Kidney tumor
Adult malignancies - Miscellaneous
Staging

Author: Sean Williamson, M.D. (see Authors page)

Revised: 10 February 2017, last major update July 2012

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Staging renal tumor kidney

Cite this page: Staging. PathologyOutlines.com website. http://pathologyoutlines.com/topic/kidneytumormalignantstaging.html. Accessed April 23rd, 2017.
Definition / General

Primary tumor (T)
  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • T1: Tumor 7 cm or less (in greatest dimension), limited to kidney
  • T1a: Tumor 4 cm or less, limited to kidney
  • T1b: Tumor more than 4 cm, not more than 7 cm, limited to kidney
  • T2: Tumor more than 7 cm, limited to kidney
  • T2a: Tumor more than 7 cm but less than or equal to 10 cm, limited to kidney
  • T2b: Tumor more than 10 cm, limited to kidney
  • T3: Tumor extends into major veins or perinephric tissue but not into the ipsilateral adrenal grand and not beyond Gerota fascia
  • T3a: Tumor grossly extends into the renal vein or its segmental (muscle containing) branches or tumor invades perirenal or renal sinus fat but not beyond 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 Gerota fascia, including contiguous extension into the ipsilateral adrenal gland

Notes:
  1. For pT3b tumors, nodules within renal sinus fat usually represent venous involvement (Mod Pathol 2007;20:44)
  2. A breakpoint of 5.5 cm instead of 7 cm for pT1 versus pT2 has been proposed (Cancer 2005;104:2116)


Regional lymph nodes (N) [not affected by laterality]
  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastases
  • N1: Metastases in regional lymph node(s)
  • __: No nodes submitted or found

Notes:
  • If a lymph node dissection is performed, pathologic examination should include 8+ nodes


Distant metastases (M)
  • M0: No evidence of metastases based on the surgical specimen and clinical review (in CAP protocol, is called "not applicable" but functions as M0 in anatomic staging below
  • M1: Distant metastasis


Stage grouping
I:T1N0M0
II:T2N0M0
III:T1 - T2N1M0orT3N0 - N1M0
IV:T4NM0orany Tany NM1


Robson classification (used in past)
I:Within renal capsule
II:Infiltrates perinephric fat or adrenal gland but within Gerota fascia
III A:Gross renal vein or inferior vena cava involvement (only large veins with smooth muscle in wall and outside or at edge of main tumor)
III B:Regional lymph nodes
III C:Angiolymphatic invasion
IV: Invades beyond Gerota fascia (thin fibrous membrane separating kidney and perinephric adipose tissue from retroperitoneum
IV A:Adjacent organs other than ipsilateral adrenal gland
IV B:Distant metastases
Gross Images: Primary Tumor (T)

Images hosted on other servers:

Venous involvement by tumor

Intravenous tumor within renal sinus

Retrograde cortical renal extension

Tumor within renal sinus vein

Micro Images: Primary Tumor (T)

Images hosted on other servers:

Tumor within sinus vein

Intravenous tumor that itself contains veins


Intravenous tumor invading into sinus fat

Intravenous tumor invading into sinus fat

Intravenous tumor invading into sinus fat