What is the tumor, node, and metastases (TNM) staging system for bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Primary tumor (T) classification for bladder cancer is as follows:

  • CIS - Carcinoma in situ, high-grade dysplasia, confined to the epithelium
  • Ta - Papillary tumor confined to the epithelium
  • T1 - Tumor invasion into the lamina propria
  • T2 - Tumor invasion into the muscularis propria: T2a, superficial muscularis propria; T2b, deep muscularis propria
  • T3 - Tumor involvement of the perivesical fat: T3a, microscopic invasion; T3b, macroscopic invasion
  • T4 - Tumor involvement of adjacent organs: T4a, invasion of prostatic stroma, seminal vesicles, uterus, or vagina; T4b, invasion of pelvic or abdominal wall

Node (N) classification for bladder cancer is as follows:

  • N0: No regional lymph node metastasis
  • N1: Metastasis in a single lymph node in true pelvis
  • N2: Metastasis in multiple regional lymph nodes in true pelvis
  • N3: Metastasis in common iliac  lymph node(s)

Distant metastasis (M) classification for bladder cancer is as follows:

  • M0: No distant metastsis
  • M1a: Non regional lymph nodes
  • M1b: Other distant metastasis

See Bladder Cancer Staging for more information on this topic.

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