The TNM classification system is recommended (tumor, lymph nodes, metastasis) since the stage will have consequences for prognosis and treatment (1).
TNM classification of renal cell carcinoma (2009)
T1: Tumor 7 cm or less in greatest dimension, limited to the kidney.
- T1a: Tumor 4 cm or less.
- T1b: Tumor more than 4 cm but not more than 7 cm.
T2: Tumor greater than 7 cm in greatest dimension, limited to the kidney.
- T2 a: Tumor more than 7 cm but not more than 10 cm.
- T2 b: Tumor more than 10 cm, limited to the kidney.
T3: Tumor extends into major veins or directly invades adrenal gland or perinephric tissues but not beyond Gerota's fascia.
- T3a: Tumor directly invades adrenal gland or perinephric tissues (including renal sinus) but not beyond the renal fascia.
- T3b: Tumor grossly extends into renal vein(s) or caval vein below diaphragm.
- T3c: Tumor grossly extends into caval vein or wall of vena cava above diaphragm.
T4: Tumor directly invades beyond the renal fascia (Including contiguous extension into the ipilaterale adrenal gland)
N0: No regional lymph node metastasis.
N1–3: Metastases to lymph nodes in the pelvis.
M0: No distant metastases.
M1: Distant metastases.