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Stage Information for Renal Cell Cancer

Note: This Stage Information section has been updated to include information from the seventh edition (2010) of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging categories to determine whether additional changes need to be made to other parts of the summary. Any necessary changes will be made as soon as possible.

The staging system for renal cell cancer is based on the degree of tumor spread beyond the kidney.[1,2,3] 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

^a Reprinted 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.
TX	Primary tumor cannot be assessed.
T0	No evidence of primary tumor.
T1	Tumor ?7 cm in greatest dimension, limited to the kidney.
T1a	Tumor ?4 cm in greatest dimension, limited to the kidney.
T1b	Tumor >4 cm but not >7 cm in greatest dimension, limited to the kidney.
T2	Tumor >7 cm in greatest dimension, limited to the kidney.
T2a	Tumor >7 cm but ?10 cm in greatest dimension, limited to the kidney.
T2b	Tumor >10 cm, limited to the kidney.
T3	Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota fascia.
T3a	Tumor 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.
T3b	Tumor grossly extends into the vena cava below the diaphragm.
T3c	Tumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava.
T4	Tumor invades beyond Gerota fascia (including contiguous extension into the ipsilateral adrenal gland).

Table 2. Regional Lymph Nodes (N)a

^a Reprinted 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.
NX	Regional lymph nodes cannot be assessed.
N0	No regional lymph node metastasis.
N1	Metastases in regional lymph node(s).

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WebMD Public Information from the National Cancer Institute

Last Updated: May 16, 2012

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.