Bladder Cancer

STAGING

The AJCC staging system for bladder cancer makes use of information of the primary tumor, original lymph nodes, and distant metastatic disease.

Primary Tumor

TX - the primary tumor can not be assessed;

T0 - no evidence of primary tumor;

Ta - non-invasive papillary carcinoma;

TIS - carcinoma in situ;

T1 - tumor invades the subepithelial connective tissue;

T2a - tumor invades the superficial muscles;

T2b - tumor invades the deep muscle;

T3a - tumor invades the perivesical tissue microscopically;

T3b - tumor invades the perivesical tissue macroscopically;

T4a - tumor invades the prostate, uterus, or vagina;

T4b - tumor invades the pelvic wall or abdominal wall.

Regional Lymph Nodes

NX - regional lymph nodes can not be assessed;

N0 - no regional lymph node metastases;

N1 - metastases in a single lymph node, 2 cm or less in greatest dimension;

N2 - metastases in a single lymph node, more than 2 cm but not more than 5 cm in greatest dimension; or multiple lymph nodes, none more than 5 cm in greatest dimension;

N3 - metastases in a lymph node more than 5 cm in greatest dimension.

Distant Metastases

MX - distant metastases can not be assessed;

M0 - no distant metastases;

M1 - distant metastases.

STAGE GROUPING:

Stage 0a, Ta - N0 M0;

Stage 0is, Tis - N0 M0;

Stage I - T1 N0 M0;

Stage II - T2a or T2b N0 M0;

Stage III - T3a, T3b, T4a N0 M0;

Stage IV - T4b N0 M0, NET N1, 2, or 3, M0, or NET, NEN, M1.