Kidney tumor
Miscellaneous renal cell carcinoma

Topic Completed: 1 March 2018

Revised: 18 September 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Staging[TI] renal cell carcinoma[TI] full text[sb]

Debra Zynger, M.D.
Page views in 2018: 4,571
Page views in 2019 to date: 6,591
Cite this page: Zynger D. Staging. website. Accessed November 18th, 2019.
Pathologic TNM staging of renal cell carcinoma, AJCC 8th edition
Primary tumor (pT)
  • pTX: Primary tumor cannot be assessed
  • pT0: No evidence of primary tumor
  • pT1a: Tumor ≤ 4 cm, limited to the kidney
  • pT1b: Tumor > 4 cm and ≤ 7 cm, limited to the kidney
  • pT2a: Tumor > 7 cm and ≤ 10 cm, limited to the kidney
  • pT2b: Tumor > 10 cm, limited to the kidney
  • pT3a: Tumor invades renal vein / branches, perirenal fat, renal sinus fat or pelvicaliceal system
  • pT3b: Tumor extends into vena cava below the diaphragm
  • pT3c: Tumor extends into vena cava above the diaphragm or invades vena cava wall
  • pT4: Tumor invades beyond Gerota fascia, including direct extension to adrenal gland
Regional lymph nodes (pN)
  • pNX: Cannot be assessed
  • pN0: No regional lymph node metastasis
  • pN1: Regional lymph node metastasis
    (regional lymph nodes = hilar, caval, aortic)
Distant metastasis (pM)
  • pM1: Distant metastasis, including noncontiguous adrenal involvement
AJCC prognostic stage groups
Stage group I: T1a - 1b N0 M0
Stage group II: T2a - 2b N0 M0
Stage group III: T1a - 3c N1 M0
T3a - 3c NX - 0 M0
Stage group IV: T4 any N M0
any T any N M1
Gross images

Contributed by Debra Zynger, M.D.




Microscopic (histologic) images

Contributed by Debra Zynger, M.D.

Renal sinus fat invasion (pT3a)

Perinephric fat invasion (pT3a)

Renal vein invasion (pT3a)

Pelvicaliceal invasion (pT3a)

Direct extension to adrenal (pT4)

Periaortic lymph node metastasis (pN1)

Bone metastasis (pM1)

Lung metastasis (pM1)

Ovary metastasis (pM1)

Stomach metastasis (pM1)

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