Renal cell carcinoma (TNM staging)

Last revised by Arlene Campos on 7 May 2024

Citation, DOI, disclosures and article data

Citation:

Maller V, Campos A, Niknejad M, et al. Renal cell carcinoma (TNM staging). Reference article, Radiopaedia.org (Accessed on 20 May 2024) https://doi.org/10.53347/rID-4699

DOI:

https://doi.org/10.53347/rID-4699

Permalink:

https://radiopaedia.org/articles/4699?iframe=true

rID:

4699

Article created:

29 Sep 2008, Vinod G Maller

Disclosures:

At the time the article was created Vinod G Maller had no recorded disclosures.

View Vinod G Maller's current disclosures

Last revised:

7 May 2024, Arlene Campos ◉

Disclosures:

At the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.

View Arlene Campos's current disclosures

Revisions:

32 times, by 24 contributors - see full revision history and disclosures

Systems:

Urogenital, Oncology

Sections:

Staging

Tags:

kidney

Synonyms:

Renal cell carcinoma (RCC) staging
RCC staging
Renal cell cancer staging
Renal cell carcinoma staging
Renal cell carcinoma staging (TNM)

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.

Tx: tumour cannot be assessed
T0: tumour not seen
T1
- T1a: tumour confined to kidney, <4 cm
- T1b: tumour 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 extension into major veins or perinephric tissues, but not into ipsilateral adrenal gland or beyond Gerota's fascia
- T3a: tumour 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)

N0: no nodal involvement
N1: metastatic involvement of regional lymph node(s)

Metastases (M)

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

Notes

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

References

1. Andy Adam, Ronald G. Grainger, Adrian K. Dixon et al. Grainger & Allison's Diagnostic Radiology. (2007) ISBN: 9780443101632 - Google Books
2. Frederick L. Greene, Charles M. Balch, Irvin D. Fleming et al. AJCC Cancer Staging Handbook. (2002) ISBN: 9780387952703 - Google Books
3. Fein A, Lee J, Balfe D et al. Diagnosis and Staging of Renal Cell Carcinoma: A Comparison of MR Imaging and CT. AJR Am J Roentgenol. 1987;148(4):749-53. doi:10.2214/ajr.148.4.749 - Pubmed
4. Sheth S, Scatarige JC, Horton KM et-al. Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector ct and three-dimensional CT. Radiographics. 2001;21 Spec No : S237-54. Radiographics (link) - Pubmed citation
5. Ng C, Wood C, Silverman P, Tannir N, Tamboli P, Sandler C. Renal Cell Carcinoma: Diagnosis, Staging, and Surveillance. AJR Am J Roentgenol. 2008;191(4):1220-32. doi:10.2214/AJR.07.3568 - Pubmed
6. 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.
7. Bianchi M, Sun M, Jeldres C et al. Distribution of Metastatic Sites in Renal Cell Carcinoma: A Population-Based Analysis. Ann Oncol. 2012;23(4):973-80. doi:10.1093/annonc/mdr362 - Pubmed
8. James D. Brierley, Mary K. Gospodarowicz, Christian Wittekind. TNM Classification of Malignant Tumours. (2017) ISBN: 9781119263579 - Google Books
9. Elkassem A, Allen B, Sharbidre K, Rais-Bahrami S, Smith A. Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the Special Series on Cancer Staging. AJR Am J Roentgenol. 2021;217(3):541-55. doi:10.2214/AJR.21.25493 - Pubmed

Incoming Links

Promoted articles (advertising)

