Renal Cancer

Contents

T (Primary tumor)
N (locoregional lymph-nodes)
Μ (Metastases)
T (Main tumor)
S tages
Ν (locoregional lymph-nodes)
Μ (distal metastases)
N omograms for renal cancer

Staging of renal cancer

T (Primary tumor)

Τχ	The tumor cannot be assessed
Τ0	There is no evidence of primary tumor
Τ1	Tumor of a diameter of <7 cm confined to the kidney
T1a	Tumor of a diameter of ≤4 cm
T1b	Tumor of a diameter of >4 cm but ≤7 cm
T2	Tumor of a diameter >7 cm confined to the kidney
T2a	Tumor of a diameter of >7 cm but ≤10 cm
T2b	Tumor of a diameter of >10 cm
T3	The tumor extends into the large vessels or the perirenal tissues, but not into the adrenal gland or beyond the Gerota fascia
T3a	The tumor invades the renal vein or its branches or the perirenal tissues but not beyond the Gerota fascia
T3b	The tumor extends macroscopically into the subdiaphragmatic vena cava inferior
T3c	The tumor extends macroscopically into the subdiaphragmatic vena cava inferior and invades its wall
T4	The tumor extends beyond the Gerota fascia or also invades directly the ipsilateral adrenal gland

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N (locoregional lymph-nodes)

Νχ	The locoregional lymph nodes cannot be assessed.
Ν0	There is no metastasis to the locoregional lymph-nodes.
Ν1	Metastasis in one lymph-node
Ν2	Metastasis in more than one lymph-nodes

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Μ (metastases)

Μχ	The presence of distal metastases cannot be assessed
Μ0	There are no distal metastases
Μ1	Presence of distal metastases

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Stages

Stage Ι	Τ1 Ν0 Μ0
Stage ΙΙ	Τ2 Ν0 Μ0
Stage ΙΙΙ	Τ3 Ν0 Μ0 or Τ1,Τ2, Τ3 Ν1 Μ0
Stage IV	Τ4 Ν_every Μ0 ή Τ_every Ν2 Μ0 ή Τ_every Ν_every Μ1

T (Primary tumor)

Tx	The tumor cannot be assessed
T0	There is no evidence of primary tumor
Tis	Carcinoma in situ
Ta	Non-invasive papillary carcinoma
T1	The tumor invades the dermis
T2	The tumor invades the muscular layer
T3	Pelvis: the tumor extends into the peripelvic fat or the renal parenchyma Ureter: The tumor extends into the periureteric fat
T4	The tumor extends into adjacent organs or, through the kidney, to the perirenal fat:

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Ν (locoregional lymph-nodes)

Nx	The locoregional lymph nodes cannot be assessed
N0	There is no metastasis to the locoregional lymph-nodes
N1	Metastasis in one lymph node of a maximum diameter < 2
N2	Metastasis in one lymph node of a maximum diameter> 2, but <5 cm, or metastases to multiple lymph-nodes, none of which has a diameter > 5 cm
N3	Metastasis in one lymph node of a maximum diameter < 5

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Μ (Distal Metastases)

Mx	The presence of distal metastases cannot be assessed
M0	There are no distal metastases
M1	Presence of distal metastases

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Nomograms for renal cancer

Name
Special features	General population
What does it calculate?	Risk of renal cancer and prevention
Creator	Harvard School of Public Health
First publication
References
Institution / name
Link	http://www.diseaseriskindex.harvard.edu/update/hccpquiz.pl?lang=english&func=home&quiz=kidney
ISUD Evaluation	*

Name
Special features	Tumor cT1
What does it calculate?	Preoperative assessment of the probability of malignancy of one small renal tumor
Creator	Lane BR, Glickman Urological Institute, Cleveland Clinic
First publication	Lane BR, et al. J Urol. 2007; 178: 429-34
References	44
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=4&audience=1
ISUD Evaluation	*

Name
Special features	Tumor cT1
What does it calculate?	Preoperative assessment of tumor aggressiveness (Fuhrman grade 3-4)
Creator
First publication
References
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*

Name
Special features	Tumor anatomical features
What does it calculate?	Preoperative assessment of the probability of malignancy and aggressiveness of a renal tumor
Creator	Kutikov A, Fox Chase Cancer Center
First publication	Kutikov A, et al. Eur Urol. 2011; 60: 241-8
References	2
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=56&audience=1
ISUD Evaluation	**

