Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
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    Patent Pending

    TNM Staging for Renal Cell Carcinoma

    Provides information about the severity of renal cell cancer based on tumor, lymph node, and metastasis characteristics.
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    Why Use

    Patients with RCC.

    The Union for International Cancer Control (UICC) TNM Staging System, updated in 2010, is broadly used to help prognose in RCC. The prognosis estimates are based on cancer-specific survival (not overall). There is overlap between some categories, and it is unclear if it can apply to modern targeted treatments, but the system has performed well where tested.

    Staging RCC may help sketch categories of survival time better than clinical judgment alone. In addition, the TNM system is a necessary input for some other, more refined prognosis scores (e.g. UCLA/UISS, SSIGN).

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The TNM staging system offers an orderly progression of worsening prognosis estimates in most validation studies. There is controversy over some subcategories (e.g. T2a versus T2b) where estimates overlap, and the system has not, to our knowledge, been validated in populations treated with modern targeted therapies.

    Management

    We are unaware of validated management algorithms using the score.

    Critical Actions

    The TNM staging system is not proven to be accurate for individual survival prediction and should be considered a general guide rather than a reliable predictor.

    Dr. Stephen Edge

    About the Creator

    Stephen B. Edge, MD, FACS, FASCO, is an adjunct professor of surgery at Vanderbilt University and the current director of the Baptist Cancer Center. Dr. Edge has co-chaired the 2010 Breast Cancer Symposium and Guideline Panel for Postmastectomy Radiation and is serving on the editorial board of the Journal of Oncology Practice. His research focuses on staging systems and risk stratification for many types of cancers.

    To view Dr. Stephen Edge's publications, visit PubMed