Staging of Kidney Cancer (Renal Cell Carcinoma)
Dr. Alex Shteynshlyuger is an experienced, board-certified urologist. He is one of the few fellowship-trained urologic oncologists in the country. He treats men and women with all stages of kidney cancer.
If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5515
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC. He specializes in the treatment of men and women with kidney cysts, masses, renal cancer and angiomyolipoma (AML).
TNM staging system for kidney cancer
The TNM staging system for kidney cancer is used worldwide. The TNM system is constantly updated to reflect the latest knowledge by the American Joint Committee on Cancer (AJCC). This staging system includes the following parameters that are important for prognosis:
- T stage = the extent of the primary kidney tumor (T stage)
- N stage – status of lymph nodes near the kidney
- M stage – the presence or absence of distant metastases
Clinical stage is based on radiographic imaging before surgery.
Pathologic staging is established after surgical removal of the entire tumor.
Tumor Grade: Fuhrman tumor grade is a measure of how abnormal the cancer cells appear under the microscope. Furhman Grade ranges from 1 to 4, with 1 indicating least abnormal appearing cells and 4 indicating very abnormal, typically more aggressive cancer type.
Stage I: The tumor is confined to the kidney and less than 7.0 cm in size. There is no spread to lymph nodes or distant organs.
Stage II: The tumor is confined to the kidney and greater than 7.0 cm in size. There is no spread to lymph nodes or distant organs.
Stage III: There are several combinations of T and N categories that are included in this stage. These include tumors of any size, with spread into the lymph nodes adjacent to the kidney or into the large veins leading from the kidney to the heart (venous tumor thrombus). This stage does not include tumors that invade into other adjacent organs or those with distant metastasis.
Stage IV: There are several combinations of T, N, and M categories that are included in this stage. This stage includes any cancers that have invaded into adjacent organs such as the colon (large bowel) or the abdominal wall and those with distant metastases.
TNM Classification of Renal Cell Carcinoma
T: Primary tumor
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Tumor ≤7.0 cm, limited to the kidney
T1a: Tumor ≤4.0 cm
T1b: Tumor >4.0 but ≤7.0 cm
T2: Tumor greater than 7.0 cm, limited to the kidney
T2a: Tumor >7.0 cm but <10 cm
T2b: Tumor >10 cm
T3: Tumor extends into major veins or perinephric tissues but not into the adrenal gland and not beyond Gerota’s fascia
T3a: Tumor extends in the renal vein or its segmental branches, or tumor invades perirenal and or renal sinus fat but not beyond Gerota’s fascia
T3b: Tumor extends into the vena cava below the diaphragm
T3c: Tumor extends into vena cava above the diaphragm or invades the wall of the diaphragm
T4: Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland
N – Regional lymph nodes
NX: Regional nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in regional lymph node(s)
N2: Metastasis in more than one regional lymph node
M – Distant metastasis
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis
If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5515
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC. He specializes in the treatment of men and women with kidney cysts, masses, renal cancer and angiomyolipoma (AML).