Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• T1: Tumor 7 cm or less in greatest dimension and limited to the kidney
  • T1a: Tumor 4 cm or less in greatest dimension and limited to the kidney
  • T1b: Tumor larger than 4 cm but 7 cm in greatest dimension and limited to the kidney
• T2: Tumor larger than 7 cm in greatest dimension and limited to the kidney
• T3: Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond Gerota’s fascia
  • T3a: Tumor directly invades adrenal gland or perirenal and/or renal sinus fat but not beyond Gerota’s fascia
  • T3b: Tumor grossly extends into the renal vein or its segmental (i.e., muscle-containing) branches, or it extends into the vena cava below the diaphragm
  • T3c: Tumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cava
• T4: Tumor invades beyond Gerota’s fascia

Regional lymph nodes (N)*

• NX: Regional lymph nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1: Metastasis in a single regional lymph node
• N2: Metastasis in more than one regional lymph node

* [Note: Laterality does not affect the N classification.]

 [Note: If a lymph node dissection is performed, then pathologic evaluation would ordinarily include at least eight nodes.]

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1: Distant metastasis