Genitourinary Updates in the Eighth Edition of the AJCC Cancer Staging Manual

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The new, eighth edition of the AJCC Cancer Staging Manual has been published, and there are many and significant changes in the staging for genitourinary organs. Pathologists will necessarily need to study the manual to acquire fluency in the staging. The staging changes and philosophy will be applicable in 2018. The TNM process involved remains the same, but some specific definition changes are present. Prostate staging is now very different; whereas prior staging included pT2a, pT2b, and pT2c, now all organ-confined disease is pT2 without consideration of half gland involvement. Staging of penis cancer previously considered urethral involvement but now corpus spongiosum involvement is considered pT2, and corpus cavernosum involvement is considered pT3 disease irrespective of the urethral involvement based on literature evidence. Invasion of the epididymis as a component of testis staging is now considered pT2 rather than pT1. These are just some of the new changes that will require understanding on the part of the pathologist. This article describes the changes and some of the background supportive literature and provides appropriate explanatory illustrations.

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