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Renal cell carcinoma staging

contributed by Dr Vinod G Maller on September 29, 2008

System: Urogenital
Section: Staging
Tag: kidney

Renal cell carcinoma staging using the TNM staging system for renal cell carcinoma. Older but still widely used system in some practices is the Robson staging system.

TNM staging

T
  • T1
    • T1a : limited to kidney < 4 cm
    • T1b : limited  to kidney > 4 cm, < 7 cm
  • T2 : limited to kidney > 7cm
  • T3 : tumour / tumour thrombus extension into adrenal or renal vein or perinephric tissues (but contained by Gerota's fascia)
    • T3a : spread to perinephric fat
    • T3b : spread to renal vein or intra diaphragmatic IVC
    • T3c : spread to supra diaphragmatic IVC
  • T4 : beyond Gerota's fascia.
N
  • N1 : single regional lymph node involved
  • N2 : beyond N1 (NB laterality does NOT affect nodal staging)
M
  • M0 : no distant metastases
  • M1 : distant metastases

Stage groupings

  • Stage I  : T1 N0 M0
  • Stage II : T2 N0 M0
  • Stage III : Everything between II and IV
  • Stage IV : any one of : M1 or N2 or T4