How is metastatic and advanced prostate cancer staged?

Updated: Dec 29, 2020
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Currently, the accepted international tumor, node, metastasis (TNM) staging system pertaining to prostate cancer includes the extent of local disease (T), the status of regional lymph nodes (N), and distant metastasis (M).

Tumor staging is as follows:

  • Stage T1-2c – Organ-confined disease
  • Stage T3a – Extracapsular extension of the tumor
  • Stage T3b – Invasion of the seminal vesicle(s)
  • Stage T4 – Tumor fixed or tumor invading adjacent structures other than the seminal vesicles (eg, the bladder neck, external sphincter, rectum, levator muscles, and/or pelvic floor)

Lymph node involvement is staged as follows:

  • Stage NX – Regional lymph nodes not assessed
  • Stage N0 – No regional lymph node metastasis
  • Stage N1 – Regional lymph node(s) metastasis

Distant metastatic involvement staging consists of the following (if more than one site of metastasis is present, the most advanced category is used):

  • Stage M0 – No distant metastasis
  • Stage M1 – Distant metastasis
  • Stage M1a – Distant metastasis other than regional lymph nodes
  • Stage M1b – Metastasis to bone(s)
  • Stage M1c – Other site(s) with or without bone involvement

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