The value of preoperative classification according to the TNM system. A critical examination of Category T2 in 96 patients with grade 3 transitional cell bladder carcinoma subjected to preparative irradiation and cystectomy.

A critical reevaluation of the preoperative classification in 96 patients with transitional cell bladder carcinomas of grade 3 (WHO) and clinical category T2 has been performed. As a result of incomplete biopsies and clinical data, it was possible to reclassify only 49 tumors (51%). 43 of these seemed to be of a lower stage than originally proposed. In addition downstaging after preoperative irradiation occurred in 77 patients (80%). In view of the uncertainties in the present series, a return to a simplified preoperative classification for clinical purposes is proposed--e.g. tumors with mucosal growth, tumors with muscle infiltration, tumors extending outside the bladder.