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Staging of kidney cancer

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.

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