Prostate cancer staging
Steven C. Campbell, M.D., Ph.D. Syed Musadiq Ali M.B.B.S.[1]
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Overview
Prostate cancer may be classified into several subtypes based on TNM system and UICC.
TNM staging
Evaluation of the (primary) tumor ('T')[1]
| T | Definition |
|---|---|
| TX | Cannot evaluate the primary tumor |
| T0 | No evidence of tumor |
| T1 | Tumor present, but not detectable clinically or with imaging |
| T1a | Tumor was incidentally found in less than 5% of prostate tissue resected (for other reasons) |
| T1b | Tumor was incidentally found in greater than 5% of prostate tissue resected |
| T1c | Tumor was found in a needle biopsy performed due to an elevated serum PSA |
| T2 | Tumor can be felt (palpated) on examination, but has not spread outside the prostate |
| T2a | Tumor is in half or less than half of one of the prostate gland's two lobes |
| T2b | Tumor is in more than half of one lobe, but not both |
| T2c | Tumor is in both lobes |
| T3 | Tumor has spread through the prostatic capsule (if it is only part-way through, it is still T2) |
| T3a | Tumor has spread through the capsule on one or both sides |
| T3b | Tumor has invaded one or both seminal vesicles |
| T4 | Tumor has invaded other nearby structures |
Evaluation of the regional lymph nodes ('N')
| N | Definition |
|---|---|
| NX | Cannot evaluate the regional lymph nodes |
| N0 | There has been no spread to the regional lymph nodes |
| N1 | There has been spread to the regional lymph nodes |
Evaluation of distant metastasis ('M')
| M | Definition |
|---|---|
| M0 | There is no distant metastasis |
| M1 | There is distant metastasis |
UICC staging
The UICC further groups the TNM data into the stages listed in the table below:[2]
- Stage I
| T | N | M | Definition |
|---|---|---|---|
| T1, T2a | N0 | M0 | Tumor involves half a lobe or less |
- Stage II
| T | N | M | Definition |
|---|---|---|---|
| T2b, T2c | N0 | M0 | Tumor involves more than half a lobe but is limited to the prostate |
- Stage III
| T | N | M | Definition |
|---|---|---|---|
| T3 | N0 | M0 | Tumor has spread beyond the prostatic capsule or into the bladder neck or seminal vesicles |
- Stage IV
| T | N | M | Definition |
|---|---|---|---|
| T4 | N0 | M0 | Tumor has become fixed to adjoining structures like the rectum or pelvic wall |
| any T | N1 | M0 | Tumor has spread to regional lymph nodes |
| any T | any N | M1 | Tumor has spread to distant sites such as lungs or liver |
References
- ↑ National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq
- ↑ "Stages of prostate cancer".