Tumor Tips

Tumor Tip of the Week 03-27-2026 TURB only-not eligible for AJCC Path Stage

03-27-2026 TURB only-not eligible for AJCC Path Stage

Scenario:

TURB of 2 separate non-contiguous bladder tumors, path shows: bladder trigone invasive poorly differentiated papillary urothelial cell carcinoma invading into lamina propria, lateral wall noninvasive high grade papillary urothelial carcinoma

Question: Is this case eligible for AJCC pathological stage? 

  • YES
  • NO

Answer:  NO! 

Rationale: Just because a patient has a surgical procedure, it does not mean that the case meets the criteria to assign AJCC Pathological Stage. 

Refer to Chapter 62 Urinary Bladder Pathological Classification- A partial or radical cystectomy is required to assign pathological stage. In this scenario, the patient did not meet the criteria for pathological staging, thus the pathological TNM categories will be BLANK with a Stage Group of 99. 

Question: What is the Grade Pathological? 

  • 3 G3: Poorly differentiated
  • H HG: High-grade
  • 9 Grade cannot be assessed (GX); Unknown

Answer: 9 Grade cannot be assessed (GX); Unknown 

Rationale: Refer to Grade Manual Note 7: For bladder, a TURB does not qualify for surgical resection. A cystectomy, or partial cystectomy, must be performed.

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