Renal Cell Carcinoma — TNM

AJCC 8th edition (2017) — kidney cancer

T — primary tumour

T1a — ≤ 4 cm, limited to the kidney

T1b — > 4 to ≤ 7 cm, limited to the kidney

T2a — > 7 to ≤ 10 cm, limited to the kidney

T2b — > 10 cm, limited to the kidney

T3a — renal vein / segmental branches, or perinephric or renal-sinus fat (not beyond Gerota's fascia)

T3b — inferior vena cava below the diaphragm

T3c — inferior vena cava above the diaphragm, or invades the caval wall

T4 — beyond Gerota's fascia, including a contiguous ipsilateral adrenal gland

N — regional lymph nodes

N0 — no regional lymph node metastasis

N1 — metastasis in regional lymph node(s)

M — distant metastasis

M0 — no distant metastasis

M1 — distant metastasis

Evidence

Original publication

Paner GP, Stadler WM, Hansel DE, Montironi R, Lin DW, Amin MB. Updates in the eighth edition of the TNM staging classification for urologic cancers. For renal cell carcinoma, T3a was expanded to include invasion of the pelvicalyceal system and renal-sinus fat, and ipsilateral adrenal involvement was reclassified (contiguous → T4, non-contiguous → M1).

European Urology, 2018

Open source

Guideline

Amin MB, Edge SB, Greene FL, et al., eds. AJCC Cancer Staging Manual, 8th edition. Chicago: Springer; 2017. Confirm the assigned stage against the manual.

Last reviewed: 2026-09

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