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TMN Staging

TNM Classification

T: Primary Tumor

• TX Primary tumor cannot be assessed
• T0 No evidence of primary tumor
• T1 Tumor 7.0 cm or less in greatest dimension, limited to the kidney
• T2 Tumor more than 7.0 cm in greatest dimension, limited to the kidney
• T3 Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond Gerota's fascia
  • T3a Tumor invades adrenal gland or perinephric tissues but not beyond Gerota's fascia
  • T3b Tumor grossly extends into renal vein(s) or vena cava below diaphragm
  • T3c Tumor grossly extends into vena cava above diaphragm
• T4 Tumor invades beyond Gerota's fascia

N: Regional Lymph Nodes:

(Hilar, abdominal para-aortic, and paracaval nodes. Laterality has no effect)

• NX Regional lymph nodes cannot be assessed
• N0 No regional lymph node metastases
• N1 Metastasis in a single regional lymph node
• N2 Metastases in more than one regional lymph node

M: Distant Metastasis

• MX Distant metastasis cannot be assessed
• M0 No distant metastases
• M1 Distant metastases

Stage Grouping:

• Stage I: T1 N0 M0
• Stage II: T2 N0 M0
• Stage III: T1 N1 M0 or T2 N1 M0 or T3 N0 or N1 M0
• Stage IV: T4 N0, N1 M0 or any T N2 M0 or any T any N M1