Citation, DOI, disclosures and article data
Citation:
Maller V, Walizai T, Campos A, et al. Renal cell carcinoma (TNM staging). Reference article, Radiopaedia.org (Accessed on 28 Feb 2025) https://doi.org/10.53347/rID-4699
The TNM system may be used for staging of renal cell carcinoma. An older but still widely used system for staging of renal cell carcinoma in some practices is the Robson staging system.
Primary tumor staging (T)
Tx: tumor cannot be assessed
T0: tumor not seen
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T1
T1a: tumor confined to kidney, <4 cm
T1b: tumor confined to kidney, >4 cm but <7 cm
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T2: limited to kidney >7 cm
T2a: tumor confined to kidney, >7 cm but not >10 cm
T2b: tumor confined to kidney, >10 cm
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T3: tumor extension into major veins or perinephric tissues, but not into ipsilateral adrenal gland or beyond Gerota's fascia
T3a: tumor grossly extends into the renal vein or its segmental (muscle-containing) branches, invades the pelvicalyceal system, or invades perirenal and/or renal sinus fat but not beyond the Gerota fascia 9
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
Regional lymph nodes (N)
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
the most common sites of metastasis are, in order: lung, bone, lymph node, liver, adrenal and brain 7
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