The classification applies only to adenocarcinomas. Transitional cell carcinoma of the prostate is classified as a urethral tumour (see Urethra). There should be histological confirmation of the disease. The regional lymph nodes are the nodes of the true pelvis, which essentially are the pelvic nodes below the bifurcation of the common iliac arteries. Laterality does not affect the N classification. Notes 1 Tumour found in one or both lobes by needle biopsy, but not palpable, is classified as T1c. 2 Invasion into the prostatic apex or into (but not beyond) the prostatic capsule is not classified as T3, but as T2. Note  Note * When more than one site of metastasis is present, the most advanced category is used. pM1c is the most advanced category. The pT and pN categories correspond to the T and N categories. However, there is no pT1 category because there is insufficient tissue to assess the highest pT category. There are no subcategories of pT2. Note 
PROSTATE (ICD‐O‐3 C61) (FIG. 477, SEE ALSO FIG . 524)
Rules for Classification 
 
 
Regional Lymph Nodes (Fig. 478)
 
 
TNM Clinical Classification 
T – Primary Tumour 
TX 
Primary tumour cannot be assessed 
T0 
No evidence of primary tumour 
T1 
Clinically inapparent tumour that is not palpable (Fig. 479) 
T1a 
Tumour incidental histological finding in 5% or less of tissue resected 
T1b 
Tumour incidental histological finding in more than 5% of tissue resected 
T1c 
Tumour identified by needle biopsy (e.g., because of elevated PSA) 
T2 
Tumour that is palpable and confined within prostate1 
T2a 
Tumour involves one half of one lobe or less (Fig. 480) 
T2b 
Tumour involves more than half of one lobe, but not both lobes (Fig. 480) 
T2c 
Tumour involves both lobes (Fig. 481) 
T3 
Tumour extends through the prostatic capsule2 
T3a 
Extraprostatic extension (unilateral or bilateral) including microscopic bladder neck involvement (Figs. 482, 483) 
T3b 
Tumour invades seminal vesicle(s) (Fig. 484) 
T4 
Tumour is fixed or invades adjacent structures other than seminal vesicles: bladder neck, external sphincter, rectum, levator muscles, and/or pelvic wall (Figs. 485, 486) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
N – Regional Lymph Nodes 
NX 
Regional lymph nodes cannot be assessed 
N0 
No regional lymph node metastasis 
N1 
Regional lymph node metastasis (Figs. 487, 488) 
Metastasis no larger than 0.2 cm can be designated pN1mi. 
 
 
 
M – Distant Metastasis*
M0 
No distant metastasis 
M1 
Distant metastasis 
M1a 
Non‐regional lymph node(s) 
M1b 
Bone(s) 
M1c 
Other site(s) 
pTNM Pathological Classification 
pM1 
Distant metastasis microscopically confirmed 
pM0 and pMX are not valid categories.
Summary 

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