Renal cell carcinoma staging (TNM)

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 (7th edition)

  • T1
    • T1a: tumour confined to kidney, <4 cm
    • T1b: ltumour confined to kidney, >4 cm but <7 cm
  • T2: limited to kidney >7 cm
    • T2a: tumour confined to kidney, >7 cm but not >10 cm
    • T2b: tumour confined to kidney, >10 cm
  • T3: tumour / tumour thrombus extension into major veins or perinephric tissues, but not into ipsilateral adrenal gland or beyond Gerota's fascia
    • T3a: spread to renal vein
    • T3b: spread to infra diaphragmatic IVC
    • T3c: spread to supra diaphragmatic IVC or invades the wall of the IVC
  • T4: involves ipsilateral adrenal gland or invades beyond Gerota's fascia
  • N0: no nodal involvement
  • N1: metastatic involvement of regional lymph node(s)
  • M0: no distant metastases
  • M1: distant metastases

Stage groupings

  • stage I: T1 N0 M0
  • stage II: T2 N0 M0
  • stage III: T3 or N1 with M0
  • stage IV: T4 or M1


  • the distinction between N1 and N2 was discontinued in the most recent version of staging
  • contiguous involvement of the ipsilateral adrenal gland is T4, noncontiguous involvement is M1

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