Stage IV includes: IVA (T1, N2, M0); (T2, N2, M0); (T3, N2, M0); (T4, Any N, M0); IVB (Any T, Any N, M1). T4: Tumor invades any of the following: upper urethra bladder mucosa, rectal mucosa, or is fixed to the pubic bone. N2: Bilateral regional lymph node metastasis. M1: distant metastasis (including pelvic lymph node metastasis). (AJCC 6th ed.) [from NCI]