Transitional cell carcinoma of the bladder (staging)

Transitional cell carcinoma of the bladder staging uses the TNM system which has replaced the previously widely used Jewett-Scott-Marshall tumor staging system. It is very similar to the staging of TCC of the renal pelvis and staging of TCC of the ureter.

TNM staging

  • Ta: non-invasive papillary tumor
  • Tis: in situ (non-invasive flat)
  • T1: through lamina propria into sub-epithelial connective tissues
  • T2: into muscularis propria
    • T2a: only invades inner half of the muscle
    • T2b: invades into outer half of the muscle
  • T3: invasion into perivesical tissues
    • T3a: microscopic extravesical invasion
    • T3b: macroscopic extravesical invasion
  • T4: direct invasion into adjacent structures
    • T4a: prostate, uterus, vaginal vault
    • T4b: pelvic side wall and/or abdominal wall

Nodal staging is the same for TCC of any part of the urinary tract.

  • N0: no nodal involvement
  • N1: single node involved <2 cm
  • N2
    • single node 2-5 cm or
    • multiple nodes all <5 cm
  • N3: one or more nodes >5 cm
  • M0: no metastases
  • M1: metastases identified

Staging groups

Individual TNM stages can then be grouped :

  • stage 0: Ta or Tis, N0, M0
  • stage I: T1, N0, M0
  • stage II: T2(a or b), N0, M0
  • stage III: T3(a or b) or T4a, N0, M0
  • stage IV
    • T4b, any N, any M
    • N1-3, any T, any M
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