Staging of bladder tumors is based primarily on the depth of tumor invasion (T category) and is important to treatment planning and prognosis. The problem is that clinical evaluation by T category alone often understages the pathologic extent of disease and does not reliably predict treatment results. The current analysis suggests that the presence of a mass palpable on bimanual examination is of prognostic value and incorporation of this feature with microscopic tumor invasion may enhance the usefulness of clinical staging.