AJCC and TNM staging system for renal cell carcinoma

American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) staging system for renal cell carcinoma.

AJCC TNM Staging System of Renal Cell Carcinoma(From Edge SB, Byrd DR, Compton CC, et al. AJCC Cancer Staging Manual. New York: Springer; 2010.)

TXPrimary tumor cannot be assessed
T0No evidence of primary tumor
T1Tumor 7 cm or less in greatest dimension, limited to the kidney
T1aTumor 4 cm or less in greatest dimension, limited to the kidney
T1bTumor more than 4 cm but not more than 7 cm in greatest dimension, limited to the kidney
T2Tumor more than 7 cm in greatest dimension, limited to the kidney
T2aTumor more than 7 cm but less than or equal to 10 cm in greatest dimension, limited to the kidney
T2bTumor more than 10 cm in greatest dimension, limited to the kidney
T3Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia
T3aTumor 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
T3bTumor grossly extends into the vena cava below the diaphragm
T3cTumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava
T4Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland)
Regional lymph node (N)
NXRegional lymph nodes cannot be assessed
N0No regional lymph node metastasis
N1Metastasis in regional lymph node(s)
Distant metastasis (M)
M0No distant metastasis
M1Distant metastasis
Anatomic stage/prognostic groups
StageTNM
IT1N0M0
IIT2N0M0
IIIT1-2N1M0
T3N0-1M0
IVT4Any NM0
Any TAny NM1

Note : Any T3 or N1 lesion is at least stage III, and any T4 or M1 lesion is stage IV.

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