The tumor, nodes, and metastasis (TNM) system separates tumors with venous involvement from those with lymphatic invasion and definesthe anatomic extent of disease more explicitly.
The TNM system has facilitated comparison of clinical and pathologic data from various centers across the globe.
- UICC-AJCC system is generally accepted Table 1
- Currently T1 lesion is 7 cm or less in size, yet 4.0 cm
- Associated with very low recurrence rate
- T1a category of <4.0 cm suggested
International TNM Staging System for Renal Cell Carcinoma
| Primary Tumor (T) | |
| TX | Primary tumor cannot be assessed |
| TO | No evidence of primary tumor |
| T1 | Tumor 7 cm or less in dimension limited to the kidney |
| T2 | Tumor more than 7 cm in dimension limited to the kidney |
| T3a | Tumor invades adrenal gland or perinephric tissues but not Gerota's fascia |
| T3b | Tumor grossly extends into renal vein or vena cava below diaphragm |
| T3c | Tumor grossly extends into vena cava above diaphragm |
| Regional Lymph Nodes (N) | |
| NX | Regional lymph nodes cannot be assessed |
| NO | No regional lymph node metastasis |
| N1 | Metastasis in a single regional lymph node or nodes |
| N2 | Metastasis in more than one regional lymph node |
| Distant Metastasis (M) | |
| MX | Distant metastasis cannot be assessed |
| MO | No distant metastasis |
| M1 | Distant Metastasis |
| Staging Grouping | |||
| I | T1 | NO | MO |
| II | T2 | NO | MO |
| III | T1 | N1 | MO |
| T2 | N1 | MO | |
| T3a | NO | MO | |
| T3a | N1 | MO | |
| T3b | NO | MO | |
| T3b | N1 | MO | |
| T3c | NO | MO | |
| T3c | N1 | MO | |
| IV | `T4T4 | NO | MO |
| Any T | N2 | MO | |
| Any T | Any N | M1 | |
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