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Summary of Changes

Tumor staging (T) has been revised and the categories redefined.

T4 is now divided into T4a and T4b.

Nodal staging (N) has been revised.

All anaplastic carcinomas are considered T4. The T4 category for anaplastic carcinomas is divided into T4a (intrathyroidal anaplastic carcinoma—surgically resectable) and T4b (extrathyroidal anaplastic carcinoma—surgically unresectable).

For papillary and follicular carcinomas, the stage grouping for patients older than 45 has been revised. Stage III includes tumors with minimal extrathyroid extension. Stage IVA includes tumors of any size extending beyond the thyroid capsule to invade subcutaneous soft tissues, larynx, trachea, esophagus OR recurrent laryngeal nerve. Stage IVB includes tumors that invade prevertebral fascia, carotid artery, or mediastinal vessels. Stage IVC includes advanced tumors with distant metastasis. J

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American Joint Committee on Cancer. (2002). Thyroid. In: Greene, F.L., et al. AJCC Cancer Staging Manual. Springer, New York, NY.

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