Stage IV includes: (T4, N0, M0, Any PSA, Any Gleason); (Any T, N1, M0, Any PSA, Any Gleason); (Any T, Any N, M1, Any PSA, Any Gleason). cT4: Tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall. pT4: Invasion of rectum, levator muscles, and/or pelvic wall. N1: Metastasis in regional lymph node(s). M1: Distant metastasis. (AJCC 7th ed.) [from NCI]