T-Tumor N – Regional Lymph Nodes M – Distant Metastasis
TX-Primary tumor cannot be evaluated
T0-No primary tumor
Ta-Noninvasive papillary carcinoma
T1S-Carcinoma in situ
T1-Tumor invades connective tissue under the epithelium
T2-Tumor invades muscle
T2a-Superficial muscle affected
T2b-Deep muscle affected
T3-Tumor invades paramedical fatty tissue
T4-Tumor invades any of the following: prostate, uterus, vagina, pelvic wall, abdominal wall
NX – Regional lymph nodes cannot be evaluated
N0 – No regional lymph node metastasis
N1 – Metastasis in a single lymph node < 2 cm in size
N2 – Metastasis in a single lymph node > 2 cm, but < 5 cm in size, or Multiple lymph nodes < 5 cm in size
N3 – Metastasis in a lymph node > 5 cm in size
MX – Distant metastasis cannot be evaluated
M0 – No distant metastasis
M1 – Distant metastases
Stage 0a: This is an early cancer that is only found on the surface of the inner lining of the bladder. Cancer cells are grouped together and can often be easily removed. The cancer has not invaded the muscle or connective tissue of the bladder wall. This type of bladder cancer is also called noninvasive papillary urothelial carcinoma (Ta, N0, M0).
Stage 0is: This stage of cancer, also known as a flat tumor or carcinoma in situ (CIS), is found only on the inner lining of the bladder. It has not grown in toward the hollow part of the bladder, and it has not spread to the thick layer of muscle or connective tissue of the bladder (Tis, N0, M0). This is always a high-grade cancer (see “Grades,” below) and is considered an aggressive disease because it can often lead to muscle-invasive disease.
Stage I: The cancer has grown through the inner lining of the bladder and into the lamina propria. It has not spread to the thick layer of muscle in the bladder wall or to lymph nodes or other organs (T1, N0, M0).
Stage II: The cancer has spread into the thick muscle wall of the bladder. It is also called invasive cancer or muscle-invasive cancer. The tumor has not reached the fatty tissue surrounding the bladder and has not spread to the lymph nodes or other organs (T2, N0, M0).
Stage III: The cancer has spread throughout the muscle wall to the fatty layer of tissue surrounding the bladder (perivesical tissue) or to the prostate in a man or the uterus and vagina in a woman. Or, the cancer has spread to the regional lymph nodes.
Stage IIIA: The tumor has grown into the perivesical tissue or has spread to the prostate, uterus, or vagina, but has not spread to the lymph nodes or other organs (T3a, T3b, or T4a; N0; M0), or the cancer has spread to a single regional lymph node (T1 to T4a, N1, M0).
Stage IIIB: The cancer has spread to 2 or more regional lymph nodes or to the common iliac lymph nodes (T1 to T4a, N2 or N3, M0).
Stage IV: The tumor has spread into the pelvic wall or abdominal wall, or the cancer has spread to lymph nodes outside of the pelvis or to other parts of the body.
Stage IVA: The tumor has spread to the pelvic wall or the abdominal wall but not to other parts of the body (T4b, any N, M0), or the cancer has spread to lymph nodes located outside of the pelvis (any T, any N, M1a).
Stage IVB: The cancer has spread other parts of the body (any T, any N, M1b).