Which classification system grades urothelial carcinoma of the bladder in terms of muscular invasion and is used to determine need for radical cystectomy?
- A TNM staging: T2 (muscle invasion) distinguishes non-muscle invasive (NMIBC) from muscle-invasive (MIBC) bladder cancer requiring radical therapy ✓
- B Jewett-Marshall (ABCD) staging system
- C WHO 1973 grading (G1/G2/G3) determines need for cystectomy
- D EORTC risk score for NMIBC determines cystectomy timing
Explanation
The critical surgical decision in bladder cancer is differentiation of non-muscle invasive (T1 or lower, NMIBC) from muscle-invasive disease (≥T2, MIBC) via the TNM system. T2 indicates superficial muscle invasion (inner half, detrusor), and all T2+ disease requires consideration of radical cystectomy or definitive chemoradiation (bladder preservation protocol). Jewett-Marshall staging has been superseded by TNM. WHO grading alone does not determine cystectomy need — a high-grade T1 tumor may still be managed conservatively with BCG and close surveillance in selected patients.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.