ในเดือนตุลาคม 2559 ทาง American Joint of Cancer Committee หรือ AJCC ได้ปรับปรุง AJCC/TNM cancer staging system เป็น version ที่ 8
สำหรับ differentiated และ anaplastic thyroid carcinoma ได้มีการเปลี่ยนแปลงที่สำคัญ ดังนี้
Differentiated thyroid carcinoma
1. The age cutoff used for staging was increased from 45 to 55 y at diagnosis.
2. Minor extrathyroidal extension detected only on histologic examination was removed from the definition of T3 disease and therefore has no impact on either T category or overall stage.
3. N1 disease no longer upstages a patient to stage III; if the patient is age <55 y at diagnosis, N1 disease is stage I; if age >55 y of age, N1 disease is stage II.
4. T3a is a new category for tumors > 4 cm confined to the thyroid gland.
5. T3b is a new category for tumors of any size demonstrating gross extrathyroidal extension into strap muscles (sternohyoid, sternothyroid, thyrohyoid, or omohyoid muscles)
6. Level VII lymph nodes, previously classified as lateral neck lymph nodes (N1b), were reclassified as central neck lymph nodes (N1a) to be more anatomically consistent and because level VII presented significant coding difficulties for tumor registrars, clinicians, and researchers.
7. In differentiated thyroid cancer, the presence of distant metastases in older patients is classified as stage IVB disease rather than stage IVC disease; distant metastasis in anaplastic thyroid cancer continues to be classified as stage IVC disease.
1. Unlike previous editions, where all anaplastic thyroid cancers were classified as T4 disease, anaplastic cancers will now use the same T definitions as differentiated thyroid cancer.
2. Intrathyroidal disease is stage IVA, gross extrathyroidal extension or cervical lymph node metastases is stage IVB, and distant metastases is stage IVC.
อ่านเพิ่มเติมได้ที่ Review AJCC8th