Kidney Cancer Stages

What Stage is My Kidney Cancer?

Staging is the process by which cancer specialists classify your cancer, which helps determine which treatment options are best for you. Based on the information in your pathology report, imaging scans and physical exam the kidney team will assess the size of your tumor, whether cancer is found in any nearby or distant lymph nodes, or whether it has spread to other body areas. In general, kidney cancer is classified in these four stages:

Stage 1 – a kidney tumor less than 7 cm at its widest point that is confined to the kidney
Stage 2 – a kidney tumor is larger than 7 cm but smaller than 10 cm that is confined to the kidney
Stage 3 – a kidney tumor of any size that has spread into the fat or blood vessels that surround the kidney, or to at least one nearby lymph node
Stage 4 – kidney cancer that has spread into a nearby organ or to another part of the body such as the lungs

How Kidney Cancer Is Staged

The American Joint Committee on Cancer (AJCC) uses the TNM classification to define the stages of kidney cancer, which looks at:

  • The size and invasiveness of the primary kidney tumor
  • Whether lymph nodes have cancer in them
  • Whether the cancer has metastasized or spread to distant body sites or organs

T is for Tumor

The number after the T indicates the size of the tumor and how far it has invaded. The larger the number, the bigger and/or more invasive the cancer. The range is from Tx (cannot be assessed) to T4 (tumor has invaded other organs).

TX primary tumor cannot be assessed
T0 no evidence of a primary tumor
T1 tumor is limited to the kidney and no larger than 7 cm at widest point

  • T1a tumor is 4 cm or smaller
  • T1b tumor is larger than 4 cm but not more than 7 cm

T2 tumor is limited to the kidney, but larger than 7 cm at the widest point

  • T2a tumor is larger than 7 cm but not more than 10 cm
  • T2b tumor is larger than 10 cm

T3 tumor has spread into major veins or fat around the kidney, but does not go beyond the outer skin of the kidney fat called Gerota’s fascia.

  • T3a tumor has invaded the nearby fatty tissue (but does not go beyond Gerota’s fascia) or started to enter the major kidney veins
  • T3b tumor has deeply invaded beyond the renal vein into a bigger vein that drains the abdomen called the vena cava (a major vein that brings blood to the heart so it can be pumped to the lungs to get oxygen)
  • T3c tumor extends within the vena cava beyond the abdomen and up into the chest, or invades the vena cava wall
  • T4 tumor has spread beyond Gerota’s fascia of the kidney and is invading into organs around the kidney, such as the adrenal gland, pancreas or intestine.

N is for Nodes

The number after the N indicates whether the cancer has spread to the nearby lymph nodes, and to what extent. The range is from NX (cannot be assessed) to N1 (metastasis to regional lymph nodes).

  • NX nearby lymph nodes cannot be assessed
  • N0 no cancer is found in nearby lymph nodes
  • N1 cancer has spread to nearby lymph nodes

M is for Metastasis

The number after the M indicates whether the cancer has spread (metastasized) to distant areas of the body. Kidney cancer metastasizes most often to distant lymph nodes, or the lungs, bones, liver or brain.

  • M0 no distant metastasis
  • M1 cancer has metastasized to at least one site distant from the kidney

Once these categories have been assigned, they are combined to determine an overall stage of disease: 1, 2, 3 or 4. In most cases, the lower the number, the better the prognosis.

Stage Groups

Stage Groups Tumor Nodes Metastases
Stage 1 T1 N0 M0
Stage 2 T2 N0 M0
Stage 3 T1 N1 M0
  T2 N1 M0
  T3 N0 M0
  T3 N1 M0
Stage 4 T4 Any N M0
  Any T Any N M1