The calculator in question is the TNM Classification for Parathyroid Carcinoma, also known as the Schulte system. This calculator is used specifically for patients diagnosed with parathyroid carcinoma, a rare type of endocrine cancer. The clinical utility of this calculator lies in its ability to stage the disease based on tumor size (T), lymph node involvement (N), and presence of distant metastasis (M). This staging system helps clinicians to determine the severity of the disease, plan appropriate treatment strategies, and predict patient prognosis. The Schulte system does not have specific exclusion criteria, but it may not be applicable or accurate in cases where the patient has other concurrent endocrine disorders or malignancies that could complicate the staging process.

TNM classification for parathyroid carcinoma (Schulte system)

# Description:
The calculator in question is the TNM Classification for Parathyroid Carcinoma, also known as the Schulte system. This calculator is used specifically for patients diagnosed with parathyroid carcinoma, a rare type of endocrine cancer. The clinical utility of this calculator lies in its ability to stage the disease based on tumor size (T), lymph node involvement (N), and presence of distant metastasis (M). This staging system helps clinicians to determine the severity of the disease, plan appropriate treatment strategies, and predict patient prognosis. The Schulte system does not have specific exclusion criteria, but it may not be applicable or accurate in cases where the patient has other concurrent endocrine disorders or malignancies that could complicate the staging process.
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# Inputs:
## Tumor classification
A. Tx: Primary tumor cannot be assessed
B. T1. Tumor with capsular invasion
C. T2: Tumor with invasion of surrounding soft tissues, excluding the vital organs trachea, larynx, and esophagus
D. T3: Tumor with vascular invasion
E. T4: Tumor with invasion of vital organs (hypopharynx, trachea, esophagus, larynx, recurrent laryngeal nerve, or carotid artery)

## Lymph node classification
F. Nx: Regional lymph nodes cannot be assessed
G. N0: No regional lymph node metastasis
H. N1: Regional lymph node metastasis present

## Metastasis classification
I. M0: No distant metastasis
J. M1: Distant metastasis present
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# Scoring:
- If (B or C) and G and I, then Stage I
- If D and G and I, then Stage II
- If ((B or C or D or E) and H and I) or (E and G and I), then Stage III
- If (B or C or D or E) and (G or H) and J, then Stage IV
- If true, then Stage cannot be fully assessed)