Prostate Cancer (cont.)
Prostate Cancer Evaluation
Evaluation of the (primary) tumor ("T"):
- TX: Cannot evaluate the primary tumor.
- T0: No evidence of tumor.
- T1: Tumor present but not detectable clinically or with imaging.
- T1a: The tumor was incidentally found in less than 5% of prostate tissue resected (for other reasons).
- T1b: The tumor was incidentally found in greater than 5% of prostate tissue resected.
- T1c: The tumor was found in a needle biopsy performed due to an elevated serum PSA.
- T2: The tumor can be felt (palpated) on examination but has not spread outside the prostate.
- T2a: The tumor is in half or less than half of one of the prostate gland's two lobes.
- T2b: The tumor is in more than half of one lobe but not both.
- T2c: The tumor is in both lobes.
- T3: The tumor has spread through the prostatic capsule (if it is only part-way through, it is still T2).
- T3a: The tumor has spread through the capsule on one or both sides.
- T3b: The tumor has invaded one or both seminal vesicles.
- T4: The tumor has invaded other nearby structures.
It should be stressed that the designation "T2c" implies a tumor which is palpable in both lobes of the prostate. Tumors which are found to be bilateral on biopsy only but are not palpable bilaterally should not be staged as T2c.
Evaluation of the regional lymph nodes ("N"):
- NX: The regional lymph nodes cannot be evaluated.
- 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"):
- MX: A distant metastasis cannot be evaluated.
- M0: There is no distant metastasis.
- M1: There is distant metastasis.
- M1a: The cancer has spread to lymph nodes beyond the regional ones.
- M1b: The cancer has spread to bone.
- M1c: The cancer has spread to other sites (regardless of bone involvement).
Pierre-Alain Hueber, MD, PhD
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