Transitional cell carcinoma of the ureter (staging)

Transitional cell carcinoma of the ureter staging uses the TNM system and is very similar to staging of TCC of the bladder and to staging of TCC of the renal pelvis. 

TNM staging

T

• Ta: noninvasive papillary tumor
• Tis: in situ (noninvasive flat)
• T1: through lamina propria into sub-epithelial connective tissues
• T2: into muscularis propria
• T3: invasion into periureteric fat
• T4: direct invasion into adjacent organs/structures

N

Nodal staging is the same for TCC of any part of the urinary tract.

• N0: no nodal involvement
• N1: single node involved <2cm
• N2
  • single node 2-5cm OR
  • multiple nodes all <5cm
• N3: one or more nodes >5cm

M

• M0: no metastases
• M1: metastases identified

Staging groups

Individual TNM stages can then be grouped:

• 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