Bladder Cancer: TNM Staging

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AJCC 8th edition§[edit | edit source]

Bladder Cancer Tumor Staging
Bladder Cancer Tumor Staging. Source: Wikipedia

pTstage[edit | edit source]

  • pTX: tumour cannot be assessed
  • pT0: no evidence of tumour
  • pTa: non-invasive (confined to epithelial mucosa) papillary carcinoma
  • pTis: carcinoma in-situ
  • pT1: invades lamina propria (subepithelial connective tissue)
    • Subdivision into pT1a vs. pT1b has been proposed with some studies suggesting that deep lamina propria invasion carries a substantially more serious prognosis. However, the value of substaging has not been validated in other studies
  • pT2
    • pT2a: invades superficial muscularis propria
    • pT2b: invades deep muscularis propria
  • pT3
    • pT3a: invades perivesical fat microscopically
    • pT3b: invades perivesical fat macroscopically
  • pT4
    • pT4a: invades prostatic stroma, seminal vesicles, uterus, or vagina
      • Extension of the tumor into the prostatic urethra WITHOUT stromal invasion is currently classified under the prostatic urethral cancer staging and does not carry an adverse prognosis for patients with known bladder cancer
    • pT4b: invades pelvic/abdominal wall
  • Prognostic value of T2 and T3 substaging has been widely debated and reported

Nstage[edit | edit source]

  • Nx: lymph nodes cannot be assessed
  • N0: no lymph node metastasis
  • N1: single regional lymph node in the true pelvis
    • True pelvis lymph nodes (5)
      1. Perivesical
      2. Obturator
      3. Internal iliac (hypogastric)
      4. External iliac
      5. Presacral lymph nodes
  • N2: multiple regional lymph node metastases in the true pelvic
  • N3: lymph node metastasis to the common iliac lymph nodes

Mstage[edit | edit source]

  • M0: no distant metastasis
  • M1: distant metastasis
  • Pathologically, organ-confined bladder cancer is considered to be pT2bN0M0 or less at the time of cystectomy

Questions[edit | edit source]

  1. What is the pT staging of bladder cancer?

Answers[edit | edit source]

  1. What is the pT staging of bladder cancer?
    1. pTX: tumour cannot be assessed
    2. pT0: no evidence of tumour
    3. pTa: non-invasive (confined to epithelial mucosa) papillary carcinoma
    4. pTis: carcinoma in-situ
    5. pT1: invades lamina propria (subepithelial connective tissue)
    6. pT2
      • pT2a: invades superficial muscularis propria
      • pT2b: invades deep muscularis propria
    7. pT3
      • pT3a: invades perivesical fat microscopically
      • pT3b: invades perivesical fat macroscopically
    8. pT4
      • pT4a: invades prostatic stroma, seminal vesicles, uterus, or vagina
      • pT4b: invades pelvic/abdominal wall

Next Chapter: Diagnosis and Evaluation[edit | edit source]