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TNM Classification- Prostate

Created: 31/5/2005


TNM Classification- Prostate

  • Only applies to adenocarcinoma
  • TCC is classified as a urethral tumour

Procedures for assessing T, N, M categories:

  • T: Examination, imaging, endoscopy, biopsy, biochemical tests
  • N: Examination, imaging
  • M: Examination, imaging, skeletal studies, biochemical tests

NB Regional lymph nodes are the nodes of the true pelvis ie. Those below the bifurcation of the common iliacs. Laterality does not effect the N classification

T-Primary Tumour

TX Primary tumour cannot be assessed

T0 No evidence of primary tumour

T1 Not palpable or visible

  • T1a Incidental on =5% of resected tissue
  • T1b Incidental on >5% of resected tissue
  • T1c Tumour identified on needle biopsy (tumour in one or both lobes on needle but not visible or palpable is T1c)

T2 Confined within prostate (invasion into apex or capsule(but not through) is T2)

  • T2a = half of one lobe
  • T2b > half of one lobe
  • T2c Both lobes

T3 Through prostatic capsule

  • T3a Extracapsular
  • T3b Seminal vesicle(s)

T4 Fixed or invades adjacent structures: bladder neck, external sphincter, rectum, levator muscles, pelvic wall

N- Regional LN’s

NX Regional LN’s cannot be assessed

N0 No Regional LN metz

N1 Regional LN metz

NB Metz no larger than 0.2cm can be designated pN1mi

M- Distant metastasis

MX Distant metastasis cannot be assessed

M0 No distant metastasis

M1 Distant metastasis

M1a Non-regional LN’s

M1b Bone(s)

M1c Other site(s)

pTNM Pathological Classification

Corresponds to T, N and M categories

No pT1 category as there is insufficient tissue

G Histological Grading

GX Cannot be assessed

G1 Well differentiated (slight anaplasia) (Gleason 2-4)

G2 Moderately differentiated (moderate anaplasia) (Gleason 5-6)

G3-4 Poorly differentiated/undifferentiated (marked anaplasia) (Gleason 7-10)

Stage Grouping

Stage I
T1a N0 M0 G1

Stage II
T1a N0 M0 G2, 3-4
T1b,c N0 M0 Any G
T1, T2 N0 M0 Any G

Stage III
T3 N0 M0 Any G

Stage IV
T4 N0 M0 Any G
Any T N1 N0 Any G
Any T Any N M1 Any G

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