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  • Staging, grading and prognosis of kidney cancer

    Last reviewed January 2013

    The tests used to diagnose kidney cancer also show how far the cancer has spread (the stage) and how the cancer cells appear and are likely to behave (the grade).

    Grading indicates how abnormal the cancer cells appear, how fast the cells will probably grow and if the cancer is likely to spread.

    Knowing the stage and grade of the cancer helps doctors plan the best treatment for you.

    Staging: TNM system

    T (Tumour) 1–4 Indicates the size of the tumour and whether it has spread to nearby tissues. A higher number after the T means that it is larger or has spread to tissues surrounding the kidney.
    N (Nodes) 0–2 Indicates whether the lymph nodes are affected. Higher numbers are used when more than one group of nodes is affected by the cancer.
    M (Metastatis) 0–1 Indicates whether the cancer has spread to more distant parts of the body. The 0 means that the cancer has not spread; 1 means the cancer has spread.

    Grading: Fuhrman system

    Grade 1 The cancer cells look fairly normal, are probably growing slowly and are not likely to spread.
    Grade 2 The cancer cells appear slightly abnormal and might grow more rapidly.
    Grade 3 Most cells appear abnormal and the cancer might grow quickly.
    Grade 4 No cancer cells look normal and they are more likely to grow and spread rapidly.


    Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease. Instead your doctor can give you an idea about common issues that affect people with kidney cancer.

    In most cases the earlier kidney cancer is diagnosed the better your prognosis. If the cancer is found after it has spread to other parts of the body it will probably be more difficult to successfully treat.

    People who are able to have surgery to remove the cancer have a higher survival rate. However other factors such as your age, general fitness and medical history are also factors.

    Information reviewed by: A/Prof Manish Patel, Urological Cancer Surgeon, University of Sydney and Westmead and Macquarie University Hospitals, NSW; Annie Angle, Cancer Nurse, Cancer Council VIC; Lyn Bland, Consumer; Gregory Bock, Cancer Nurse Coordinator (Urology), WA Cancer and Palliative Care Network; Prof Ian Davis, Professor of Medicine and Head of Eastern Health Clinical School, Faculty of Medicine and Nursing and Health Science, Monash University and Senior Medical Oncologist, Eastern Health, VIC; Karen Hall, Clinical Nurse, Cancer Services Division, Flinders Medical Centre and Nurse Health Counsellor, Cancer Council SA; and Frank Hughes, Helpline – Cancer Information and Support, Cancer Council QLD.

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