Prostate Cancer — TNM + Grade Group

AJCC 8th edition (2017) — combines T / N / M with PSA and the Grade Group

T — primary tumour (clinical)

T1a — incidental finding at TURP, ≤ 5% of tissue resected

T1b — incidental finding at TURP, > 5% of tissue resected

T1c — non-palpable, identified by needle biopsy (e.g. because of a raised PSA)

T2a — palpable, ≤ half of one lobe

T2b — palpable, > half of one lobe but not both lobes

T2c — palpable in both lobes

T3a — extracapsular extension (unilateral or bilateral)

T3b — invades the seminal vesicle(s)

T4 — fixed, or invades adjacent structures (bladder neck, sphincter, rectum, levator, pelvic wall)

N — regional lymph nodes

N0 — no regional lymph node metastasis

N1 — metastasis in regional (pelvic) lymph node(s)

M — distant metastasis

M0 — no distant metastasis

M1a — non-regional lymph node metastasis

M1b — bone metastasis

M1c — other site(s), with or without bone disease

Grade Group (ISUP / modified Gleason)

Grade Group 1 — Gleason ≤ 6

Grade Group 2 — Gleason 3+4 = 7

Grade Group 3 — Gleason 4+3 = 7

Grade Group 4 — Gleason 8

Grade Group 5 — Gleason 9–10

Serum PSA at diagnosis

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Evidence

Original publication

Paner GP, Stadler WM, Hansel DE, Montironi R, Lin DW, Amin MB. Updates in the eighth edition of the TNM staging classification for urologic cancers. For prostate cancer, pathological T2 sub-stages were collapsed and the stage groups were revised to incorporate the ISUP Grade Group and the serum PSA alongside T, N and M.

European Urology, 2018

Open source

Guideline

Amin MB, Edge SB, Greene FL, et al., eds. AJCC Cancer Staging Manual, 8th edition. Chicago: Springer; 2017. Grade Group = ISUP grade / modified Gleason (GG1 Gleason ≤6, GG2 3+4, GG3 4+3, GG4 Gleason 8, GG5 Gleason 9–10). Confirm against the manual.

Last reviewed: 2026-09

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