Kidney cancer staging

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Schematic showing a T1 kidney cancer. (WC/CRUK)

The article deals with kidney cancer staging. A general discussion of staging is found in cancer staging.

General

  • TNM staging used.

TNM staging system

Tumour stage

Renal sinus invasion

Renal sinus invasion is when any of the following are present:[1]

  1. Tumour in an endothelial lined space of the renal sinus.
  2. Tumour touching renal sinus fat.
  3. Tumour within the loose connective tissue of the renal sinus.

Notes:

  • Most cases are pT1a or pT3a.
    • pT2 is very rare and pT1b is uncommon for CCRCC - in a series of 120 cases:[2]
      • 3% of >7 cm CCRCCs are limited to the kidney.
      • 32% of 4.1-7.0 cm CCRCCs are limited to the kidney.

Lymph node staging

Notes:

  • Previously divided into N1 (one lymph node positive) and N2 (multiple lymph nodes positive).
    • Now only N1 - was changed in 2009.[3]
      • There is data to suggest N1 and N2 behave differently;[4] however, it is disputed.[5][6]

See also

References

  1. ↑ Trpkov, K.; Grignon, DJ.; Bonsib, SM.; Amin, MB.; Billis, A.; Lopez-Beltran, A.; Samaratunga, H.; Tamboli, P. et al. (Oct 2013). "Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations.". Am J Surg Pathol 37 (10): 1505-17. doi:10.1097/PAS.0b013e31829a85d0. PMID 24025521.
  2. ↑ Bonsib, SM. (Oct 2005). "T2 clear cell renal cell carcinoma is a rare entity: a study of 120 clear cell renal cell carcinomas.". J Urol 174 (4 Pt 1): 1199-202; discussion 1202. PMID 16145369.
  3. ↑ Lee, C.; You, D.; Park, J.; Jeong, IG.; Song, C.; Hong, JH.; Ahn, H.; Kim, CS. (Aug 2011). "Validation of the 2009 TNM Classification for Renal Cell Carcinoma: Comparison with the 2002 TNM Classification by Concordance Index.". Korean J Urol 52 (8): 524-30. doi:10.4111/kju.2011.52.8.524. PMID 21927698.
  4. ↑ Canfield, SE.; Kamat, AM.; Sánchez-Ortiz, RF.; Detry, M.; Swanson, DA.; Wood, CG. (Mar 2006). "Renal cell carcinoma with nodal metastases in the absence of distant metastatic disease (clinical stage TxN1-2M0): the impact of aggressive surgical resection on patient outcome.". J Urol 175 (3 Pt 1): 864-9. doi:10.1016/S0022-5347(05)00334-4. PMID 16469567.
  5. ↑ Dimashkieh, HH.; Lohse, CM.; Blute, ML.; Kwon, ED.; Leibovich, BC.; Cheville, JC. (Nov 2006). "Extranodal extension in regional lymph nodes is associated with outcome in patients with renal cell carcinoma.". J Urol 176 (5): 1978-82; discussion 1982-3. doi:10.1016/j.juro.2006.07.026. PMID 17070225.
  6. ↑ Lam, JS.; Klatte, T.; Breda, A.. "Staging of renal cell carcinoma: Current concepts.". Indian J Urol 25 (4): 446-54. doi:10.4103/0970-1591.57906. PMID 19955666.
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