T | PRIMARY TUMOUR |
TX | Primary tumour cannot be assessed |
T0 | No evidence of primary tumour |
T1a | Tumour 4 cm or less in greatest dimension, limited to the kidney |
T1b | Tumour greater than 4 cm, but not more than 7 cm, in greatest dimension, limited to the kidney |
T2 | Tumour more than 7.0 cm in greatest dimension, limited to the kidney |
T3a | Tumour invades adrenal gland or perinephric tissues but not beyond Gerota's fascia |
T3b | Tumour grossly extends into renal vein(s) or vena cava below diaphragm |
T3c | Tumour grossly extends into vena cava above diaphragm |
T4 | Tumour invades beyond Gerota's fascia |
| |
N | REGIONAL LYMPH NODES * |
| The regional lymph nodes are the hilar, abdominal para-aortic, and para caval nodes. Laterality does not affect the N categories |
NX | Regional lymph nodes cannot be assessed |
N0 | No regional lymph node metastasis |
N1 | Metastasis in a single regional lymph node |
N2 | Metastasis in more than one regional lymph node |
| |
* | Laterality does not affect the N classification |
| |
NOTE | If a lymph node dissection is performed, then pathologic evaluation would ordinarily include at least eight nodes |
| |
M | DISTANT METASTASIS |
| Including extraregional lymph nodes |
MX | Distant metastasis cannot be assessed |
M0 | No distant metastasis |
M1 | Distant metastasis |
| |
V | INVASION OF VEINS (TNM Atlas UICC 1985) |
VX | Venous invasion cannot be assessed |
V0 | Veins do not contain tumour |
V1 | Renal vein contains tumour |
V2 | Vena cava contains tumour |
| |
GRADE | (Fuhrman Nuclear Grade – ref: Am J Surg Pathol 6:655-663, 1982) |
1 | Tumour composed of cells with small (approx. 10µ) round uniform nuclei with inconspicuous or absent nucleoli |
2 | Tumour composed of cells with larger (approx. 15µ) nuclei which exhibited irregularities in outline and nucleoli when examined under high (400x)power |
3 | Tumour composed of cells with large nuclei (approx.20µ) with an obviously irregular outline and prominent large nuclei even at low (100x) power |
4 | Tumour composed of features similar to grade 3 with the addition of bizarre, often multilobed nuclei and heavy chromatin clumps. These tumours often had areas of spindled-shaped cells resembling sarcomas |
X | Unknown/not assessed |