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26

NCCN Guidelines for Patients

®

:

Kidney Cancer, Version 1.2017

3

Cancer staging

TNM scores

TNM scores

The AJCC (

A

merican

J

oint

C

ommittee on

C

ancer)

staging system is used to stage kidney cancer. In

this system, each letter—T, N, and M—describes

a different area of cancer growth. Your doctors will

assign a score to each letter, based on the results

of cancer tests. These scores will be combined to

assign the cancer a stage.

T = Tumor

The T score describes the growth of the primary

tumor. This score tells you how large the tumor

has grown. It also tells you if the tumor has grown

into nearby tissues. The tumor size is measured

in cm (

c

enti

m

eters). It may help to compare the

measurement to everyday objects. For example, a

green pea is about 1 cm wide. A golf ball is a little

more than 4 cm wide. A baseball is a little more than

7 cm wide. T scores for kidney cancer include:

†

†

TX

primary tumor cannot be assessed.

†

†

T0

no signs of a primary tumor.

†

†

T1

tumors are only in the kidney and are not

larger than 7 cm at the widest point.

T1a

tumors are 4 cm or smaller.

T1b

tumors are more than 4 cm but not

larger than 7 cm.

†

†

T2

tumors are only in the kidney and are larger

than 7 cm at the widest point.

T2a

tumors are more than 7 cm but not

larger than 10 cm.

T2b

tumors are larger than 10 cm.

†

†

T3

tumors extend beyond the kidney. They

have grown into a major vein, like the renal vein

or vena cava, or into fatty tissue around the

kidney. The renal veins carry blood out of the

kidneys then merge with the vena cava. The

vena cava is a large vein that carries blood up

to the heart. T3 tumors have not grown into the

adrenal gland on top of the kidney or beyond

Gerota’s fascia.

T3a

tumors have grown into the fat in or

around the kidney, or into the renal vein or

muscles of the vein, or both.

T3b

tumors have grown into the vena cava

below the diaphragm, a sheet of muscles

under the ribs that helps a person to breathe.

T3c

tumors have grown into the vena cava

above the diaphragm or into the wall of the

vena cava.

†

†

T4

tumors have grown beyond Gerota’s fascia

and may extend into the adrenal gland on top of

the kidney with the tumor.

N = Nodes

The N score describes how much the cancer has

spread within nearby lymph nodes. Lymph nodes are

small groups of special disease-fighting cells found

all over the body. N scores for kidney cancer include:

†

†

NX

means nearby lymph nodes cannot be

assessed.

†

†

N0

means the cancer hasn’t spread to nearby

lymph nodes.

†

†

N1

means the cancer has spread to nearby

lymph nodes.