TNM Classification for Bladder Cancer
The tumor-node-metastasis (TNM) classification for staging of bladder cancer is provided below. [1, 2]
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 lamina propria (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 (perivesical, obturator, internal and external iliac, or sacral lymph node) |
N2 |
Multiple regional lymph node metastasis in the true pelvis (perivesical, obturator, internal and external iliac, or sacral lymph node metastasis) |
N3 |
Lymph node metastasis to the common iliac lymph nodes |
Distant metastasis (M) |
|
MO |
No distant metastasis |
M1 |
Distant metastasis |
M1a |
Distant metastasis limited to lymph nodes beyond the common iliacs |
M1b |
Non–lymph node distant metastases |
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 IIIA |
T3a |
N0 |
M0 |
T3b |
N0 |
M0 |
|
T4a |
N0 |
M0 |
|
T1-T4a |
N1 |
M0 |
|
Stage IIIB |
T1-T4a |
N2,N3 |
M0 |
Stage IVA |
T4b |
Any N |
M0 |
Any T |
Any N |
M1a |
|
Stage IVB |
Any T |
Any N |
M1b |