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BACKGROUND The tumor-node-metastasis (TNM) classification system to categorized anaplastic thyroid cancer (ATC) was revised. METHODS The revised system was evaluated using a large database of ATC patients. RESULTS A total of 757 patients were analyzed. The proportion and median overall survival values (OS months) for each T category were T1 (n = 8, 1.1%, 12.5), T2 (n = 43, 5.7%, 10.9), T3a (n = 117, 15.5%, 5.7), T3b (n = 438, 57.9%, 3.9), and T4 (n = 151, 19.9%, 5.. The OS of the N0 and N1 patients were 5.9 and 4.3, respectively (log