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TNM system for urothelial cancer

Authoring team

The TNM system for classifying urothelial cancer is organised as shown below:

Tumour:

  • Tis: carcinoma in situ
  • T1: no palpable tumour:
    • pTa: tumour confined to epithelium
    • pT1: invasion of subepithelial connective tissue
  • T2: no mass or thickening palpable:
    • pT2: invasion of superficial bladder muscle
  • T3: palpable hard, mobile mass:
    • pT3a: invasion of deep muscle (outer half)
    • pT3b: invasion beyond bladder wall:
      • pT3bI: microscopically
      • pT3bII: macroscopically
  • T4: palpable hard, fixed mass:
    • pT4a: invasion of prostate, uterus, vagina
    • pT4b: invasion of pelvic wall, abdominal wall

Nodes:

  • No - no nodal involvement
  • N1 - single ipsilateral regional node
  • N2 - contralateral or multiple regional nodes
  • N3 - fixed regional nodes
  • N4 - extra-regional nodes
  • Nx - nodal status not known

Metastases:

  • M0 - no metastases evident
  • M1 - metastases present
  • Mx - metastatic status not known

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