Stages of kidney cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for kidney cancer is the TNM system. For kidney cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the kidney and has not spread to other parts of the body. Regional means close to the kidney or around it. Distant means in a part of the body farther from the kidney.

Find out more about staging cancer.

Stage 1

The tumour is in the kidney and is not larger than 7 cm.

Stage 2

The tumour is in the kidney and is larger than 7 cm.

Stage 3

The tumour has grown outside of the kidney into nearby veins or into the layer of fat surrounding the kidney (perinephric tissues). But it has not grown into the adrenal gland above the kidney or to the thin, fibrous tissue on the outside of the kidney (called Gerota’s fascia).

OR

 The cancer has spread to nearby lymph nodes.

Stage 4

The tumour has grown through the thin, fibrous tissue on the outside of the kidney and may have grown into the adrenal gland above the kidney.

OR

The cancer has spread to other parts of the body (called distant metastasis), such as to the lungs, liver or bone. This is also called metastatic kidney cancer.

Recurrent kidney cancer

Recurrent kidney cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.

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