Transitional cell carcinoma of the bladder is staged T2b. What does T2b specifically denote in TNM staging for bladder cancer?

• A Superficial muscle (inner half) invasion
• B Deep muscle (outer half) invasion ✓
• C Perivesical fat invasion
• D Invasion of adjacent organs (prostate/uterus)

Explanation

Bladder cancer T-staging: T1 = subepithelial connective tissue; T2a = superficial muscularis propria (inner half); T2b = deep muscularis propria (outer half); T3a = microscopic perivesical fat; T3b = macroscopic perivesical fat; T4a = prostate/uterus/vagina; T4b = pelvic/abdominal wall. Both T2a and T2b are treated with radical cystectomy (or bladder-preserving chemoradiation in selected patients), but T2b may have marginally higher local recurrence risk; the T2 substage distinction does not currently alter treatment recommendations.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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