Stage IV includes: (T4, N0, M0); (T4, N1, M0); (Any T, N2, M0); (Any T, Any N, M1). T4: For male penile urethra and female urethra: Tumor invades other adjacent organs (e.g., invasion of the bladder wall). For prostatic urethra: Tumor invades other adjacent organs (e.g., extraprostatic invasion of the bladder wall, rectal wall). N0: No regional lymph node metastasis. N1: Single regional lymph node metastasis in the inguinal region or true pelvis [perivesical, obturator, internal (hypogastric) and external iliac], or presacral lymph node. N2: Multiple regional lymph node metastasis in the inguinal region or true pelvis [perivesical, obturator, internal (hypogastric) and external iliac], or presacral lymph node. M0: No distant metastasis. M1: Distant metastasis. (AJCC 8th ed.) [from NCI]