Clinical staging relates to the findings on DRE (digital rectal examination). It conveys information as to the primary tumor volume and whether the disease has spread locally out of the prostate. The skill of the examining physician, the anatomy of the patient, and the location of the prostate cancer within the gland are all important determinants that effect the quality of information that we derive from the DRE.
TNM SYSTEM
| T1 disease clinically inapparent that is not palpable on DRE |
T1a Tumor is an incidental histologic finding and is seen in 5% or less of resected tissue
T1b Tumor is an incidental histologic finding and is seen in more than 5% of resected tissue
T1c Tumor identified by needle biopsy because of an elevated PSA
| T2 Tumor that is palpable and confined within the prostate
T2a Tumor involves half a lobe or less T2b Tumor involves more than a half a lobe, but not both lobes T2c Tumor involves both lobes
T3 Tumor extends through the prostatic capsule
| T3a Unilateral extracapsular extension T3b Bilateral extracapsular extension T3c Tumor invades seminal vesicle(s)
T4 Tumor is fixed or invades adjacent structure other than seminal
vesicles
| T4a Tumor invades bladder neck, or external sphincter, or rectum T4b Tumor invades levator muscles and/or is fixed to pelvic wall |