I think the above numbers are from the AJCC 1992 cancer staging manual. The current manual is AJCC2007 and I don't have that one. I do have the AJCC2002 manual in front of me and here is the TNM system in the manual:
T1a positive tissue is less than 5% of the tested tissue
T1b positive tissue is more than 5% of the tested tissue
T1c Tumor is identified by needle biopsy after an elevated PSA test (Most of us here)
T2a Involves 1/2 of one lobe
T2b Involves more than 1/2 on one lobe and the other lobe is negative
T2c Involves both lobes
T3 Extension to periprostatic tissue
T3a Unilateral or bilateral extracapsular extension
T3b Seminal vesicle invasion
T4a Extension or fixation to adjacent structures (bladder neck, rectum, Rectovesicle Fascia, external sphincter, extension to bone but not in the bone)
T4b In a nutshell it's anything beyond the T4a areas.
N0 No Lymphatic invasion
N1 Local lymphatic invasion, There is no more definition of whether there is more than one lymph node involved nor the size of the invasion.
Nx Lymphatic invasion is unknown
M0 There is no invasion in tested areas
M1a Distant lymphatic invasion is detected;
M1b Metastatic invasion to the bones
M1c Distant metastatic disease other then lymphatic invasion.
Mx Metastatic invasion is unknown
My understanding is that for these parameters, AJCC2002 and AJCC2007 are the same for prostate cancer.
For tumor sizing, David, Jon Epstein is proposing that we combine T4a with T3b. They would be designated T3b. T4 would be the only designation for anything further than T3b.
It's important to note, that doctors still use some of the older manuals in their staging practices. So we do see some T3c here are HW, but it is actually T3b in todays manual. The older T3a and T3b were combined to T3a. This changed in the AJCC2002 manual.
If anyone would like a copy of the AJCC2002 manual, send me an Email and I will send it to you. It is free online but not an easy search at the AJCC website. The AJCC 2007 manual is out, but to obtain it there is a fee. This is the only reason I don't have it. But if anyone has it, please send it to me. There are no changes in prostate cancer in it, but it would be great to keep the current manual as a reference for other cancers.
Prostate Cancer Forum Co-Moderator
Post Edited (TC-LasVegas) : 12/9/2009 2:52:01 PM (GMT-7)