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Staging of bladder cancer

The T stage describes the extent of the tumor in the wall of the organ, depth of infiltration in the urinary bladder, ureter, and renal pelvis wall. The T classification is differentiated into clinical T stage (T), which is clinically diagnosed (with endoscopy, palpation, image diagnostics) and histopathological pT classification. In principle, the pathological stage (pT) can only be given after a histological examination of a cystectomy specimen, but a specimen from a transurethral resection will provide the pT stage for superfical tumors (≤ T1), as long as muscularis mucosa in included in the specimen.

The N stage describes whether there is metastasis to lymph nodes and how extensive the spread is. N0 and M0 indicate that distant metastasis has not been found.

 

 

 

 

TNM tumor classification for urinary bladder (13)
T/N category  Depth of growth (T)/size (N) 

Ta

Tis

T1

Non-infiltrating papillary

In situ (intraepithelial): "Flat tumor"

Infiltration of submucosal connective tissue (lamina propria)

T2

T2a

T2b

Muscle infiltration (muscularis propia)

Inner half

Outer half

T3

T3a

T3b

Infiltration of perivesical fat

Microscopically

Macroscopically (extravesical mass)

T4a

T4b

Tumor invades prostate, uterus, or vagina

Tumor invades pelvic wall or abdominal wall (fixed tumor)

N1

N2

N3

Solitary lymph node ≤ 2 cm

Solitary lymph node > 2 cm < 5 cm, or multiple ≤ 5 cm 

 > 5 cm

 

TNM classification of tumor in the renal pelvis and ureter

For tumors in the renal pelvis and ureter, the following are used: Ta, Tis, T1, T2, T3, T4, N1, N2 and N3.

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