Español
PDFs by language
Our 24/7 cancer helpline provides information and answers for people dealing with cancer. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear.
Chat live online
Select the Live Chat button at the bottom of the page
Our highly trained specialists are available 24/7 via phone and on weekdays can assist through video calls and online chat. We connect patients, caregivers, and family members with essential services and resources at every step of their cancer journey. Ask us how you can get involved and support the fight against cancer. Some of the topics we can assist with include:
For medical questions, we encourage you to review our information with your doctor.
After someone is diagnosed with kidney cancer, doctors will try to figure out whether it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.
The stages of kidney cancer range from I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And within a stage, an earlier letter (or number) means a lower stage. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.
The staging system most often used for kidney cancer is the American Joint Committee on Cancer (AJCC) TNM system. The TNM system is based on 3 key pieces of information:
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. To learn more, see Cancer Staging.
The system described below is the most recent version of the AJCC system, effective as of January 2018.
Kidney cancer is typically given a clinical stage based on the results of a physical exam, biopsy, and imaging tests (described in Tests for Kidney Cancer). If surgery is done, the pathologic stage (also called the surgical stage) is determined by examining tissue removed during the operation.
Kidney cancer staging can be complex. If you have any questions about your stage, please ask your doctor to explain it to you in a way you understand.
Stage |
Stage grouping |
Stage description* |
I |
T1 N0 M0 |
The tumor is 7 cm across or smaller and is only in the kidney (T1). There is no spread to lymph nodes (N0) or distant organs (M0). |
II |
T2 N0 M0 |
The tumor is larger than 7 cm across but is still only in the kidney (T2). There is no spread to lymph nodes (N0) or distant organs (M0). |
III
|
T3 N0 M0 |
The tumor is growing into a major vein (like the renal vein or the vena cava) or into tissue around the kidney, but it is not growing into the adrenal gland or beyond Gerota’s fascia (T3). There is no spread to lymph nodes (N0) or distant organs (M0). |
OR |
||
T1 to T3 N1 M0 |
The main tumor can be any size and may be outside the kidney, but it has not spread beyond Gerota’s fascia. The cancer has spread to nearby lymph nodes (N1) but has not spread to distant lymph nodes or other organs (M0). |
|
IV |
T4 Any N M0 |
The main tumor is growing beyond Gerota’s fascia and may be growing into the adrenal gland on top of the kidney (T4). It may or may not have spread to nearby lymph nodes (any N). It has not spread to distant lymph nodes or other organs (M0). |
OR |
||
Any T Any N M1 |
The main tumor can be any size and may have grown outside the kidney (any T). It may or may not have spread to nearby lymph nodes (any N). It has spread to distant lymph nodes and/or other organs (M1). |
*The following additional categories are not listed in the table above:
The stage of the cancer is important, but other factors should be considered when determining prognosis (outcome) and treatment of people with Stage IV (metastatic) renal cell carcinoma. The two systems that are commonly used are the Memorial Sloan Kettering Cancer Center (MSKCC) criteria and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria.
These two systems use 5 or 6 factors which, when combined, put people into low-, intermediate-, and high-risk groups.
The MSKCC system includes:
The IMDC system includes:
For each system, people with:
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Ch. 60 - Kidney. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017.
Correa AF, Lane BR, Rini BI, Uzzo RG. Ch 66 - Cancer of the kidney. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
McNamara MA, Zhang T, Harrison MR, George DJ. Ch 79 - Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier: 2020.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer. V.2.2020. Accessed at: www.nccn.org on November 21, 2019.
Last Revised: February 1, 2020
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
Donate now so we can continue to provide access to critical cancer information, resources, and support to improve lives of people with cancer and their families.
If this was helpful, donate to help fund patient support services, research, and cancer content updates.