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Renal Cell Cancer Treatment (PDQ®)

Stage Information for Renal Cell Cancer

The staging system for renal cell cancer is based on the degree of tumor spread beyond the kidney.[1-3] Involvement of blood vessels may not be a poor prognostic sign if the tumor is otherwise confined to the substance of the kidney. Abnormal liver function test results may be caused by a paraneoplastic syndrome that is reversible with tumor removal, and these types of results do not necessarily represent metastatic disease. Except when computed tomography (CT) examination is equivocal or when iodinated contrast material is contraindicated, CT scanning is as good as or better than magnetic resonance imaging for detecting renal masses.[4]

Definitions of TNM

The American Joint Committee on Cancer has designated staging by TNM classification to define renal cell cancer.[5]

Table 1. Primary Tumor (T)a
aReprinted with permission from AJCC: Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89.
TX Primary tumor cannot be assessed.
T0 No evidence of primary tumor.
T1 Tumor ≤7 cm in greatest dimension, limited to the kidney.
T1a Tumor ≤4 cm in greatest dimension, limited to the kidney.
T1b Tumor >4 cm but not >7 cm in greatest dimension, limited to the kidney.
T2 Tumor >7 cm in greatest dimension, limited to the kidney.
T2a Tumor >7 cm but ≤10 cm in greatest dimension, limited to the kidney.
T2b Tumor >10 cm, limited to the kidney.
T3 Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota fascia.
T3a Tumor grossly extends into the renal vein or its segmental (muscle containing) branches, or tumor invades perirenal and/or renal sinus fat but not beyond Gerota fascia.
T3b Tumor grossly extends into the vena cava below the diaphragm.
T3c Tumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava.
T4 Tumor invades beyond Gerota fascia (including contiguous extension into the ipsilateral adrenal gland).
Table 2. Regional Lymph Nodes (N)a
aReprinted with permission from AJCC: Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89.
NX Regional lymph nodes cannot be assessed.
N0 No regional lymph node metastasis.
N1 Metastases in regional lymph node(s).
Table 3. Distant Metastasis (M)a
aReprinted with permission from AJCC: Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89.
M0 No distant metastasis.
M1 Distant metastasis.
Table 4. Anatomic Stage/Prognostic Groupsa
Stage T N M
aReprinted with permission from AJCC: Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89.
I T1 N0 M0
II T2 N0 M0
III T1 or T2 N1 M0
T3 N0 or N1 M0
IV T4 Any N M0
Any T Any N M1

References

  1. Bassil B, Dosoretz DE, Prout GR Jr: Validation of the tumor, nodes and metastasis classification of renal cell carcinoma. J Urol 134 (3): 450-4, 1985. [PUBMED Abstract]
  2. Golimbu M, Joshi P, Sperber A, et al.: Renal cell carcinoma: survival and prognostic factors. Urology 27 (4): 291-301, 1986. [PUBMED Abstract]
  3. Robson CJ, Churchill BM, Anderson W: The results of radical nephrectomy for renal cell carcinoma. J Urol 101 (3): 297-301, 1969. [PUBMED Abstract]
  4. Consensus conference. Magnetic resonance imaging. JAMA 259 (14): 2132-8, 1988. [PUBMED Abstract]
  5. Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89.
  • Updated: February 25, 2015