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Kidney Cancer Staging: TNM Classification


Kidney cancer staging helps to determine the disease prognosis and to select an appropriate treatment strategy.

TNM is the most commonly used system for staging kidney cancers. “T” stands for “Tumor Size”, “N” for “Lymph Nodes”, and “M” for “Metastasis”. Numbers and/or letters after T (1, 2, 3, and 4), N (0 and 1), and M (0 and 1) provide more details about each of these factors.

Higher the number means higher the severity of the disease. Once T, N, and M categories are determined, this information is combined to assign an overall stage (from I to IV).

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Kidney Cancer - T Staging
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Kidney Cancer - N and M Staging

Before discussing the staging, we will understand the NORMAL ANATOMY of kidney and surrounding structures.

Following table describes the characteristics of kidney cancer according to different stages:

STAGE TNM DESCRIPTION
I T1 N0 M0 Tumor is limited to kidney and measures </=7 cm in largest dimension. No spread of disease to nearby lymph nodes or distant body organs.
II T2 N0 M0 Tumor is limited to kidney and measures >7 cm in largest dimension. No spread of disease to nearby lymph nodes or distant body organs.
III T1-2 N1 M0 Tumor is limited to kidney irrespective of size. It has spread to nearby lymph nodes without spread to distant body organs.
OR
T3 N0-1 M0 Tumor has extended up to a renal vein (or its branches) or has spread to inferior vena cava; or the fatty tissue around the kidney, but not to the adrenal gland or beyond Gerota’s fascia.
No spread of disease to nearby lymph nodes or distant body organs.
IV T4 Any N M0 The tumor has extended beyond the Gerota’s fascia and may be up to the adrenal gland. It may or may not has spread to nearby lymph nodes. It has not spread to distant body organs.
OR
Any T Any N M1 Tumor of any size with or without an extension outside of the kidney. It may or may not have spread to nearby lymph nodes. It has spread to distant body organs like the brain, bones, lungs, liver, peritoneum, etc.

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Watch the video below where Cancerbro explains the TNM STAGING of kidney cancer.

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