Transitional cell carcinoma staging
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Transitional cell carcinoma Microchapters |
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Differentiating Transitional cell carcinoma from other Diseases |
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Diagnosis |
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Transitional cell carcinoma staging On the Web |
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American Roentgen Ray Society Images of Transitional cell carcinoma staging |
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Directions to Hospitals Treating Transitional cell carcinoma |
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Risk calculators and risk factors for Transitional cell carcinoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Staging
Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
The TNM (Tumor, Nodes, Metastasis) staging system categorizes bladder cancer using the following scale:
- Stage 0 -- Noninvasive tumors that are only in the bladder lining
- Stage I -- Tumor goes through the bladder lining, but does not reach the muscle layer of the bladder
- Stage II -- Tumor goes into the muscle layer of the bladder
- Stage III -- Tumor goes past the muscle layer into tissue surrounding the bladder
- Stage IV -- Tumor has spread to neighboring lymph nodes or to distant sites (metastatic disease)
Grade of transitional cell cancer of the upper tract has generally been found to correlate with stage. Superficial tumors are generally grade I or II, whereas the majority of infiltrative tumors are grades III and IV. Prognosis is worse for patients with high-grade (grades III and IV) tumors than for those with low-grade (grades I and II) tumors. [1]
- Clinical staging is based on a combination of radiographic procedures (e.g., intravenous pyelogram and computed tomographic scans) and, more recently, ureteroscopy and biopsy.
- The advent of rigid and flexible ureteroscopic techniques has permitted endoscopic access to the ureter and renal pelvis.
- This may permit greater accuracy in preoperative definition of the stage and grade of an upper tract neoplasm.
- Because of the inaccessibility of ureteral and pelvic anatomy, accurate staging requires pathologic analysis of the surgically excised specimen.
- The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define carcinoma of the renal pelvis and ureter.
T: Primary Tumor
| T | Description |
|---|---|
| TX | Primary tumor cannot be assessed |
| T0 | No evidence of primary tumor |
| Ta | Papillary noninvasive carcinoma |
| Tis | Carcinoma in situ |
| T1 | Tumor invades subepithelial connective tissue |
| T2 | Tumor invades the muscularis |
| T3 | (For renal pelvis only) Tumor invades beyond muscularis into peripelvic fat or the renal parenchyma T3. (For ureter only) Tumor invades beyond muscularis into periureteric fat |
| T4 | Tumor invades adjacent organs, or through the kidney into the perinephric fat |
N:Regional Lymph Nodes
| N | Description |
|---|---|
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastasis |
| N1 | Metastasis in a single lymph node, ≤2 cm in greatest dimension |
| N2 | Metastasis in a single lymph node, >2 cm but not >5 cm in greatest dimension; or multiple lymph nodes, none >5 cm in greatest dimension |
| N3 | Metastasis in a lymph node, >5 cm in greatest dimension |
M: Distant Metastasis
| T | Description |
| M0 | There is no evidence of distant metastasis |
| M1 | There is evidence of distant metastasis |
TNM Classification
| Stage | T | N | M |
| Stage 0a | Ta | N0 | M0 |
| Stage 0is | Tis | N0 | M0 |
| Stage I | T1 | N0 | M0 |
| Stage II | T2 | N0 | M0 |
| Stage III | T3 | N0 | M0 |
| Stage III | T3 | N0 | M0 |
| Stage IV | T4 | N0 | M0 |
| Any T | N1, N2 | M0 | |
| Stage IIIB | Any T | N3 | M0 |
| T4 | Any N | M0 | |
| Stage IV | Any T | Any N | M1 |
References
- ↑ Transitional cell cancer. National cancer institute. http://www.cancer.gov/types/kidney/hp/transitional-cell-treatment-pdq#section/_1