Clinical T

This input is used for staging


**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for thyroid tumors. **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. * Anaplastic is defined by: histology (8020/3, 8021/3, 8030/3, 8031/3, 8032/3) or Grade 4 (undifferentiated, anaplastic) **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. * If the tumor appears to be in the T1, T2 or T3 categories, but no size or category is specified, assign TX **Note 4:** Assign the appropriate T category (T1, T2 or T3) based on the tumor size for the following descriptions Single invasive tumor confined to thyroid Extension into thyroid capsule, but not beyond Multiple foci confined to thyroid Confined to thyroid, NOS Localized, NOS **Note 5:** Multifocal tumors of all histological types should be designated (m) (the largest determines the classification), e.g, T2. * Record the information regarding solitary vs. multifocal tumors in **Site-Specific Factor 1, Solitary vs Multifocal Tumor**


Clinical T Clinical T Display Description Registrar Notes
cX cTX Primary tumor cannot be assessed Clinical classification criteria met, evaluation done:
Physician unable to assess T
Extension cannot be determined
Tumor size (TS) unknown for T categories where TS needed to determine T
Physician assigns cTX, no other information available to determine T

Confined 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,
LIMITED 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

Stated as T1[NOS]
c1A cT1a Tumor 1 cm or less in greatest dimension,
LIMITED to the thyroid
Stated as T1a
c1B cT1b Tumor more than 1 cm but not more than 2 cm in greatest dimension,
LIMITED to the thyroid
Stated as T1b
c2 cT2 Tumor more than 2 cm but not more than 4 cm in greatest dimension,
LIMITED to the thyroid
Stated as T2
c3 cT3 Tumor more than 4 cm in greatest dimension
Limited to the thyroid

Any tumor with minimal extrathyroid extension
(e.g., extension to sternothyroid muscle or perithyroid soft tissues)
Stated as T3

Minimal extrathyroid extension including:
Strap muscle(s):

Pericapsular 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

Note 2: Anaplastic tumors: Assign T4, or one of its subcategories. Assign T4 [NOS] if no information available to assign T4a or T4b.

Tumor invades, bone, nerve or extrinsic deep muscles

Stated as T4[NOS]
c4A cT4a Tumor extends beyond the thyroid capsule and invades any of the following:
Subcutaneous soft tissues
Recurrent laryngeal nerve

(anaplastic carcinoma only) Tumor (any size) limited to the thyroid
Cricoid cartilage
Recurrent laryngeal
Sternocleidomastoid muscle

Stated as T4a
c4B cT4b Tumor invades:
Prevertebral fascia
Mediastinal vessels

Or encases carotid artery

(anaplastic carcinoma only) Tumor (any size) extends beyond the thyroid capsules
Blood vessel(s) (major):
Carotid artery (encased)
Jugular vein
Thyroid artery or vein
Skeletal muscle, other than strap or sternocleidomastoid muscle
Thyroid cartilage
Tumor described as ""FIXED to adjacent tissues""

Further contiguous extension including:
Mediastinal tissues
Prevertebral fascia

Stated as T4b
88 88 Not applicable Primary site/histology not TNM defined
In situ case but no pTis is defined by TNM
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Clinical classification criteria not met
Clinical classification criteria met, evaluation done:
No information about diagnostic workup
Results not documented in record
Clinical evaluation of primary tumor not done or unknown if done
Tumor first detected on surgical resection (no clinical workup)
Evidence of metastatic disease [(cM1) or (pM1)], no other workup
Only Clinical Stage Group documented (no T, N, or M information available)
\* 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]. \# T4 [NOS] is not defined in AJCC 7th edition.