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":63754687,"studyId":142625,"caseSlug":"renal-cell-carcinoma-t-staging-ajcc-8th-edition","caption":"Figure 1: renal cell carcinoma T staging (AJCC 8th edition)","thumbnail":"https://prod-images-static.radiopaedia.org/images/63754687/58e8dd474106a24dbde79a210a106a3768ec1a24e2c7aadc17bf53d52394bbe4_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":413,"studyId":6449,"caseSlug":"renal-cell-carcinoma-18","caption":"Case 1","thumbnail":"https://prod-images-static.radiopaedia.org/images/413/61818bc68fd83d9e5e1495088ee9fe_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":29666385,"studyId":58429,"caseSlug":"renal-cell-carcinoma-with-vena-cava-tumour-thrombus","caption":"Case 2","thumbnail":"https://prod-images-static.radiopaedia.org/images/29666385/9d462377a6c760a6b0059f999641cf_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"probable"},{"imageId":676,"studyId":37492,"caseSlug":"renal-cell-carcinoma-39","caption":"Case 3","thumbnail":"https://prod-images-static.radiopaedia.org/images/676/e0ac2a3f0bad745e1e71e4786756b7_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":818057,"studyId":13236,"caseSlug":"renal-cell-carcinoma-8","caption":"Case 4","thumbnail":"https://prod-images-static.radiopaedia.org/images/818057/efbb6762eee8d3fb6f124c9528a020_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":1270575,"studyId":14376,"caseSlug":"renal-cell-carcinoma-9","caption":"Case 5: T1bN0","thumbnail":"https://prod-images-static.radiopaedia.org/images/1270575/fb46b97485249baec54dde721f1719_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":3417339,"studyId":23094,"caseSlug":"renal-cell-carcinoma-29","caption":"Case 6: T1bN0Mx","thumbnail":"https://prod-images-static.radiopaedia.org/images/3417339/3b64dca4b0691506dfa35f47ac88ae_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":5243296,"studyId":26335,"caseSlug":"renal-cell-carcinoma-t2-stage","caption":"Case 7: T2N0M0 ","thumbnail":"https://prod-images-static.radiopaedia.org/images/5243296/27f16e73e2413c8ff527e4e7e1273f_big_gallery.jpg","isStack":true,"diagnosticCertainty":"probable"},{"imageId":9944102,"studyId":34026,"caseSlug":"renal-cell-carcinoma-38","caption":"Case 8: T2bN0M0","thumbnail":"https://prod-images-static.radiopaedia.org/images/9944102/491253bf6398441635edfc91e92618bc5a547c4d8f48124352af05f7747788fe_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":27453533,"studyId":55770,"caseSlug":"renal-cell-carcinoma-51","caption":"Case 9: T1a","thumbnail":"https://prod-images-static.radiopaedia.org/images/27453533/c52fc1fad0b04f50a075e81ffb35c7_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":59408812,"studyId":125496,"caseSlug":"renal-cell-carcinoma-with-vascular-extension","caption":"Case 10: T3a","thumbnail":"https://prod-images-static.radiopaedia.org/images/59408812/26aadbd11a1c0abb18a7898d885f2967bd7ee94bd74ca227f3bab586c46556c3_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":62051618,"studyId":135544,"caseSlug":"clear-cell-renal-cell-carcinoma-13","caption":"Case 11: T1a","thumbnail":"https://prod-images-static.radiopaedia.org/images/62051618/e0611dd00cb762eafe38b617e8910e1f682a1f461a6092c3d0b7199ad529ec64_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":61926879,"studyId":135018,"caseSlug":"papillary-renal-cell-carcinoma-7","caption":"Case 12: T3","thumbnail":"https://prod-images-static.radiopaedia.org/images/61926879/a915d08bb11207f38d1ac54550b2a39e075a34c6b4ef129b6963a6fde458af88_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":64229676,"studyId":144755,"caseSlug":"renal-cell-carcinoma-stage-i-1","caption":"Case 12: T1a","thumbnail":"https://prod-images-static.radiopaedia.org/images/64229676/04c2a799f3f681be42c052fda19bbbec5618fb7ae6522a38afa34f79b42c6793_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"}],"ddx_inclusions":[],"lang":"gb"}

Renal cell carcinoma (TNM staging)

Citation, DOI, disclosures and article data

On this page:

TNM staging (8^thedition)

Primary tumour staging (T)

Regional lymph nodes (N)

Metastases (M)

Stage groupings

Notes

References

Incoming Links

Promoted articles (advertising)

Renal cell carcinoma (TNM staging)

Citation, DOI, disclosures and article data

On this page:

TNM staging (8th edition)

Primary tumour staging (T)

Regional lymph nodes (N)

Metastases (M)

Stage groupings

Notes

References

Incoming Links

Promoted articles (advertising)

TNM staging (8^thedition)