Bladder Cancer — TNM

Name: Bladder Cancer — TNM calculator — MedScore
Creator: Nabil Alzein

AJCC 8th edition (2017) — urinary bladder carcinoma

T — primary tumour

Ta — non-invasive papillary carcinoma

Tis — urothelial carcinoma in situ (flat tumour)

T1 — invades the lamina propria (subepithelial connective tissue)

T2a — invades the superficial muscularis propria (inner half)

T2b — invades the deep muscularis propria (outer half)

T3a — invades perivesical soft tissue, microscopically

T3b — invades perivesical soft tissue, macroscopically (extravesical mass)

T4a — extravesical tumour invades the prostatic stroma, seminal vesicles, uterus or vagina

T4b — extravesical tumour invades the pelvic wall or abdominal wall

N — regional lymph nodes

N0 — no lymph node metastasis

N1 — single regional node in the true pelvis (perivesical, obturator, internal/external iliac or sacral)

N2 — multiple regional nodes in the true pelvis

N3 — metastasis to the common iliac nodes

M — distant metastasis

M0 — no distant metastasis

M1a — distant metastasis limited to lymph nodes beyond the common iliacs

M1b — non-lymph-node distant metastases

About this score

When to use

Assigns the AJCC 8th-edition stage group (0a to IVB) of urinary bladder cancer from T, N and M. ⁦[1]⁩

Pearls and pitfalls

Some combinations — Ta or Tis with nodal disease, and T4b N1–N3 M0 — have no cell in the stage table, so they are not assigned a stage here. ⁦[2]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

Amin MB, Edge SB, Greene FL, et al., eds. AJCC Cancer Staging Manual, 8th edition (Urinary bladder, pp. 757–65). New York: Springer; 2017. Stage groups 0a–IVB as used here. Confirm against the manual.

Springer, 2017

[2] Guideline

PDQ® Adult Treatment Editorial Board. Bladder Cancer Treatment (PDQ®) – Health Professional Version. National Cancer Institute — reprints the AJCC 8th-edition stage tables with permission. Ta/Tis with nodal disease and T4b N1–N3 M0 have no cell in that table, so this tool does not assign them.

Open source

Last reviewed: 2026-10

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.