Urethra
General
Staging - urethral carcinoma


Topic Completed: 03 January 2019

Revised: 3 January 2019

Copyright: (c) 2019, PathologyOutlines.com, Inc.

PubMed Search: Staging urethral carcinoma [title]

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Cite this page: Zynger D. Staging - urethral carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/urethrastaging.html. Accessed January 18th, 2019.

TNM staging of ureter carcinoma (AJCC 8th edition)
Definition / general
  • All carcinomas of the urethra are covered by this staging system
Essential features
  • AJCC 7th edition staging was sunset on December 31, 2017; as of January 1, 2018, use of the 8th edition is mandatory
ICD coding
  • ICD-10: C68.0 - malignant neoplasm of urethra
Primary tumor (pT)
Prostatic urethra
  • pTX: cannot be assessed
  • pT0: no evidence of primary tumor
  • pTa: noninvasive papillary carcinoma
  • pTis: carcinoma in situ of the prostatic urethra, periurethra or ducts
  • pT1: invasion of prostatic urethral subepithelial connective tissue
  • pT2: invasion of prostatic stroma
  • pT3: invasion of periprostatic fat
  • pT4: invasion of adjacent organs (example: bladder wall, rectal wall)

Penile urethra
  • pTX: cannot be assessed
  • pT0: no evidence of primary tumor
  • pTa: noninvasive papillary carcinoma
  • pTis: carcinoma in situ
  • pT1: invasion of urethral subepithelial connective tissue
  • pT2: invasion of corpus spongiosum
  • pT3: invasion of corpus cavernosum
  • pT4: invasion of adjacent organs (example: bladder wall)

Female urethra
  • pTX: cannot be assessed
  • pT0: no evidence of primary tumor
  • pTa: noninvasive papillary carcinoma
  • pTis: carcinoma in situ
  • pT1: invasion of urethral subepithelial connective tissue
  • pT2: invasion of periurethral muscle
  • pT3: invasion of anterior vagina
  • pT4: invasion of adjacent organs (example: bladder wall)
Regional lymph nodes (pN)
  • pNX: cannot be assessed
  • pN0: no regional lymph node metastasis
  • pN1: metastatsis in 1 regional lymph node
  • pN2: metastasis in greater than 1 regional lymph node

Note:
  • Regional lymph nodes include superficial / deep inguinal, perivesical, obturator, internal iliac / hypogastric, external iliac, presacral, sacral NOS, pelvic NOS
Distant metastasis (pM)
  • pM1: distant metastasis
Prefixes
  • y: preoperative radiotherapy or chemotherapy
  • r: recurrent tumor stage
AJCC prognostic stage groups
  • Stage 0a:Ta N0 M0
  • Stage 0is:Tis N0 M0
  • Stage I:T1 N0 M0
  • Stage II:T2 N0 M0
  • Stage III:T3 N0 M0
  • T1 - 3 N1 M0
  • Stage IV:T4 N0 - 2 M0 - 1
  • TX - 4 N2 M0 - 1
  • TX - 4 NX - 2 M1

Registry data collection variables
  • Urothelial carcinoma grade (high / low)
  • Squamous cell / adenocarcinoma grade (1 - 3)
Histologic grade (G)
  • Urothelial carcinoma
    • LG: low grade
    • HG: high grade
  • Squamous cell / adenocarcinoma
    • GX: cannot be assessed
    • G1: well differentiated
    • G2: moderately differentiated
    • G3: poorly differentiated
Histopathologic type
Board review question #1
A urothelial carcinoma of the prostatic urethra at the deepest point of invasion involves the bladder wall. Which is the correct pT category?

  1. pT1
  2. pT2
  3. pT3
  4. pT4
Board review answer #1
D. pT4