Table 22-3. TNM staging system for prostate cancer

Table 22-3. TNM staging system for prostate cancer.
T—Primary tumor
Tx	Cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ (PIN)
T1a	≤ 5% of tissue in resection for benign disease has cancer, normal DRE
T1b	> 5% of tissue in resection for benign disease has cancer, normal DRE
T1c	Detected from elevated PSA alone, normal DRE and TRUS
T2a	Tumor palpable by DRE or visible by TRUS on one side only, confined to prostate
T2b	Tumor palpable by DRE or visible by TRUS on both sides, confined to prostate
T3a	Extracapsular extension on one or both sides
T3b	Seminal vesicle involvement
T4	Tumor directly extends into bladder neck, sphincter, rectum, levator muscles, or into pelvic sidewall
N—Regional lymph nodes (obturator, internal iliac, external iliac, presacral lymph nodes)
Nx	Cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a regional lymph node or nodes
M—Distant metastasis
Mx	Cannot be assessed
M0	No distant metastasis
M1a	Distant metastasis in nonregional lymph nodes
M1b	Distant metastasis to bone
M1c	Distant metastasis to other sites
DRE, digital rectal examination; PIN, prostatic intraepithelial neoplasia; PSA, prostate-specific antigen; TRUS, transrectal ultrasound.
Source: American Joint Committee on Cancer: Cancer Staging Manual, 5th ed. Lippincott-Raven, 1997.