Radiation Oncology/Bladder/Staging
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Bladder Cancer Staging
AJCC 7th Edition (2009)
[edit | edit source]Primary Tumor:
- Ta - non-invasive papillary carcinoma
- Tis - carcinoma in situ, "flat tumor"
- T1 - invades subepithelial connective tissue
- T2 - invades muscularis propria
- T2a - invades superficial muscle (inner half)
- T2b - invades deep muscle (outer half)
- T3 - invades perivesical tissue
- T3a - microscopically
- T3b - macroscopically (extravesical mass)
- T4 - invades other organs
- T4a - invades prostatic stroma, uterus, vagina
- T4b - invades pelvic wall, abdominal wall
Regional Lymph Nodes:
- Regional nodes include (primary nodal drainage): hypogastric, obturator, iliac (int/ext), perivesical, sacral, presacral
- Regional nodes (secondary nodal drainage): common iliac
- N0 - none
- N1 - single LN metastasis in the true pelvis (below common iliac)
- N2 - multiple LN metastases in the true pelvis (below common iliac)
- N3 - metastases to the common iliac LNs
Stage Grouping:
- Stage 0a - Ta N0M0
- Stage 0is - Tis N0M0
- Stage I - T1 N0
- Stage II - T2 N0
- Stage III - T3N0 or T4aN0
- Stage IV - T4b or any N+ or M1
Changes from 6th Edition:
- For T4 via prostate invasion, must invade prostate stroma. Subepithelial invasion of the prostatic urethra is not sufficient to qualify for T4.
- N-stages reclassified
Older staging systems
[edit | edit source]AJCC 6th Edition (2002)
Primary Tumor:
- Ta - non-invasive papillary carcinoma
- Tis - carcinoma in situ, "flat tumor"
- T1 - invades subepithelial connective tissue
- T2 - invades muscle
- T2a - invades superficial muscle (inner half)
- T2b - invades deep muscle (outer half)
- T3 - invades perivesical tissue
- T3a - microscopically
- T3b - macroscopically (extravesical mass)
- T4 - invades other organs
- T4a - invades prostate, uterus, vagina
- T4b - invades pelvic wall, abdominal wall
Regional Lymph Nodes:
- Regional nodes are the nodes of the true pelvis below the common iliac.
- N1 - single LN, 2 cm or less
- N2 - single LN 2-5 cm; or multiple LN < 5 cm
- N3 - LN > 5 cm
Stage Grouping:
- Stage 0a - Ta N0M0
- Stage 0is - Tis N0M0
- Stage I - T1 N0
- Stage II - T2 N0
- Stage III - T3N0 or T4aN0
- Stage IV - T4b or any N+ or M1
AJCC 5th Edition (1997)
No changes compared to 6th Edition
AJCC 4th edition (1992)
- T1 (same), T2 (superficial muscle), T3a (deep muscle), T3b (perivesical fat), T4 (invades prostate, uterus, vagina, pelvic wall, abdominal wall)
UICC Staging: 3rd Edition (1978)
- 3rd edition (1978) - T3 is deep muscle invasion (similar to T2b)