Primary urethral cancer (staging)

Primary urethral cancer staging often uses the TNM system and is as follows:

TNM staging

Primary tumor staging (T)

• Tx: primary tumor cannot be assessed
• T0: no evidence of primary tumor
• Tis: carcinoma in situ
• Ta: non-invasive papillary, polypoid, or verrucous carcinoma
• T1: invasion of subepithelial connective tissue
• T2: invasion of corpus spongiosum/prostate or peri urethral muscles
• T3: corpus cavernosum, beyond prostate capsule, anterior vagina, bladder neck
• T4: invasion of adjacent organs

For transitional cell carcinoma

• Tx: primary tumor cannot be assessed
• T0: no evidence of primary tumor
• Tis: carcinoma in situ
• Tis pu: carcinoma in situ with involvement of prostatic urethra
• Tis pd: carcinoma in situ with involvement of prostatic ducts
• Ta: non-invasive papillary, polypoid, or verrucous carcinoma
• T1: invasion of subepithelial connective tissue
• T2: invasion of corpus spongiosum/prostate or periurethral muscles
• T3: corpus cavernosum, beyond prostate capsule, anterior vagina, bladder neck
• T4: invasion of adjacent organs

​Nodal status (N)

• Nx: nodal status cannot be assessed
• N0: no nodal involvement
• N1: single nodal metastasis <2 cm in greatest dimension
• N2: single node more than 2 cm in greatest dimension or multiple nodes

Metastases (M)

• Mx: distant metastatic disease cannot be assessed
• M0: no distant metastases
• M1: distant metastases present

Stage groupings

• stage 0a
  • ​Ta, N0, M0
• stage 0is
  • ​Tis, N0, M0
  • Tis pu, N0, M0
  • Tis pd, N0, M0
• stage I
  • ​T1, N0, M0
• stage II​
  • T2, N0, M0
• stage III
  • ​T1, N1, M0
  • T2, N1, M0
  • T3, N0, M0
  • T3, N1, M0
• stage IV
  • ​T4, N0, M0
  • T4, N1, M0
  • any T, N2, M0
  • any T, Any N, M1