Transitional cell carcinoma of the bladder (staging)

Last revised by Dr Morten Hagir on 04 May 2022

Transitional cell carcinoma of the bladder staging uses the TNM system which has replaced the previously widely used Jewett-Scott-Marshall tumor staging system. It is very similar to the staging of TCC of the renal pelvis and staging of TCC of the ureter.

TNM staging (8th edition)

  • Ta: non-invasive papillary tumor
  • Tis: in situ (non-invasive flat)
  • T1: through lamina propria into sub-epithelial connective tissues
  • T2: into muscularis propria
    • T2a: only invades inner half of the muscle
    • T2b: invades into outer half of the muscle
  • T3: invasion into perivesical tissues
    • T3a: microscopic extravesical invasion
    • T3b: macroscopic extravesical invasion
  • T4: direct invasion into adjacent structures
    • T4a: prostate, seminal vesicles, uterus, vaginal vault
    • T4b: pelvic side wall and/or abdominal wall
  • N0: no nodal involvement
  • N1: single node in the true pelvis (hypogastric, obturator, external iliac or presacral nodes)
  • N2: multiple nodes in the true pelvis
  • N3: metastasis in a common iliac node
  • M0: no metastases
  • M1a: Non-regional lymph node involvement
  • M1b: Other distant metastasis

Staging groups

Individual TNM stages can then be grouped 3,4:

  • stage 0: Ta or Tis, N0, M0
  • stage I: T1, N0, M0
  • stage II: T2(a or b), N0, M0
  • stage III: T3(a or b) or T4a, N0, M0
  • stage IV
    • T4b, any N, any M
    • N1-3, any T, any M

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Cases and figures

  • Case 1: T3b
    Drag here to reorder.
  • Case 2: T4a with ureteric and uterine invasion
    Drag here to reorder.
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