Renal Cell Carcinoma Staging 

Updated: May 05, 2017
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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TNM Classification for Renal Cell Carcinoma

The TNM classification for renal cell carcinoma is provided below. [1, 2]

Table. TNM Classification for Renal Cell Carcinoma (Open Table in a new window)

Primary tumors (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤7 cm in greatest dimension, limited to the kidney
T1a Tumor ≤4 cm in greatest dimension, limited to the kidney
T1b Tumor >4 cm but ≤7 cm in greatest dimension, limited to the kidney
T2 Tumor >7 cm in greatest dimension, limited to the kidney
T2a Tumor >7 cm but ≤10 cm in greatest dimension, limited to the kidney
T2b Tumor >10 cm, limited to the kidney
T3 Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond the Gerota fascia
T3a Tumor grossly extends into the renal vein or its segmental (muscle-containing) branches, or tumor invades perirenal and/or renal sinus fat but not beyond the Gerota fascia
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 the Gerota fascia (including contiguous extension into the ipsilateral adrenal gland)
Regional lymph node (N)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in regional lymph node(s)
Distant metastasis (M)
M0 No distant metastasis
M1 Distant metastasis

Table. Anatomic stage/prognostic groups (Open Table in a new window)

Stage T N M
I T1 N0 M0
II T2 N0 M0
III T1-2 N1 M0
T3 N0-1 M0
IV T4 N2 M0
Any T Any N M1