Kidney Cancer Staging

The staging system most often used for kidney cancer is the American Joint Committee on Cancer (AJCC) TNM system.

The TNM system is based on 3 key pieces of information:

The size and extent of the main (primary) tumor (T):
How large is the tumor? Has it has grown into nearby areas?
The spread to nearby lymph nodes (N):
Has the cancer spread to nearby lymph nodes?
The spread (metastasis) to distant sites (M):
Has the cancer spread to other organs such as the bones, brain, or lungs?

The stages of kidney cancer range from I (1) through IV (4).

The lower the number, the less the cancer has spread.
A higher number, such as stage IV, means cancer has spread more. [1]

T1

T2

T3

T4

Kidney Purpose

The main functions of the kidneys are to clean the blood, balance fluids, remove waste through urine, keep chemicals and electrolytes in balance, make hormones for a stable blood pressure, make red blood cells, and keep our bones strong. [2]

Kidney Cancer Stages

Descriptions by American Urological Association and American Cancer Society

The "T" in the TNM system is the size of the main (primary) tumor and whether it has grown into nearby areas.

T1 Tumor

Stage I tumors include cancers of any size that are confined to the kidney.

Characteristics of T1 tumors:
• T1: Tumor 7.0 cm (about 2.8 inches) or less, confined to the kidney

• T1a: Tumor 4.0 cm (about 1.6 inches) or less, confined to the kidney

• T1b: Tumor 4.0 to 7.0 cm, confined to the kidney

T2 Tumor

Stage II tumors include cancers of any size that are confined to the kidney.

Characteristics of T2 tumors:
• T2: Tumor greater than 7.0 cm, confined to kidney

• T2a: Tumor greater than 7.0 cm and less than 10.0 cm, confined to the kidney

• T2b: Tumor greater than 10 cm (about 3.9 inches), confined to the kidney

T3 Tumor

Stage III tumors are either locally invasive (T3) or involve lymph nodes.

Characteristics of T3 tumors:

The tumor can be any size, but it has not grown outside the kidney.
The cancer may have spread to nearby lymph nodes but has not spread to distant lymph nodes or other organs.
Tumor grows into major veins (renal vein or the inferior vena cava) or into tissue around the kidney, but not into the adrenal gland and not beyond Gerota’s fascia

T4 Tumor

Stage IV tumors have spread beyond the kidney into organs nearby (T4) or distant (beyond the kidney) metastases.

Characteristics of T4 tumors:

• The tumor can be any size and may have grown outside the kidney.

The tumor may or may not have spread to nearby lymph nodes.
The tumor has spread to distant lymph nodes and/or other organs.
Tumor reaches beyond Gerota’s fascia (including the adrenal gland).
This is not a localized tumor.

Kidney Cancer Close Up

Credits - To the American Urological Association and the American Cancer Society for the descriptions on this page.
All of the information is copyright protected.

[1] Kidney Cancer Stages, American Cancer Society

[2] Kidney Cancer Patient Guide, American Urological Association (pdf)

Kidney Health Basics, Urology Care Foundation, American Urological Association (pdf)

[3] Kidney Illustrations by iStock