor 1 cm or less in greatest dimension, \nLIMITED to the thyroid", "Stated as T1a" ], [ "c1B", "cT1b", "Tumor more than 1 cm but not more than 2 cm in greatest dimension, \nLIMITED to the thyroid", "Stated as T1b" ], [ "c2", "cT2", "Tumor more than 2 cm but not more than 4 cm in greatest dimension, \nLIMITED to the thyroid", "Stated as T2" ], [ "c3", "cT3", "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\nMinimal extrathyroid extension including:\n    Strap muscle(s):\n         Omohyoid\n         Sternohyoid\n         Sternothyroid\n         Thyrohyoid\n\nPericapsular soft tissue/connective tissue" ], [ "c4", "cT4", "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]" ], [ "c4A", "cT4a", "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" ], [ "c4B", "cT4b", "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", "Clinical classification criteria not met \nClinical classification criteria met, evaluation done:\n    No information about diagnostic workup\n    Results not documented in record\nClinical evaluation of primary tumor not done or unknown if done\nTumor first detected on surgical resection (no clinical workup)\nEvidence of metastatic disease [(cM1) or (pM1)], no other workup\nOnly Clinical Stage Group documented (no T, N, or M information available)" ] ]
}




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