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Parathyroid carcinoma proposed TNM definitions AJCC UICC 8th edition

Parathyroid carcinoma proposed TNM definitions AJCC UICC 8th edition
Primary tumor (T)
T category T criteria
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Atypical parathyroid neoplasm (neoplasm of uncertain malignant potential)*
T1 Localized to the parathyroid gland with extension limited to soft tissue
T2 Direct invasion into the thyroid gland
T3 Direct invasion into recurrent laryngeal nerve, esophagus, trachea, skeletal muscle, adjacent lymph nodes, or thymus
T4 Direct invasion into major blood vessel or spine
* Defined as tumors that are histologically or clinically worrisome but do not fulfill the more robust criteria (ie, invasion, metastasis) for carcinoma. They generally include tumors that have two or more concerning features, such as fibrous bands, mitotic figures, necrosis, trabecular growth, or adherence to surrounding tissues intraoperatively. Atypical parathyroid neoplasms usually have a smaller dimension, weight, and volume than carcinomas and are less likely to have coagulative tumor necrosis.
Regional lymph nodes (N)
N category N criteria
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
N1a Metastasis to level VI (pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes) or superior mediastinal lymph nodes (level VII)
N1b Metastasis to unilateral, bilateral, or contralateral cervical (levels I, II, III, IV, or V) or retropharyngeal nodes
Distant metastasis (M)
M category M criteria
M0 No distant metastasis
M1 Distant metastasis
Prognostic stage groups
There are not enough data to propose anatomic stage and prognostic groups for parathyroid carcinoma.
Because the available data on tumor characteristics and prognosis are so limited, the AJCC acknowledge that proposing a staging system at this time would be premature. Instead, the AJCC propose and define specific variables to be ascertained and recorded prospectively to facilitate development of a formal staging system in the future.
TNM: tumor, node, metastasis; AJCC: American Joint Committee on Cancer.
Used with permission of the American College of Surgeons, Chicago, Illinois. The original source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing.
Graphic 110637 Version 12.0

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