Clinical staging based on imaging and bimanual examination.
Pathological staging based on TURBT or cystectomy.
| Tx | Tumour can’t be assessed |
| T0 | No evidence primary tumour |
| Ta | Non invasive papillary carcinoma |
| Tis | Carcinoma in situ |
| T1 | Invades subepithelial connective tissue (lamina propria) |
| T2a | Invades muscle/detrusor – inner half |
| T2b | Invades muscle/detrusor – outer half |
| T3a | Invades perivesical fat/tissue – microscopic |
| T3b | Invades perivesical fat/tissue – macroscopic (extravesical mass) |
| T4a | Invades prostate stroma, seminal vesicles, uterus, vagina |
| T4b | Invades pelvic side wall or abdominal wall |
| Nx | Nodes can’t be assessed |
| N0 | No nodal metastasis |
| N1 | Single lymph node in true pelvis (obturator, internal iliac, ext iliac, presacral) |
| N2 | Multiple lymph nodes in true pelvis |
| N3 | Common iliac nodes |
| Mx | Can’t be assessed |
| M0 | No metastatic disease |
| M1a | Non regional lymph node metastases |
| M1b | Other metastases |
Clinical bimanual examination under anaesthesia before and after examination can suggest whether tumour is fixed to side wall, but significant understaging and overstaging with EUA.
EORTC calculator provides estimate of risk of recurrence and progression based on:
- Number of tumours (Single, 2-7, 8+)
- Diameter > 3 cm
- Recurrence rate > 1 / yr
- T1 or Ta
- Concomitant CIS
- Grade