最新肾癌分期方案研究.pptx

;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 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 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; 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;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 - Distant metastasis;Anatomical staging classfication; Clinical stages stage I - T1, N0, M0 stage II - T2, N0, M0 stage