Table 4. Definition of TNM Stage IIIa

StageTNMDescriptionIllustration
IIIAT3a, T3b, T4a, N0, M0–pT3a = Microscopically.
Two-panel drawing showing stage IIIA bladder cancer in a male (left panel) and a female (right panel); both panels show cancer in the bladder and in (a) the layer of fat around the bladder and (b) one lymph node in the pelvis. Also shown are the right and left common iliac arteries, the prostate (left panel), and the uterus (right panel).
–pT3b = Macroscopically (extravesical mass).
–T4a = Extravesical tumor invades directly into prostatic stroma, uterus, vagina.
N0 = No lymph node metastasis.
M0 = No distant metastasis.
T1–T4a, N1, M0T1 = Tumor invades lamina propria (subepithelial connective tissue).
T2 = Tumor invades muscularis propria.
–pT2a = Tumor invades superficial muscularis propria (inner half).
–pT2b = Tumor invades deep muscularis propria (outer half).
T3 = Tumor invades perivesical soft tissue.
–pT3a = Microscopically.
–pT3b = Macroscopically (extravesical mass).
T4 = Extravesical tumor directly invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall.
–T4a = Extravesical tumor invades directly into prostatic stroma, uterus, vagina.
N1 = Single regional lymph node metastasis in the true pelvis (perivesical, obturator, internal and external iliac, or sacral lymph node).
M0 = No distant metastasis.
IIIBT1–4a, N2, N3, M0T1 = Tumor invades lamina propria (subepithelial connective tissue).
Two-panel drawing showing stage IIIB bladder cancer in a male (left panel) and a female (right panel); both panels show cancer in the bladder and in (a) more than one lymph node in the pelvis that is not near the common iliac artery and (b) one lymph node near the common iliac artery. Also shown are the right and left common iliac arteries, the prostate (left panel), and the uterus (the right panel).
T2 = Tumor invades muscularis propria.
–pT2a = Tumor invades superficial muscularis propria (inner half).
–pT2b = Tumor invades deep muscularis propria (outer half).
T3 = Tumor invades perivesical soft tissue.
–pT3a = Microscopically.
pT3b = Macroscopically (extravesical mass).
T4 = Extravesical tumor directly invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall.
–T4a = Extravesical tumor invades directly into prostatic stroma, uterus, vagina.
N2 = Multiple regional lymph node metastasis in the true pelvis (perivesical, obturator, internal and external iliac, or sacral lymph node metastasis).
N3 = Lymph node metastasis to the common iliac lymph nodes.
M0 = No distant metastasis.

T = primary tumor; N = regional lymph node; M = distant metastasis; p = pathological.

aReprinted with permission from AJCC: Urinary bladder. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp. 757–65.

From: Bladder Cancer Treatment (PDQ®)

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PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
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