Urinary Bladder TURBT Synoptic Report — CAP elements with AJCC 9th Edition (auto stage)

AJCC 9 (bladder) pT summary (expanded): 
- pTa: Non-invasive papillary carcinoma confined to urothelium. 
- pTis: Carcinoma in situ (flat, non-invasive). 
- pT1: Tumor invades subepithelial connective tissue (lamina propria) but not muscularis propria. Report depth in lamina propria if available. 
- pT2: Tumor invades muscularis propria (detrusor muscle). 
     Subdivisions: 
      pT2a = superficial (inner half) muscularis propria; 
      pT2b = deep (outer half). 
- pT3: Tumor invades perivesical tissue (perivesical fat) — pT3a microscopic, pT3b macroscopic/extravesical mass. 
- pT4: Tumor invades adjacent organs/structures (prostate stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall). 

Note: In TURBT specimens, assessment of detrusor muscle presence and its invasion is critical. If muscle absent, avoid assigning pT2 even if deep invasion suspected; recommend re-resection if staging uncertain.

AJCC 9 (bladder) pN summary: 
- pN0: No regional lymph node metastasis. 
- pN1: Metastasis in a single regional lymph node. 
- pN2: Metastasis in multiple regional lymph nodes. 
- pN3: Metastasis in common iliac lymph node(s). 

Note: Report number of positive nodes, size of deposits, extranodal extension. Lymph node status upstages to stage III/IV depending on T and M.

AJCC 9 (bladder) pM summary: 
- pM0: No distant metastasis. 
- pM1: Distant metastasis present. 
     Subclassification includes: 
      pM1a (non-regional lymph node), 
      pM1b (lung), pM1c (other sites). 

Any pM1 = Stage IV. Document site(s), number, and method of confirmation (biopsy/imaging).