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)

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

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Table 1. TNM Classification for Renal Cell Carcinoma

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

Table 3. Histologic Grade

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