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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.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
T1Tumor ≤7 cm in greatest dimension, limited to the kidney.
T1aTumor ≤4 cm in greatest dimension, limited to the kidney.
T1bTumor >4 cm but not >7 cm in greatest dimension, limited to the kidney.
T2Tumor >7 cm in greatest dimension, limited to the kidney.
T2aTumor >7 cm but ≤10 cm in greatest dimension, limited to the kidney.
T2bTumor >10 cm, limited to the kidney.
T3Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota fascia.
T3aTumor 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.
T3bTumor grossly extends into the vena cava below the diaphragm.
T3cTumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava.
T4Tumor 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.
NXRegional lymph nodes cannot be assessed.
N0No regional lymph node metastasis.
N1Metastases 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.
M0No distant metastasis.
M1Distant metastasis.
Table 4. Anatomic Stage/Prognostic Groupsa
StageTNM
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.
IT1N0M0
IIT2N0M0
IIIT1 or T2N1M0
T3N0 or N1M0
IVT4Any NM0
Any TAny NM1

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: December 5, 2014