TNM Definitions for Renal Cell Carcinoma*

Primary tumor

TX

No information to assess primary tumor

T0

No evidence of a primary tumor

T1

≤ 7 cm in greatest dimension

Limited to kidney

T1a

≤ 4 cm in greatest dimension

T1b

> 4 cm but ≤ 7 cm in greatest dimension

T2

≥ 7 cm in greatest dimension

Limited to kidney

T2a

> 7 cm but ≤ 10 cm in greatest dimension

T2b

> 10 cm in greatest dimension

T3

Extends into major veins or invades perinephric tissues but not beyond Gerota fascia or into the adrenal gland

T3a

Extends into renal veins or its segmental branches or invades perirenal and/or renal sinus fat, but not beyond Gerota fascia

T3b

The tumor is growing into the part of the large vein leading into the heart (vena cava) that is within the abdomen

T3c

The tumor has grown into the part of the vena cava that is within the chest or it is growing into the wall of the vena cava

T4

The tumor has spread beyond Gerota’s fascia (the fibrous layer that surrounds the kidney and nearby fatty tissue). The tumor may have grown into the adrenal gland (on top of the kidney).

Regional lymph node metastasis

NX

Not assessable

N0

None

N1

Present

Distant metastasis

M0

None

M1

Distant metastasis, including spread to distant lymph nodes