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Kidney cancer

Are we overclassifying renal cancer?

Nature Reviews Urology volume 7, page 646 (2010)Cite this article

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In 2010, the American Joint Committee on Cancer (AJCC) and the Union Internationale Contre le Cancer (UICC) updated the TNM staging system for renal cell carcinoma (RCC). The revised guidelines divided T2 tumors into T2a and T2b, based on tumor diameter of >7 cm but <10 cm and >10 cm, respectively. The updated guidelines also redesignated tumors with venous extension: tumors which involved the renal vein or inferior vena cava [IVC] below the diaphragm (Level I caval involvement) were previously classified as pT3b. In the new system, tumors with extension or thrombus in the renal vein are designated pT3a, whereas those with evidence of Level I IVC involvement or thrombus are reclassified as pT3b.

Two studies aimed to determine whether these changes to the TNM system result in greater prognostic accuracy for patients with these tumor characteristics. Results have just been published in European Urology.

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ORIGINAL RESEARCH PAPERS

  1. Martínez-Salamanca, J. et al. Prognostic impact of the 2009 UICC/AJCC TNM staging system for renal cell carcinoma with venous extension. Eur. Urol. doi: 10.1016/j.eururo.2010.10.001

  2. Waalkes, S. et al. Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? Eur. Urol. doi: 10.1016/j.eururo.2010.10.005

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  1. Annette Fenner
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Fenner, A. Are we overclassifying renal cancer?. Nat Rev Urol 7, 646 (2010). https://doi.org/10.1038/nrurol.2010.199

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