Histologic classification
- Conventional renal cell carcinoma (clear cell) (80-90%).
- Papillary renal cell carcinoma (type 1 and type 2) (10-15%).
- Chromophobic renal cell carcinoma (3-5%).
- Collective tubular carcinoma (Ductus Bellini carcinoma) (<1%).
- Xp11 translocated carcinoma (<1%).
- Medullary cell renal cell carcinoma
- Oncocytoma
TNM classification of renal cell carcinoma (hypernephroma).
| T | Infiltration depth of the tumor |
| T1 | Tumor 7 cm or less in greatest extent, confined to kidney |
| T1a | Tumor 4 cm or less in greatest extent |
| T1b | Tumor more than 4 cm but not more than 7 cm in greatest extent |
| T2 | Tumor more than 7 cm in greatest extent, confined to kidney |
| T2a | Tumor more than 7 cm but not more than 10 cm in greatest extent |
| T2b | Tumor more than 10 cm in greatest extension |
| T3 | Tumor spreads into larger veins or directly infiltrates perirenal (“around the kidney”) tissue, but not into the ipsilateral (“on the same side of the body”) adrenal gland and not beyond Gerota’s fascia |
| T3a | Tumor with macroscopic spread into the renal vein or its segmental branches (with muscular wall) or with infiltration (“invasion”) of the perirenal and/or peripelvic adipose tissue, but not beyond the Gerota fascia |
| T3b | Tumor with macroscopic spread into the vena cava below the diaphragm |
| T3c | Tumor with macroscopic spread into the vena cava above the diaphragm or with infiltration of the wall of the vena cava |
| T4 | Tumor infiltrates beyond Gerota fascia (included continuous spread to ipsilateral adrenal gland) |
| N | Lymph node involvement (regional lymph nodes) |
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastases |
| N1 | Metastases (daughter tumors) in a regional lymph node |
| N2 | Metastases in more than one regional lymph node |
| M | Metastases (daughter tumors) |
| M0 | No distant metastases |
| M1 | Distant metastases |
G: Grading
- G1: well differentiated
- G2: moderately differentiated
- G3: poorly differentiated
- G4: undifferentiated
TNM classification (UICC 2009) for staging.
| Stage classification (UICC) | |||
| I | T1 | N0 | M0 |
| II | T2 | N0 | M0 |
| III | T3T1, T2, T3 | N0N1 | M0M0 |
| IV | T4Each T Each T | N0, N1 N2 Any N | M0 M0 M1 |
Robson classification (1963)
- I: confined to the kidney
- II: within the gerota fascia
- III: invasion into large veins, lymph node metastasis.
- IV: Infiltration of neighboring organs, distant metastases.
Wg. Classification of renal cysts is made according to the classification of Bosniak into simple and complicated cysts (see below Cystic Kidney Disease/Classification). Further notes
- Stage III renal cell carcinoma with affected lymph nodes (pT1-3N1M0) should be considered stage IV tumors because there were no longer significant differences in overall survival between patients with lymph node-positive stage III and stage IV tumors after 5 years.