Bladder Cancer Staging 

Updated: Dec 20, 2017
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: E Jason Abel, MD  more...
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TNM Classification for Bladder Cancer

The TNM classification for staging of bladder cancer is provided below. [1]

Table. TNM Classification for Bladder Cancer (Open Table in a new window)

Primary tumor (T)

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Ta

Noninvasive papillary carcinoma

Tis

Carcinoma in situ: “flat tumor”

T1

Tumor invades subepithelial connective tissue

T2

Tumor invades muscularis propria

pT2a

Tumor invades superficial muscularis propria (inner half)

pT2b

Tumor invades deep muscularis propria (outer half)

T3

Tumor invades perivesical tissue

pT3a

Microscopically

pT3b

Macroscopically (extravesical mass)

T4

Tumor invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall

T4a

Tumor invades prostatic stroma, uterus, vagina

T4b

Tumor invades pelvic wall, abdominal wall

Regional lymph nodes (N)

Regional lymph nodes include both primary and secondary drainage regions. All other nodes above the aortic bifurcation are considered distant lymph nodes.

NX

Lymph nodes cannot be assessed

N0

No lymph node metastasis

N1

Single regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node)

N2

Multiple regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node metastasis)

N3

Lymph node metastasis to the common iliac lymph nodes

Distant metastasis (M)

MO

No distant metastasis

M1

Distant metastasis

Table. Anatomic stage/prognostic groups (Open Table in a new window)

Stage

T

N

M

Stage 0a

Ta

N0

M0

Stage 0is

Tis

N0

M0

Stage I

T1

N0

M0

Stage II

T2a

N0

M0

 

T2b

N0

M0

Stage III

T3a

N0

M0

 

T3b

N0

M0

 

T4a

N0

M0

Stage IV

T4b

N0

M0

 

Any T

N1-3

M0

 

Any T

Any N

M1