TNM Classification for Renal Cell Carcinoma
The tumor-node-metastasis (TNM) classification for renal cell carcinoma is provided below. [1, 2]
Table 1. 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 2. 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 |
NX, N0, or N1 |
M0 |
|
IV |
T4 |
Any N |
M0 |
Any T |
Any N |
M1 |
Table 3. Histologic Grade (Open Table in a new window)
Grade |
|
X |
Grade cannot be assessed |
1 |
Nucleoli absent or inconspicuous and basophilic at 400x magnification |
2 |
Nucleoli conspicuous and eosinophilic at 400x magnification, visible but not prominent at 100x magnification |
3 |
Nucleoli conspicuous and eosinophilic at 100x magnification |
4 |
Marked nuclear pleomorphism and/or multinucleate giant cells and/or rhabdoid and/or sarcomatoid differentiation |