Renal cell carcinoma (TNM staging)
Updates to Article Attributes
TheTNM 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.
TNM staging (8th edition)
Primary tumour staging (T)
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
tumourinvades perirenal and/or renal sinus fat but not beyond the Gerota fascia9T3b: 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
-<li><p><strong>T3a:</strong> tumour grossly extends into the renal vein or its segmental (muscle-containing) branches, or tumour invades perirenal and/or renal sinus fat but not beyond the Gerota fascia</p></li>- +<li><p><strong>T3a:</strong> 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 <sup>9</sup></p></li>
References changed:
- 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. <a href="https://doi.org/10.2214/AJR.21.25493">doi:10.2214/AJR.21.25493</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33759558">Pubmed</a>
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