KIDNEY CANCER: TNM STAGING
T staging
- TX Primary tumor cannot be assessed
- T0 No evidence of primary tumor
- T1
- T1a: Tumor ≤ 4.0 cm and confined to the kidney
- T1b: Tumor > 4.0 cm and ≤ 7.0 cm and confined to the kidney
- T2
- T2a: Tumor > 7.0 cm and ≤ 10.0 cm and confined to the kidney
- T2b: Tumor > 10.0 cm and confined to the kidney
- T3
- T3a: Tumor
- Grossly extends into the renal vein or its segmental branches OR
- Invades pelvicalyceal system OR
- Invades perirenal and/or renal sinus fat but not beyond Gerota fascia
- Invasion of the perisinus fat medially has been shown to have worse prognosis that perrenal fat laterally.
- Medial invasion places the tumor in proximity to the venous system and likely increases the risk of metastatic dissemination
- 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)
- Ipsilateral adrenal involvement is even worse, and these are now classified as pT4 if due to direct local extension, or pM1 otherwise, consistent with a hematogenous route of dissemination.
N staging
- NX Regional lymph nodes cannot be assessed
- N0 No regional lymph nodes metastasis
- N1 Metastasis in regional lymph node(s) (5 yr survival 0-20%)
M staging
- MX Distant metastasis cannot be assessed
- M0 No distant metastasis
- M1 Distant metastasis present (5 yr survival 0-10%)
Questions
- What is the T staging for RCC?
Answers
- What is the T staging for RCC?
- T1a: tumor ≤ 4.0 cm and confined to the kidney
- T1b: tumor > 4.0 cm and ≤ 7.0 cm and confined to the kidney
- T2a: tumor > 7.0 cm and ≤ 10.0 cm and confined to the kidney
- T2b: tumour > 10cm and confined to the kidney
- T3a: tumour invades renal vein or its segmental branch or pelvicalyceal system or perirenal/perihilar fat
- T3b: tumour invades IVC below diaphragm
- T3c: tumour invades IVC above diaphragm or wall of IVC
- T4: tumour invades outside of Gerota’s fascia including contiguous extension into the ipsilateral adrenal gland
References
- Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, et al. (Eds.). AJCC Cancer Staging Manual (8th edition). Springer International Publishing: American Joint Commission on Cancer; 2017
