Classification and Staging of Bladder Carcinoma.

Abstract

Bladder carcinoma is a chronic, heterogeneous, field-change, neoplastic diathesis in most of the patient., that it afflicts. Staging initially considered the primary lesion(s) and local nodal involvement (Jewett-Strong-Marshall), but variable disease characteristics cannot be accommodated by this system. For clinical research purposes, longitudinal observations on patients with bladder carcinoma seem useful for identifying and classifying types of patients with types of urothelial neoplasms. For general use, however, the classification of the American Joint Committee provides for common taxonomy concerning the primary tumor(s), T(m); nodal involvement, (N); metastases, (M); grade, (G); and lymphatic involvement, (L+/L-). It also provides for indicating how the information for each of these tumor characteristics or activities was obtained, i.e. clinical, (cT); surgical biopsy of a metastatic pelvic node, (sN+); or pathological evaluation of cystectomy specimen, (pTpN). This system clearly describes patients in different stages of disease treated by different modalities, using previously defined rules. It should be employed in initial and subsequent follow-up of patients, particularly when analyzing the results of treatment.