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Patients are staged using the AJCC (2002) staging system (5).

AJCC Staging System (2002)

Primary tumour (T) and Pathologic Tumour Size (pT)
Tx: Unable to assess
T0: No evidence of primary tumour
T1: No tumour palpable or visible on imaging
     T1a: incidental finding in up to 5% of TURP specimen
     T1b: incidental finding in more than 5% of TURP specimen; Gleason score less than 6.
     T1c: tumour identified by needle biopsy (e.g. because of an elevated PSA)
T2: Tumour confined within the prostate 
      T2a: involves up to one-half of one lobe
      T2b: involves more than one-half of one lobe
      T2c: involves both lobes
T3: Tumor extends through capsule and/or seminal vesicle(s)
      T3a: extracapsular extension (unilateral or bilateral)
      T3b: invasion of seminal vesicle(s)
T4: Tumor is fixed or invading adjacent structures, including bladder neck, external sphincter, rectum, levator muscles, pelvic wall

pT1: There is no pathologic T1 classification
pT2: Organ confined
  pT2a: unilateral, involving one half of one lobe or less
  pT2b: unilateral, involving more than one half of one lobe but not both lobes
  pT2c: bilateral disease
pT3: Extraprostatic extension
  pT3a: positive surgical margin should be indicated by an R1 descriptor (residual miscroscopic disease)
  pT3b: seminal vesicle invasion
pT4: Invasion of bladder, rectum

Regional lymph node (N) metastasis (pelvic lymph nodes distal to the bifurcation of the common iliac arteries) and Pathologic Node Involvement (pN)
NX: Regional lymph nodes cannot be assessed; not accessed surgically
N0: No regional lymph node metastasis on pelvic node dissection
N1: Regional lymph node metastases on pelvic node dissection
Distant lymph node metastasis is classified as M1a (see below)
pN0: No positive lymph node(s)
pN1: Metastasis in regional lymph node(s)

Distant metastasis (M)
MX: Unable to assess
M0: No distant metastasis
M1: Distant metastasis
       M1a: non-regional lymph node(s)
       M1b: bone(s)
       M1c: other site(s) with or without bone disease


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