How is clear cell renal cell carcinoma (CCRCC) staged?

Updated: Mar 11, 2019
  • Author: Ronald J Cohen, MB, BCh, PhD, FRCPA, FFPATH; Chief Editor: Liang Cheng, MD  more...
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Clear cell renal cell carcinoma (CCRCC) is currently staged according to the 2002 version of the American Joint Committee on Cancer's TNM (tumor-node-metastasis) staging system for renal tumors. [96] Most criteria of this revised system reflect the pattern of spread common in CCRCC.

Tumors restricted to the kidney are stratified as follows:

  • T1a (4 cm or less in maximal diameter)

  • T1b (greater than 4 cm but not greater than 7 cm)

  • T2 (greater than 7 cm)

Tumors not restricted to the kidney are stratified as follows:

  • T3a (invading adrenal gland or perinephric and/or renal sinus fat but not beyond Gerota's fascia)

  • T3b (extending into the renal vein, or the inferior vena cava [IVC] but below the diaphragm)

  • T3c (extending into the IVC above the diaphragm or invading into the wall of the IVC)

  • T4 (extension beyond Gerota's fascia)

Tumors are stratified according to regional lymph node metastasis as follows:

  • NX (nodes not assessed)

  • N0 (no nodal involvement)

  • N1 (involvement of a single node)

  • N2 (involvement of more than one node)

Finally, tumors are stratified according to distant metastasis as follows:

  • MX (distant metastasis not assessed)

  • M0 (no distant metastasis)

  • M1 (distant metastasis present)

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