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5 - Staging of renal cancer

Published online by Cambridge University Press:  08 August 2009

By
Giles Rottenberg  and
Sheila C. Rankin
Edited by
Uday Patel
Giles Rottenberg
Affiliation:
Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
Sheila C. Rankin
Affiliation:
Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
Uday Patel
Affiliation:
St George's Hospital, London
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Summary

Introduction: Why stage disease?

The staging of renal tumors is important as it divides them into groups that enable a logical framework for treatment planning, entry into clinical trials, and prognostication. With the increasing use of techniques such as nephron-sparing surgery and laparoscopic surgery the radiological staging information will determine the type of surgical approach. Also, unlike surgery which provides tissue for pathological staging, ablative therapies such as cryotherapy or radiofrequency ablation rely solely on radiological staging, with the occasional benefit of renal biopsy.

History of staging

The first staging system for renal tumors was introduced by Flocks and Kadesky in 1958 and subsequently modified by Robson in 1963. The TNM criteria was introduced in 1978 and revised in 1987, 1997, and most recently in 2002 (Table 5.1). These modifications reflected a change in surgical approach and better understanding of the survival characteristics of the different groups.

The 1997 AJCC (American Joint Committee on Cancer) revision resulted in reclassification of T1 lesions from confined tumors less than or equal to 2.5 cm to those lesions 7 cm or less. Confined tumors measuring greater than 7 cm were classified as T2. A subsequent study demonstrated an 83% 5-year survival for T1 tumors with a 57% 5-year survival for T2 tumors. This major difference in prognosis underlies the rationale for the division between T1 and T2 tumors.

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Chapter
Information
Carcinoma of the Kidney , pp. 91 - 111
Publisher: Cambridge University Press
Print publication year: 2007

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References

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  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
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  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
Available formats
×