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Staging

The TNM staging system parallels the American Urologic System staging.

Prostate Cancer Staging (Abridged Version)

AJCC Jewett Definition
T0 No evidence of primary
T1 A Clinically inapparent
T2 B Confined to prostate gland
T3 C Through the capsule
T4 Fixed; adjacent structures
N_, M_ D Distant metastases

Criteria for TNM Clinical Staging: Physical examination including digital examination, histologic verification of malignancy, imaging, endoscopy, laboratory tests.

Criteria for TNM Pathologic Staging: total removal of the prostate and seminal vesicles as well as pelvic lymph node dissection is required for pathologic staging.

Brief Summaries of 6th Edition Categories

TNM Classification Histological/Clinical Features
T1 T1 Not palpable or visible
T1a <=5%
T1b >5%
T1c Diagnosed on needle biopsy only
T2 T2 Confined to prostate
T2a One-half of one lobe or less
T2b >one-half of one lobe but not both lobes
T2c Both lobes
T3 T3 Through prostatic capsule
T3a Extracapsular
T3b Seminal vesicles(s)
T4 Fixed or invading adjacent structures: bladder neck, external sphincter, rectum, levator muscles, pelvic wall
N1 Regional lymph node(s)
M1a Non-regional lymph nodes(s)
M1b Bone(s)
M1c Other site(s)

Collaborative Stage Elements

For more details on Collaborative Stage, see the Intro to Collaborative Staging module.