Σταδιοποίηση σε Ca Ουρήθρας

 

Ca Ουρήθρας

AJCC Stages

Stages

T

N

M

0a

Ta

N0

M0

0is

Tis

N0

M0

Tis pu

N0

M0

Tis pd

N0

M0

I

T1

N0

M0

II

T2

N0

M0

III

T1

N1

M0

T2

N1

M0

T3

N0

M0

T3

N1

M0

IV

T4

N0

M0

T4

N1

M0

Any T

N2

M0

Any T

Any N

M1

(T) Primary Tumor

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Ta

Noninvasive papillary, polypoid, or verrucous carcinoma

Tis

Carcinoma in situ

T1

Tumor invades subepithelial connective tissue

T2

Tumor invades any of the following: Corpus spongiosum, prostate, periurethral muscle

T3

Tumor invades any of the following: Corpus cavernosum, beyond prostatic capsule, anterior vagina, bladder neck

T4

Tumor invades other adjacent organs

Urothelial (Transitional Cell) Carcinoma of the Prostate

Tis pu

Carcinoma in situ, involvement of the prostatic urethra

Tis pd

Carcinoma in situ, involvement of the prostatic ducts

T1

Tumor invades urethral subepithelial connective tissue

T2

Tumor invades any of the following: Prostatic stroma, corpus spongiosum, periurethral muscle

T3

Tumor invades any of the following: Corpus cavernosum, beyond prostatic capsule, bladder neck (extraprostatic extension)

T4

Tumor invades other adjacent organs (invasion of the bladder)

(N) Regional Lymph Nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Metastasis in a single lymph node ≤ 2 cm in greatest dimension

N2

Metastasis in a single node > 2 cm in greatest dimension or in multiple nodes

(M) Distant Metastasis

M0

No distant metastasis

M1

Distant metastasis

(G) Histologic Grade

World Health Organization

International Society of Urologic Pathology (WHO/ISUP) Grading System

LG

Low grade

HG

High grade

General Histologic Grading System

GX

Grade cannot be assessed

G1

Well differentiated

G2

Moderately differentiated

G3

Poorly differentiated

G4

Undifferentiated

Incidence of Primary Urethral Carcinoma

Histologic Subtype

Incidence in Males

Incidence in Females

Transitional cell carcinoma

70.2%

33.9%

Squamous cell carcinoma

18.4%

31.1%

Adenocarcinoma

11.4%

35.0%

Observed and Overall 1- and 5-Year Survival Rates

Stage

1-Year Survival

5-Year Survival

0a

97%

79%

0is

93%

62%

I

90%

59%

II

82%

51%

III

79%

28%

IV

59%

22%

Χαρακτηριστικά Επέκτασης

Local spread

  • In women: Local extension
    • Bladder neck, vagina, vulva
  • In men: Infiltrate via vascular spaces of corpus spongiosum and periurethral tissues
  • Anterior tumors may infiltrate to skin surface
  • Posterior/bulbomembranous tumors spread locally to perineum

Lymphatic metastases to regional nodes

  • Anterior urethral cancer nodal distribution
    • Superficial and deep inguinal nodes
    • Occasionally external iliac nodes
  • Posterior urethral cancer nodal distribution
  • Pelvic nodes
  • Usually indicative of metastatic disease
  • Palpable inguinal nodes occur in 20%
  • Female cancer often spreads systemically without regional nodal disease

Hematogenous spread uncommon except in

  • Primary transitional cell carcinoma (TCC) of prostatic urethra
  • Advanced local disease

Κατηγοριοποίηση (Ιστολογικοί Τύποι)
  • Women: Location is anterior or entire
    • Anterior tumors exclusively in distal 1/3 of urethra
      • 46% of urethral tumors
      • Squamous cell carcinoma most common
    • Entire urethral tumors usually high grade and locally advanced
  • Men: Location is posterior or anterior
  • Posterior: Prostatic urethra (10%)
  • Posterior: Bulbomembranous urethra (60%)
  • Anterior: Penile urethra (30%)