Doctors classify renal cell carcinoma in stages to determine how to best treat it and predict how the cancer will act. There are several classification options.
Renal cell carcinoma is the most common kidney cancer. People who have obesity or smoke are at an increased risk. It’s often curable when contained in your kidney or surrounding area but becomes difficult to treat once it spreads to distant body parts.
The most common staging system is the American Joint Committee on Cancer (AJCC)’s TNM system. This staging system divides kidney cancer into stages 1–4. Read on to learn more about this staging system.
The TNM system classifies kidney cancer as stages 1–4 based on:
- T: The extent of your tumor
- N: Whether your tumor has spread to lymph nodes
- M: Whether your cancer has spread to distant tissues
These three factors are staged independently and used to determine your overall stage.
T (tumor)
The T in the TNM system has five grades, T0–T4.
- T0: There’s no evidence of a tumor.
- T1: The tumor is 7 centimeters (2.8 inches) across or smaller.
- T2: The tumor is larger than 7 cm (2.8 in.) across but contained in the kidney.
- T3: The tumor has grown into a major vein like your renal vein, vena cava, or tissue around your kidney but not into your adrenal gland or the layer of tissue surrounding your kidney, called Gerota’s fascia.
- T4: The main tumor has grown beyond Gerota’s fascia and may be growing into your adrenal gland.
N (node)
The N in the TNM system has three grades, N0–NX.
- N0: Your cancer has not spread to any nearby lymph nodes
- N1: Your cancer has spread to nearby lymph nodes
- NX: The number of nearby lymph nodes your cancer has spread to remains unknown
M (metastasis)
The M in the TNM system has two grades, M0 and M1.
- M0: Your cancer hasn’t spread to distant organs
- M1: Your cancer has spread to distant lymph nodes or organs
Combinations
Once doctors know your individual TNM stages, they can use these to determine your cancer’s overall stage by combining your three scores.
Doctors use your TNM scores to divide your cancer from stages 0–4:
| Stage | T | N | M |
|---|---|---|---|
| Stage 1 | T1 | N0 | M0 |
| Stage 2 | T2 | N0 | M0 |
| Stage 3 | T3 OR T1–T3 | N0 OR N1 | M0 OR M0 |
| Stage 4 | T4 OR Any T | Any N OR Any N | M0 OR M1 |
Here’s a look at each stage.
Stage 1 renal cell carcinoma
Stage 1 kidney cancer is in your kidney, and your original tumor is smaller than 7 cm (2.8 in.) across. Your cancer hasn’t spread to lymph nodes or distant body parts.
Stage 2 renal cell carcinoma
Stage 2 renal cell carcinoma has grown larger than 7 cm (2.8 in.) across but still hasn’t spread outside your kidney.
Stage 3 renal cell carcinoma
You may receive a diagnosis of stage 3 renal cancer in one of two situations:
- Your cancer is growing into major veins or tissue around your kidney but hasn’t spread to lymph nodes or distant areas.
- Your original tumor may or may not be growing into nearby major veins or tissues, but it has spread to nearby lymph nodes.
Stage 4 renal cell carcinoma
You may receive a diagnosis of stage 4 renal cell carcinoma in one of two situations:
- Your tumor is growing beyond the layer of tissue covering your kidney called Gerota’s fascia, may be growing into your adrenal gland, and may have spread to nearby lymph nodes.
- Your cancer has spread to distant areas.
Doctors use terms other than the TNM system and numbered stages to classify the spread of renal cell carcinoma.
Metastatic renal cell carcinoma
Metastatic renal cell carcinoma is when your cancer has spread to distant tissues. Metastatic cancer is the same as M1 or stage 4.
SEER staging
The National Cancer Institute doesn’t use the TNM system to report survival statistics in its Surveillance, Epidemiology, and End Results (SEER) program. Instead, it divides cancer into three stages:
- Localized: if it’s in your kidney only
- Regional: if it’s spread to nearby tissues
- Distant: if it’s metastasized to distant areas
Renal cell carcinoma makes up more than
| Stage | 5-year relative survival |
|---|---|
| Localized | 93.2% |
| Regional | 76.1% |
| Distant | 17.8% |
| All stages | 78.7% |
Here are some frequently asked questions people have about renal cell carcinoma.
What are the stages of renal cell carcinoma?
Under the TJCC’s TNM system, renal cell carcinoma involves stages 1–4. Doctors stage it based on the extent of your tumor, whether it’s spread to nearby lymph nodes, and whether it’s spread to distant body parts.
Where is the first place kidney cancer spreads to?
The most common places that kidney cancer spreads to are your:
- lungs
- lymph nodes
- bones
- liver
- adrenal glands
Is stage 4 renal cell carcinoma curable?
Doctors do not typically consider Stage 4 kidney cancer kidney cancer as curable, and it generally has a
The AJCC’s TNM staging system is the most common staging system for renal cell carcinoma. This system divides your cancer into stages 1–4 based on the extent of your tumor, whether it’s spread to lymph nodes, and whether it’s spread to distant body parts.
Your doctor can recommend the best treatment options for your cancer based on its stage. They can also give you the best idea of what to expect during your treatment.