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TNM staging classification system

T - Primary tumour
TX Primary tumour cannot be assessed
T0 No evidence of primary tumour
T1 Tumour <7 cm in greatest dimension, limited to the kidney
T1a Tumour <4 cm in greatest dimension, limited to the kidney
T1b Tumour > 4 cm but <7 cm in greatest dimension, but not more than 7 cm
T2 Tumour > 7 cm in greatest dimension, limited to the kidney
T3 Tumour extends into major veins or directly invades adrenal gland or perinephric tissues but not beyond Gerota’s fascia
T3a Tumour directly invades adrenal gland or perinephric tissues1but not beyond Gerota’s fascia
T3b Tumour grossly extends into renal vein(s)2or its segmental branches, or the vena cava below the diaphragm
T3c Tumour grossly extends into vena cava or its wall above diaphragm
T4 Tumour directly invades beyond Gerota’s fascia
N - Regional lymph nodes
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 1 regional lymph node
pN0 lymphadenectomy specimen ordinarily includes 8 or more lymph nodes. If the lymph nodes are negative,
but the number ordinarily examined is not met, classify as pN0
M - Distant metastasis
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis