Bladder Carcinoma and a TNM System of Classification

Abstract

The classification proposed here is modified in some areas from the TNM [tumor, node, metastasis] system of the International Union Against Cancer and has as 1 major departure a data sheet that is intended to provide some clinical information in addition to a classification. Being 1 of the last to propose that data be collected without firm reasons already established for collecting the data, this data sheet will provide for a clinical summary for each admission and can be used for a variety of purposes, including communication with the referring physician, record room, tumor registry/clinic, attending physician, et al. It is not complex and can be filled out during the patient''s hospital stay. This sheet should be suitable for inclusion in the patient''s chart. On the reverse side are the rules for TNM classification. There also will be line drawings of the bladders of both sexes included for permanent chart records. These, too, may be disseminated. This is an initial effort in a complex area because biopsies are used for staging. Separation of the influence of biopsy material from other pathological material is provided for by a P category. The system must be tested, and it will surely undergo revision, but the ultimate goal, that of standardizing the system of classification across the USA and Europe, can be approached by that which is incorporated.