Renal cell carcinoma staging: A patient has a 9 cm tumor in the left kidney with renal vein tumor thrombus extension but no inferior vena cava involvement and no nodal or distant metastases. What is the pTNM stage?
- A pT3aN0M0 ✓
- B pT2bN0M0
- C pT3bN0M0
- D pT4N0M0
Correct answer: A. pT3aN0M0
Explanation
According to AJCC 8th edition TNM staging for renal cell carcinoma: pT2a = tumor >7 cm but ≤10 cm limited to kidney; pT2b = tumor >10 cm limited to kidney; pT3a = tumor extends into renal vein or its segmental branches, renal sinus fat, or perirenal fat (not beyond Gerota's fascia); pT3b = tumor extends into infradiaphragmatic IVC; pT3c = tumor extends above diaphragm or into IVC wall. A 9 cm tumor with renal vein involvement but no IVC extension is pT3a, not T2b. The renal vein thrombus upgrades it from T2 to T3a regardless of tumor size.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.