Name
Special features	Tumor anatomical features
What does it calculate?	Preoperative assessment of the probability of malignancy and aggressiveness of a renal tumor
Creator	Kutikov A, Fox Chase Cancer Center
First publication	Kutikov A, Uzzo RG. J Urol 2009; 182: 844-53
References	75
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=56&audience=1
ISUD Evaluation

Name
Special features	Tumor anatomical features
What does it calculate?	Preoperative assessment of the probability of having lymph-node metastases
Creator	Hutterer GC, University of Montreal
First publication	Hutterer GC, et al. Int J Cancer. 2007; 121: 2556-61
References	12
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*******

Name
Special features	Tumor anatomical features
What does it calculate?	Preoperative assessment of the probability of having distal metastases
Creator	Hutterer GC, University of Montreal
First publication	Hutterer GC, et al. BJU Int. 2008; 101: 39-43
References	9
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*******

Name
Special features	ΤΝΜ 2002
What does it calculate?	Preoperative assessment of cancer specific mortality over the next 1, 2, 5, 10 years
Creator	Karakiewicz PI, University of Montreal
First publication	Karakiewicz PI, et al. Eur Urol. 2009; 55: 287-95
References	21
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*******

Name
Special features	ΤΝΜ 2002
What does it calculate?	Preoperative assessment of the probability of metastasis 12 years after nephrectomy (radical or partial)
Creator	Raj, GV, Memorial Sloan-Kettering Cancer Center
First publication	Raj GV, et al.. J Urol. 2008; 179: 2146-51
References	31
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=5&audience=1
ISUD Evaluation	**

Name
Special features	ΤΝΜ 2002
What does it calculate?	Immediate postoperative mortality (within the first 30 days)
Creator	Cloutier V, University of Montreal
First publication	Cloutier V, et al. Eur Urol. 2009; 56: 998-1003
References	5
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	**

Name
Special features	ΤΝΜ 2002
What does it calculate?	Risk of renal failure after partial nephrectomy
Creator
First publication
References
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*

Name
Special features	ΤΝΜ 2002
What does it calculate?	Probability to avoid renal failure in the next seven-year period after partial or radical nephrectomy.
Creator	Sorbellini M, Memorial Sloan-Kettering Cancer Center
First publication	Sorbellini M, et al.. J Urol. 2006; 176: 472-6
References	30
Institution / name	Cleveland Clinic
Link	http://rcc.simpal.com/RCEval.cgi?RCID=arrigas%40ccf.org_kidney%20post%20combo.txt
ISUD Evaluation	**

Name
Special features	Renal cancer
What does it calculate?	Cancer-specific mortality and from other competing causes in the next five-year period
Creator	Kutikov A, Fox Chase Cancer Center
First publication	Kutikov A, et al. J Clin Oncol. 2010; 28: 311-7
References	28
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=3&audience=1
ISUD Evaluation	*******

Name
Special features	Renal cancer
What does it calculate?	Overall survival, cancer-specific and probability of relapse after nephrectomy for the next 1, 2, 3, 4, and 5 years
Creator	Zisman Α, University of California School of Medicine (UISS model)
First publication	Zisman A, et al. J Clin Oncol. 2002; 20: 4559-66
References	189
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=7&audience=1
ISUD Evaluation	**

Name
Special features	Renal cancer
What does it calculate?	5-year relapse-free survival after nephrectomy
Creator	Kattan MW, Memorial Sloan-Kettering Cancer Center
First publication	Kattan MW, et al. J Urol. 2001; 166: 63-7
References	309
Institution / name	Memorial Sloan-Kettering Cancer Center
Link	http://nomograms.mskcc.org/Renal/PostSurgery.aspx
ISUD Evaluation	**

Name
Special features	Clear-cell carcinomas Τ1a-T3b NOMO
What does it calculate?	5-year relapse-free survival after nephrectomy for the next 1, 2, 5, 10 years
Creator	Sorbellini M, Memorial Sloan-Kettering Cancer Center
First publication	Sorbellini M, et al. J Urol. 2005; 173: 48-51
References	157
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=8&audience=1
ISUD Evaluation	*******

