最新肾癌分期方案研究.pptx

Wang Jun
Department of Urology
Staging System of Renal Cell Carcinoma
Renal Cell Carcinoma Staging
Staging of renal cell carcinoma is generally categorized by the Robson ,TNM and clinical classification systems.
The Robson Staging System of Renal Cell Carcinoma
The Robson system monly used in clinical practice. This system was designed to correlate stage at presentation with prognosis. The Robson staging system is as follows:
Stage I - Tumor confined within capsule of kidney
Stage II - Tumor invading perinephric fat but still contained within the Gerota fascia
Stage III - Tumor invading the renal vein or inferior vena cava (A), or regional lymph-node involvement (B), or both (C)
Stage IV - Tumor invading adjacent viscera (excluding ipsilateral adrenal) or distant metastases
Staging System of Renal Cell Carcinoma
The Tumor, Nodes, and Metastases (TNM) Classification System
Primary tumor (T)
TX - Primary tumor cannot be assessed
T0 - No evidence of primary tumor
T1 - Tumor 7 cm or smaller in greatest dimension, limited to the kidney
T2 - Tumor larger than 7 cm in greatest dimension, limited to the kidney
T3 - Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
T3a - Tumor invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
T3b - Tumor grossly extends into the renal vein(s) or vena cava below the diaphragm
T3c - Tumor grossly extends into the renal vein(s) or vena cava above the diaphragm
T4 - Tumor invading beyond the Gerota fascia
TNM Staging System (,2009)
The Tumor, Nodes, and Metastases (TNM) Classification System
Regional lymph nodes (N) - Laterality does not affect the N classification
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
Distant metastasis (M)
MX - Distant metastasis cannot be assessed
M0 - No distant metastasis
M1 - Dist