Prostate cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Steven C. Campbell, M.D., Ph.D. Syed Musadiq Ali M.B.B.S.[2]

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Prostate cancer may be classified into several subtypes based on TNM system and UICC.

TNM staging

Evaluation of the (primary) tumor ('T')[1]

T Definition
TX Cannot evaluate the primary tumor
T0 No evidence of tumor
T1 Tumor present, but not detectable clinically or with imaging
T1a Tumor was incidentally found in less than 5% of prostate tissue resected (for other reasons)
T1b Tumor was incidentally found in greater than 5% of prostate tissue resected
T1c Tumor was found in a needle biopsy performed due to an elevated serum PSA
T2 Tumor can be felt (palpated) on examination, but has not spread outside the prostate
T2a Tumor is in half or less than half of one of the prostate gland's two lobes
T2b Tumor is in more than half of one lobe, but not both
T2c Tumor is in both lobes
T3 Tumor has spread through the prostatic capsule (if it is only part-way through, it is still T2)
T3a Tumor has spread through the capsule on one or both sides
T3b Tumor has invaded one or both seminal vesicles
T4 Tumor has invaded other nearby structures

Evaluation of the regional lymph nodes ('N')

N Definition
NX Cannot evaluate the regional lymph nodes
N0 There has been no spread to the regional lymph nodes
N1 There has been spread to the regional lymph nodes

Evaluation of distant metastasis ('M')

M Definition
M0 There is no distant metastasis
M1 There is distant metastasis

UICC staging

The UICC further groups the TNM data into the stages listed in the table below:[2]

  • Stage I
T N M Definition
T1, T2a N0 M0 Tumor involves half a lobe or less
  • Stage II
T N M Definition
T2b, T2c N0 M0 Tumor involves more than half a lobe but is limited to the prostate
  • Stage III
T N M Definition
T3 N0 M0 Tumor has spread beyond the prostatic capsule or into the bladder neck or seminal vesicles
  • Stage IV
T N M Definition
T4 N0 M0 Tumor has become fixed to adjoining structures like the rectum or pelvic wall
any T N1 M0 Tumor has spread to regional lymph nodes
any T any N M1 Tumor has spread to distant sites such as lungs or liver


  1. National Cancer Institute. Physician Data Query Database 2015.
  2. "Stages of prostate cancer".

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