Name
Special features	Clear-cell carcinomas
What does it calculate?	Cancer-specific mortality after nephrectomy
Creator	Karakiewicz PI, University of Montreal
First publication	Karakiewicz PI, et al. J Clin Oncol. 2007; 25: 1316-22
References	89
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*******

Name
Special features	Clear-cell carcinomas
What does it calculate?	Probability of survival from cancer after nephrectomy for the next 1, 2, 5, 10 years
Creator	Karakiewicz PI, University of Montreal
First publication	Karakiewicz PI, et al. J Urol. 2009; 182: 2607-12
References	4
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Kidney/rcc_calc.php
ISUD Evaluation	*******

Name
Special features	Clear-cell carcinomas
What does it calculate?	Probability of survival from cancer after nephrectomy for the next 1, (3), 5 (7), 10 years
Creator	Thompson RH, Mayo Clinic (Mayo DSSIGN)
First publication	Thompson RH, et al. J Urol. 2007; 177: 477-80
References	22
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=10&audience=1
ISUD Evaluation	**

Name
Special features	Clear-cell carcinomas
What does it calculate?	Probability of survival from cancer after nephrectomy for the next 1, (3), 5 (7), 10 years
Creator	Frank I, Mayo Clinic (Mayo SSIGN)
First publication	Frank I, et al. J Urol. 2002; 168: 2395-400
References	320
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=10&audience=1
ISUD Evaluation	**

Name
Special features	Renal cancer
What does it calculate?	Cancer-specific mortality and life expectancy for the next 15 years after treatment
Creator	Laboratory for Quantitative Medicine, Massachusetts General Hospital
First publication
References
Institution / name	CancerMath.net (http://www.lifemath.net/cancer/index.html)
Link	http://www.lifemath.net/cancer/renalcell/outcome/index.php
ISUD	*

Name
Special features	Renal cancer
What does it calculate?	Overall survival after recurrence of resected cancer over the next 1-5 years
Creator	Eggener SE, Memorial Sloan-Kettering Cancer Center
First publication	Eggener SE, et al.. J Clin Oncol. 2006; 24: 3101-6
References	41
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=12&audience=1
ISUD Evaluation	*******

Name
Special features	Renal-cell cancer
What does it calculate?	Overall survival after the onset of classical immunotherapy for the next 1-3 years
Creator	Motzer RJ, Memorial Sloan-Kettering Cancer Center
First publication	Motzer RJ, et al. J Clin Oncol. 1999; 17: 2530-40
References	594
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=11&audience=1
ISUD Evaluation	*

Name
Special features	Renal-cell cancer
What does it calculate?	12-month disease-free survival
Creator	Motzer RJ, Memorial Sloan-Kettering Cancer Center
First publication	Motzer RJ, et al. Cancer. 2008; 113: 1552-8
References	50
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=14&audience=1
ISUD Evaluation	*

Name
Special features	Renal-cell cancer
What does it calculate?	Protocol of postoperative follow-up of patients with renal cancer
Creator	National Comprehensive Cancer Network
First publication	NCCN Guidelines, Version 2.2012
References
Institution / name	Fox Chase Cancer Center, Philadelphia, Pennsylvania USA
Link	http://labs.fccc.edu/nomograms/nomogram.php?id=45&audience=1&status=1
ISUD Evaluation	*

Name
Special features	Urothelial cancer of renal pelvis or ureter
What does it calculate?	Assessment of the 5-year survival from cancer after nephrectomy-ureterectomy
Creator	Jeldres C, University of Montreal
First publication	Jeldres C, et al. Cancer. 2010; 116: 3774-84
References	3
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Other/calc_uttc1.php?
ISUD Evaluation	*******

Name
Special features	Urothelial cancer of renal pelvis or ureter
What does it calculate?	Assessment of cancer-specific mortality in patients with adreno-cortical carcinoma for the next 1 to 2 years from diagnosis
Creator	Zini L, University of Montreal
First publication	Zini L, et al. BJU Int. 2009; 104: 1661-7
References	2
Institution / name	Cancer Prognostics and Health Outcomes Unit, University of Montreal
Link	http://www.nomogram.org/Other/calc_adr1.php?
ISUD Evaluation	*******

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