TNM BLADDER CANCER STAGING Dr. Mahnaz Roayaei Radiation Oncologist Assistant Professor Isfahan University of Medical Sciences
Feb 09, 2016
TNM BLADDER CANCER STAGING
Dr. Mahnaz RoayaeiRadiation OncologistAssistant Professor Isfahan University of Medical Sciences
AMERICAN JOINT COMMITTEE ON CANCER 2009 TNM BLADDER CANCER STAGING
• PRIMARY TUMOR (T)• REGIONAL LYMPH NODES(N)• DISTANT METASTASIS (M)
The primary pathologic substages of the TNM staging system
such as pT2a and pT2b, cannot be determined from TURBT
specimens.
Patients who have documented muscularis propria-invasive bladder cancer require an additional set of studies:
1. chest x-ray 2. CT scan3. liver function studies4. Creatinine , and electrolytes5. Bimanual examination6. MRI lymphangiography7. A prostatic urethra and bulbous urethra
biopsy
Tumor extends through the muscle to involve the full
thicknessof the bladder and
into the serosa
• CTS or MRI, are not reliable for staging.• Only, when they show unequivocal tumor
extension outside the bladder
Nonstromal invasive urothelial tumors of theprostate are not classified as T4, as the prognosis in this group is quite good
REGIONAL LYMPH NODES
N2 :Metastasis in multiple lymph nodes in primarydrainage region
N3: Common
iliac lymph node
involvement
DISTANT METASTASI
S (M)
Thanks for your attention
Ref of photographs:Color Atlas by Dr.Hamid Eemami
Associate Professor of Radiation OncologyIsfahan University of Medical Sciences