最新肾癌分期.pptx

?Staging System of Renal Cell CarcinomaWang JunDepartment of Urology?Staging System of Renal Cell CarcinomaRenal Cell Carcinoma StagingStaging of renal cell carcinoma is generally categorized by the Robson ,TNM and clinical classification systems.The Robson?Staging System of Renal Cell CarcinomaThe Robson system is commonly 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 kidneyStage II - Tumor invading perinephric fat but still contained within the Gerota fasciaStage 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?TNM Staging System (UICC,2009) The Tumor, Nodes, and Metastases (TNM) Classification System Primary tumor (T)TX - Primary tumor cannot be assessedT0 - No evidence of primary tumorT1 - Tumor 7 cm or smaller in greatest dimension, limited to the kidneyT2 - Tumor larger than 7 cm in greatest dimension, limited to the kidneyT3 - Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond the Gerota fasciaT3a - Tumor invades adrenal gland or perinephric tissues but not beyond the Gerota fasciaT3b - Tumor grossly extends into the renal vein(s) or vena cava below the diaphragmT3c - Tumor grossly extends into the renal vein(s) or vena cava above the diaphragmT4 - Tumor invading beyond the Gerota fascia?TNM Staging System (UICC,2009)The Tumor, Nodes, and Metastases (TNM) Classification SystemRegional lymph nodes (N) - Laterality does not affect the N classificationNX - Regional lymph nodes cannot be assessedN0 - No regional lymph node metastasisN1 - Metastasis in a single regional lymph nodeN2 - Metastasis in more than 1 regional lymph nodeDistant metastasis (M)MX - Distant metastasis cannot be assessedM0 - No distant metastasisM1 - Dis