Prostate Cancer - Staging (part5)
The 2002 TNM staging system is used to stage prostate cancer, as follows:
T - Primary tumor
TX - Primary tumor cannot be assessed
T0 - No evidence of primary tumor
T1 - Clinically inapparent tumor not palpable or visible by imaging
T1a - Tumor incidental histologic finding in less than or equal to 5% of tissue resected
T1b - Tumor incidental histologic finding in greater than 5% of tissue resected
T1c - Tumor identified by needle biopsy (because of elevated PSA level); tumors found in 1 or both lobes by needle biopsy but not palpable or reliably visible by imaging
T2 - Tumor confined within prostate
T2a - Tumor involving less than half a lobe
T2b - Tumor involving less than or equal to 1 lobe
T2c - Tumor involving both lobes
T3 - Tumor extending through the prostatic capsule; no invasion into the prostatic apex or into, but not beyond, the prostatic capsule
T3a - Extracapsular extension (unilateral or bilateral)
T3b - Tumor invading seminal vesicle(s)
T4 - Tumor fixed or invading adjacent structures other than seminal vesicles (eg, bladder neck, external sphincter, rectum, levator muscles, pelvic wall)
NX - Regional lymph nodes (cannot be assessed)
N0 - No regional lymph node metastasis
N1 - Metastasis in regional lymph node or nodes
Regional lymph nodes are assessed by surgical removal or biopsy of the pelvic lymph nodes, including the obturator chain. The surgical boundaries are the bifurcation of the common iliac, the obturator nerve, and the node of Cloquet.
Distant metastasis:
PM1c - More than 1 site of metastasis present
MX - Distant metastasis cannot be assessed
M0 - No distant metastasis
M1 - Distant metastasis
M1a - Nonregional lymph node(s)
M1b - Bone(s)
M1c - Other site(s)